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---', ORANCOU-27 Ug E <br />A�Ro CERTIFICATE OF LIABILITY INSURANCE DATEIMWDDMYYYI <br />6/4/2021 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS <br />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), <br />AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the <br />pollCy(ies) must have ADDITIONAL INSURED <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of <br />this certificate does not confer rights to the certificate holder in lieu <br />provisions or be endorsed. <br />the policy, Certain policies may require an endorsement. A statement on <br />of such <br />PRODUCER License 0 0757776 <br />endorsements . <br />C ACT JUliana Bae, CISR <br />HUB International Insurance Services Inc. <br />PHONE <br />AIC, No, Ea):(714) 569-27203817 ,o: x(714)7843998 <br />4695 MacArthur Court <br />Suitert <br />Newport Beach, CA 92660 <br />• AIL , uliana.bae hubintemaUonai.com <br />IN URER8 AFFORDING COVERAGE MID <br />SURER A: Nonprofits' Insurance Alliance of California Inc Of 184 <br />INSURED Orange County Coastkeeper <br />INSURE a: Nationwide Mutual Insurance Company 23787 <br />dba Inland Empire Waterkeeper <br />INSURER C, State Compensation Insurance Fund of California 35076 <br />dba Coachella Valley Waterkeeper <br />3151 Airway Ave, Suite F-110 <br />INSURERo: <br />INSURER E : <br />Costa Mesa, CA 92626 <br />WSURFR F <br />CrTVFOafSCe <br />THIS <br />INDICATED. <br />CERTIFICATE <br />EXCLUSIONS <br />IN9R <br />--- "' <br />IS TO CERTIFY THAT THE POLICIES <br />NOTWITHSTANDING ANY REQUIREMENT, <br />MAY BE ISSUED OR MAY <br />AND CONDITIONS OF SUCH <br />TYPE OF INSURANCE <br />OF <br />PERTAIN, <br />POLICIES. <br />AODL <br />"^'""""��^• <br />INSURANCE <br />SUBF <br />- <br />LISTED BELOW RAVE BEEN <br />TERM OR CONDITION OF <br />THE INSURANCE AFFORDED BY <br />LIMIT$ SHOWN MAY HAVE BEEN <br />POLICY NUMBER <br />ISSUED <br />ANY CONTRACT <br />THE POLICIES <br />REDUCED BY <br />POLICYEFF <br />4n/2021 <br />TO THE INSURED <br />OR OTHER <br />DESCRIBED <br />PAID CLAIMS. <br />POUCYEXP <br />417/2922 <br />REVISION NUMBER: <br />NAMED ABOVE FOR <br />DOCUMENT WITH RESPECT <br />HEREIN IS SUBJECT <br />LIMRS <br />THE POLICY PERIOD <br />TO WHICH THIS <br />TO ALL THE TERMS, <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE X OCCUR <br />❑ <br />X <br />02117392 <br />CMe CURR NCE <br />, 11000,000 <br />_MEffiEj°AMA E -RENTED <br />S 500,000 <br />MEDEXP(Anyonemrwrii <br />S 20,000 <br />PERSONAL & AOV INJURY <br />1,0001000 <br />B <br />CP3029126331 <br />12112I2020 <br />12I12f2021 <br />X JEN'LAGGRE <br />AUTOMOBILE <br />X <br />ATE LIMIT APPLIES PER <br />POLICYL-J JEp& LOC <br />T" 1L <br />ANYAUTO S8CCHHEE <br />TO.S LED <br />AUTOSONLY X AU"1101V11 <br />AIMY <br />GENERAL AGGREGATE <br />3,000,000 <br />PR UCT - OMPlOP AGG <br />3,000,000 <br />LIQUOR LUIBILIT <br />COMaINEDSINGLE LIMIT <br />BODILY INUURY Per Mwn <br />S 11000,000 <br />1,000,000 <br />S <br />S <br />�OPERTYI AMAGEacdeeM <br />CHCURRENCE <br />S 2.000,000 <br />A <br />X <br />UM8R <br />EXCESMADE <br />02117392UMB <br />4n/2021 <br />4n/2022 <br />R TE <br />2,000,00DIED <br />,000 <br />�( ER OTH- <br />S <br />C <br />AN 11COMSgNL&I ON <br />11ND EMPLOYERS' EDIBILITY <br />ANYPROPRIETORrPARTNERIEXECUTIVE YIN <br />ppFFI ERNEM EXCLUDED? EJ <br />'rn+nCa&MY In �ifij <br />IL yyae, tleaM Une" <br />ESCRIPTION OF OPERATIONS Mbw <br />NIA <br />906307520 <br />711/2020 <br />711/2021 <br />EACH <br />11000,000 <br />E.L. DISEASE -EA EMPLOYEE <br />S 1,000,000 <br />E.1- DISEASE - POUCY LIMIT <br />S 11000,000 <br />DESCRIPTION OF OPEMnONS I LOCA-IONS I VEHICLES (ACOR0101, AdWUanM Ranurlhe soMtlma n apes U nqulretl) <br />MY M aMCMtl Nmo RE: Agreement A•2019-126. Operations of the named Insured during the current Policy period. The City of Santa Ana, its officers, employees, agents and <br />volunteers are additional insureds with respect to general liability per CG2010 0413 and CG2037 0413. Coverage is primary and non -Contributory per NIACE61 <br />1117. 30 days notice of cancellation will be provided per policy provisions. Revises certificate Issued 4113121. <br />CERTIFICATE HMI naw <br />y1�1]KIVI ALiLMILNI1JIVDIU SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />City Of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />Risk Management Division 20�� ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 Civic Center Plaza C <br />Santa Ana, CA 92702 AUTHORIZED REPRESENTATIVE <br />M. LAMBERT = <br />ACORD 25 (20161031 <br />� •-••�-��•+ ��.... �vmrv"AI IUN. An rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />