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<br />' Date: 2020.09.14 15.41:46 -07-00'
<br />.ACC>R6r CERTIFICATE OF LIABILITY INSURANCE
<br />111 1
<br />DATE(MMIDD/YYYY)
<br />9/3/2020
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollcy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />Dealey, Renton & Associates
<br />P. O. Box 12675
<br />Oakland CA 94604-2675
<br />CONTACT
<br />PHONE FAX
<br />• 510-465.3090 AIC No:510-452-2193
<br />ADDRESS: certificates Beale renton.com
<br />INSURERS AFFORDING COVERAGE
<br />NAIC II
<br />INSURERA: Continental Insurance Company
<br />35289
<br />LicenseM 0020739
<br />INSURED CANNGOR-02
<br />Cannon Corporation
<br />1050 Southwood Drive
<br />INSURER B: Valley Fore Insurance Company
<br />20508
<br />INSURER c: HARTFORD INSURANCE COMPANY
<br />38288
<br />INSURER D: Beazley Insurance Company Inc
<br />37540
<br />San Luis Obispo CA 93401
<br />INSURER E :
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER:1564012275 REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />M R
<br />TYPE OF INSURANCE
<br />ADDL
<br />SUBR
<br />POLICY NUMBER
<br />POLICY EFF
<br />IMMi
<br />POLICY EXP
<br />IMMIDDIYYYY)LIMITS
<br />B
<br />X
<br />COMMERCIAL GENERALLIABILITY
<br />CLAIMS-MAGE � OCCUR
<br />Y
<br />V
<br />6079204724
<br />9/1/2020
<br />9/1/2021
<br />EACH OCCURRENCE
<br />$1,000,000
<br />DAM ETORENTED
<br />PREMISES fEaoccunence
<br />$500,000
<br />X
<br />MED EXP (Any one person)
<br />$ 15,000
<br />Contractual Liab
<br />Included
<br />PERSONAL &ADV INJURY
<br />$1,000,000
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />] JEC � LOC
<br />$2,000,000POLICY
<br />S-COMP/OPAGG
<br />$2,000,000OTHER:
<br />$AUTOMOBILE
<br />LIABILITY
<br />MGENERALAGGREGATE$2,000,000AGGREGATE
<br />D SINGLE LIMIT
<br />$ntANY
<br />JURY(Per person)
<br />$OWNED
<br />AUTO
<br />SCHEDULEDJURY
<br />ONLY AUTOS
<br />Peraccldent
<br />( IHIRED
<br />$AUTOS
<br />NON -OWNED
<br />ONLY AUTOS ONLY
<br />Y DAMAGEAUTOS
<br />ent
<br />$
<br />A
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />Y
<br />Y
<br />6079210751
<br />9/1 /2020
<br />9/1/2021
<br />EACH OCCURRENCE
<br />$ 9,000,000
<br />I
<br />AGGREGATE
<br />$9,000,000
<br />EXCESS LIAB
<br />I CLAIMS -MADE
<br />DELI I X I RETENTION$ 1, D,D
<br />$
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS'LIABILITY YIN
<br />ANYPROPRIETORIPARTNER/EXECUTIVE
<br />OFFICER/MEMSEREXCLUDED7
<br />N/A
<br />Y
<br />57WE1116HIH
<br />9/1/2020
<br />1/1/2021
<br />X PERTOTRH-
<br />E.L. EACH ACCIDENT
<br />$1,000,000
<br />E.L. DISEASE - EA EMPLOYEE
<br />$1,000,000
<br />(Mandatory In NH)
<br />If yes, describe under
<br />E.L. DISEASE- POLICY LIMIT
<br />$1,000,000
<br />DESCRIPTION OF OPERATIONS below
<br />D
<br />Professional Liability
<br />V27737190102
<br />9/1/2020
<br />9/1/2021
<br />Limit
<br />$2,000,000
<br />Aggregate
<br />$2,000,000
<br />DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required)
<br />Umbrella Liability policy is a follow -form to underlying General Liability/Auto Liability/Employers Liability.
<br />RE: JN 190815 - City of Santa Ana Engineering Technical and Admin. Support Services/City of Santa Ana contract #A-2019-117-03
<br />City of Santa Ana, its officers, employees, agents, volunteers and representatives are named as an additional insured as respects general and auto liability as
<br />required per written contract or agreement. General and Auto Liability are Primary/Non-Contributory per policy form wording. Insurance coverage includes
<br />waiver of subrogation per the attached endorsement(s). Certificate of Insurance shall provide thirty (30) day prior written notice of cancellation
<br />of
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Attn: Risk Management Division
<br />20 Civic Center Plaza, 4th Floor AUTHORIZED REPRESENTATIVE
<br />Santa Ana CA 92701
<br />(k..A{C,i s'riTiu. <_I,tGu---- �. � RiekMan+�mtadDMaiDn
<br />x�1 �; REVIEWED&APPROVE) 6Y:.
<br />©1988-2015 ACORD C (,) -
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD I IMMUMIR` RI:k Management Arlalyzt
<br />
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