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<br />Date3021.060113:3841-07'M
<br />MAGEL-7
<br />ATEa�JEzo CERTIFICATE OF LIABILITY INSURANCE °0303/24/20211M(
<br />/2021
<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 poii°y(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 />Bruce Gendelman Co., Inc.
<br />Suite 101
<br />500 W Brown Deer Rd
<br />Milwaukee, WI 53217
<br />CO
<br />COVERAGES CFRTIFICATFNIIMRFR- RcaaclD10 aD fulnco.
<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 />INSR
<br />TYPE OF INSURANCE
<br />AOOL
<br />SUB
<br />POLICY NUMBER
<br />POLICY EFF
<br />POLICY EXP
<br />04112/2022
<br />DMRB
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE OCCUR
<br />X
<br />1660SK446321PHX21
<br />04/1212021
<br />EACHOCCURRENCE
<br />S 2,000,000
<br />oAMAGE io Ea�
<br />300,000
<br />EXP An eneyareon
<br />S 6,000
<br />PERS NALb ADV INJURY
<br />; 2,000,000
<br />GENL
<br />X
<br />AGGREGATE LIMIT APPLIES PER.
<br />POLICY ❑ ipm LOC
<br />GENERAL AGGREGATE
<br />4,000,000
<br />PRODUCTS &PMPIOP AGG
<br />S 4,000,000
<br />OTHER
<br />A
<br />AUTOMOBILE
<br />DgeRRY
<br />laimiiam SINGLE LIMIT
<br />2,00B4O00
<br />ANY AUTO
<br />AUpTEO�S ONLYNAUUT0o3WU�OoBpOp�ILY
<br />AUTOS ONLY AUTOS ONLY
<br />1660SK446321PHX21
<br />04/12/2021
<br />04112/2022
<br />BODILY INJURY Per arson
<br />INJ RY PBr ectiQl
<br />S
<br />OP=, AMAGE
<br />Par
<br />B
<br />X
<br />UMBRELLALIAS X
<br />EXCESS LIAR
<br />OCCUR
<br />CLAIMS -MADE
<br />X
<br />CUPBK4735202142
<br />04/12/2021
<br />04/12/2022
<br />EACH OCCURRENCE
<br />; 3,000,000
<br />pccaecATE
<br />3,000,000
<br />DED X RETENTION 1 5,000
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY 1,JN
<br />ANY PROPRIETO��RRpMARTNEREXECUTIVE
<br />(MFmW5at%MM M F EXCLUDED? ®
<br />d s. glPTf ba u F OP flATIONS almv
<br />NIA
<br />U88K6011892142E
<br />04/12/2021
<br />04/12(2022
<br />X PER OTH.
<br />T
<br />.L FA HgCCIDENT
<br />1,000,000
<br />L. DISEASE - EA EMPLOYE
<br />S 1,OOB4O00
<br />L. DISEASE- LIMIT
<br />S 1,000,000
<br />D
<br />PROFESSIONAL LIAR
<br />PMAGE000821
<br />04/12/2021
<br />04/12/2022
<br />EA CLAIM
<br />2,000,000
<br />$25,000 DEDUCTIBLE
<br />AGGREGATE
<br />2,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule, may be anched If mom space is required)
<br />Agreement No. A-2018-096
<br />See additional pages for additional Insured and primary / non-contributory
<br />coverages.
<br />CITSA03
<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 />Risk Management Div, 4th Floor
<br />20 Civic Center Plaza AUTHORIZED REPRESENTATIVE R L�Ma agY ettfD m
<br />Santa Ana, CA92701 y(,,,,-- Q�„ _-f„Dv o''j.��� REmEwED&APPRov1DBy:
<br />ACORD 25 (2016103) t`1 'e`K"- a 119968-20��N15 ACORD C � l f�M� R.
<br />ie
<br />Risk Management Analyst
<br />The ACORD name and logo are registered marks of ACORD
<br />
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