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PROTE24 OP ID: MO '4CORO CERTIFICATE OF LIABILITY INSURANCE DATE4/21/2021 /21 /21 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 877-242-9600 Central Insurance Agency, Inc. 93 East Main Street CONTACT Central Insurance Agency, Inc NAME PHONE 877-242-9600 FAX 877-243-8995 (A/C, No, Ext): (A/C, No): Smithtown, NY 11787 George Gavaris E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURERA: Employers Assurance Company 25402 INSURED Protection America Inc. PPO#120313 21360 Nordhoff St. INSURER B : INSURERC: Infinity Select Insurance Company 20260 INSURER D : #104C Chatsworth, CA 91311 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE DDL INSD UBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS -MADE ❑ OCCUR PREMISES Ea occurrence $ MED EXP (Any oneperson) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO ❑ JECT LOC PRODUCTS - COMP/OP AGG $ $ OTHER: C AUTOMOBILE LIABILITY ANY AUTO X X 604610110722001 10/08/2020 10/08/2021 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ PROPERTY DAMAGE ccident Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/ R/EXECUTIVE EXCLUDED? OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A X EIG2562084-02 11 /06/2020 11 /06/2021 X PER OTH- STATUTE ER E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Santa Ana, its officers, employees, agents, and representatives are named as additional insured under the Commercial Auto Liability on this policy pursuant to written contract, agreement, or memorandum of understanding. Waiver of subrogation applies to the Workers Compensation per the attached endorsement. City of Santa Ana Risk Management Division 20 Civic Center Plaza Santa Ana CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Risk Mowgmenf Division <'j/44■*. 1',.` ReoEwm & APPROVED 13 W1 .I. FiJ_ ']afii �eerr¢ars ACORD 25 (2016/03) © 1988-2015 ACORD CC The ACORD name and logo are registered marks of ACORD