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4 NTIT'o DATE (MM/DD/YYYY) ACOROF CERTIFICATE OF LIABILIT kME b A i(e/26/2022 ( g THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NQJAGHTS UPON TF'_ C RTIFICAT HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGr Ar—ACWMNO&E POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CON AC B E N H G�a RY�22H6TUI REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. l 1 UGC U le IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have Ayr ,TIONAL 11�r''QQvi ^^fi�t e endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certair, rilicies may re u a�ehdo�ektt A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME Hiscox Inc. d/b/a/ Hiscox Insurance Agency in CA PHONE FAX A/C No Ext : ($$$) 202-3007 A/C No: 520 Madison Avenue E-MAIL ADDRESS: contact@hISCOX.COm 32nd Floor INSURER(S)AFFORDING COVERAGE NAIC# New York, New York 10022 INSURERA: Hiscox Insurance Company Inc 10200 INSURED INSURER B Bridgemore Consulting, Inc 5405 Grand Prix Ct INSURERC: Fontana, CA 92336 INSURER D : 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 ADDL INSD SUBR WVD POLICYNUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE OCCUR PREM SESOEa oNcurrDence $ 100,000 MED EXP (Any one person) $ 5,000 A Y Y P 100. 148.911.2 03/11/2022 03/11/2023 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY ❑ PRO ❑ LOC JECT X PRODUCTS - COMP/OP AGG $ S/T Gen. Agg. $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS AUTOS UMBRELLALIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER OTH- STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? ❑ N/A E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ A Professional Liability Y P100.148.365.2 03/11/2022 03/11/2023 Each Claim: $ 2,000,000 Aggregate: $ 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Santa Ana is named additional insured per attached endorsement CERTIFICATE HOLDER CANCELLATION City of Santa Ana Risk Management Division 20 Civic Center Plaza SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 4th Floor THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Santa Ana, CA 92701 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE f F! Ri& Managanad DMsian +�/ a\@ REVIEWED & APPROVED BY: @ 1988-2015 ACORD I ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Risk management Specialist