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"""'ally aged by France P.
<br />Francine R. Villareal Wheal
<br />Date: 2021.M,21 I&s3:Me (Xr
<br />TOYOASS-01 GHODGES
<br />'4� CERTIFICATE OF LIABILITY INSURANCE
<br />OAT111/2DIYYYY)
<br />5/11/2021
<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 policy(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 License#OK07568
<br />Cumbre Insurance Services, LLC
<br />3110 E. Guasti Road
<br />Suite 500
<br />C MEACT Gail Hodges
<br />PHONE FAX
<br />(ac, No, Eat: (707) 992-3743 uc, No):(909) 484-2491
<br />noo&e$S: hodgesg@cumbreins.com
<br />Ontario, CA 91761
<br />INSURE S AFFORDING COVERAGE
<br />NAIC a
<br />INSURER A: Citizens Insurance Company of America
<br />31534
<br />INSURED
<br />INSURER B: Hanover American Insurance
<br />36064
<br />INSURER C: Capitol Secial Insurance Corporation
<br />10328
<br />Toyon Associates, Inc.
<br />INSURER D :
<br />1800 Sutter St. 6th Floor
<br />Concord, CA 94520
<br />INSURER E
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER: REVISION NIIMRFR-
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOROTHER DOCUMENTWITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR
<br />TYPE OF INSURANCE
<br />ADDLSUBR
<br />POLICY NUMBER
<br />POLICY EFF
<br />POLICY EXPJJ1L
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE N OCCUR
<br />x
<br />OB311114834
<br />1/112021
<br />11112022
<br />EACH OCCURRENCE
<br />$ 2,000,000
<br />DAANIAGETORENTED
<br />PREMISS (Ea occwenc,lMEDEXP
<br />$ 300,000
<br />An ane erson
<br />$ 5,000
<br />PERSONAL&ADV INJURY
<br />$ 2,000,000
<br />AGGREGATE LIMIT APPLIES PER:
<br />POLICY LOC
<br />GENERAL AGGREGATE
<br />$ 4,000,000
<br />GENL
<br />X
<br />PRODUCTS-COMPIOPAGG
<br />$ 4,000.000
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />Eeaal. EDideISINGLE LIMIT
<br />$ 2,000,000
<br />BODILY INJURY Perperson)
<br />IxANYAUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AU�r�OpSWN
<br />X
<br />OB3H114834
<br />1/1/2021
<br />11112022
<br />BODILY INJURY (Per accident
<br />$
<br />ALTOS ONLY X AUTOS ONLY
<br />PPeOPER nt FMAGE
<br />AUMBRELLA
<br />LIAR
<br />X
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 5,000,000
<br />AGGREGATE
<br />$ 5,000,000
<br />dX
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />X
<br />OB311114834
<br />1/112021
<br />1N/2022
<br />DED I I RETENTION$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANY PROPRIETORIPARTNEMEXECUTIVE
<br />OFFICabryEn NH) EXCLUDED?
<br />Use. describe under
<br />DESCRIPTION OF OPERATIONS belo v
<br />NIA
<br />Z3H133875
<br />1/112021
<br />111l2022
<br />X PER OTH-
<br />ER
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L. DISEASE - EA EMPLOYE
<br />1,000,000
<br />$
<br />E.L DISEASE -POLICY LIMIT
<br />1,000,000
<br />C
<br />ERRORS & OMISSIONS
<br />SGC0003979-08
<br />1/112021
<br />1/1/2022
<br />EA. ERRONEOUS ACT
<br />5,000,000
<br />C
<br />CLAIMS MADE
<br />SGC0003979-08
<br />11112021
<br />111/2022
<br />AGGREGATE
<br />5,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES ACORD 101, Addlllonal Remarks Schedule, me be attached if more s ace is required)
<br />CITY OF SANTA ANA, ITS OFFICERS, EMPLOY ES AGENTS AND REPRESENTATIVES ARE HEREBY NAMED AS ADDITIONAL INSURED'S AS RESPECTS TO
<br />LIABILITY ARISING OUT OF THE NAMED INSUREDS OPERATIONS, COVERAGE IS PRIMARY AND NON CONTRIBUTORY PER 391-1331 06 09. ADDITIONAL
<br />INSURED IS GRANTED A 30 DAY NOTICE OF CANCELLATION WITH THE EXCEPTION OF A 10 DAY NOTICE FOR NON-PAYMENT OF PREMIUM
<br />UNDERWRITERS AT LLOYDS
<br />CYBER LIABILITY POLICY #ESJ0325280680
<br />SEE ATTACHED ACORD 101
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />CityOf Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />Risk Management Division - 4th Floor ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plan
<br />Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE
<br />ItLkMwgmlod Dhsim
<br />REVIEWED&APPROJ®BY:
<br />ACORD 25 (2016/03) V © 1988.2015 ACORD Cl1' f'k"M z Vx""'Al
<br />The ACORD name and logo are registered marks of ACORD I
<br />Risk Nl,n,gemem Analy't
<br />
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