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ACORa CERTIFICATE OF LIABILITY INSURANCE DATE(/03/2 YYYY) 1103/2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Heather Verdui Mike Smith, New Jersey Lic. P&C /Surplus N 9940165 Axis Insurance Services, LLC PAICHONE (201)847-9175 FAX , No : (201)847-9174 l : AIC E-MAILEx IL hverdui@axisins.com ADDRESS: 795 Franklin Avenue, Suite 210 Franklin Lakes NJ 07417 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Allied Word Insurance Co 22730 INSURED INSURER B INSURER C : Keenan &Associates INSURER D: 2355 Crenshaw Blvd, Suite 200 INSURER E: Torrance CA 90501 INSURER F: COVERAGES CERTIFICATE NUMBER- 10760 EO20121 Priominkl MI still 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. IXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MWDDINWY MWDYI YYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 15,000,000 PREMISES Ea occurrence) 8 CLAMS -MADE OCCUR MED EXP(Any one person) $ Limits are Per Claim X Emors & Omissions PERSONAL &ADV INJURY s A 0307-7977 10/01/2020 10/01/2021 GEN'LAGGREGATE LIMITAPPLIES PER: POLICY PRO- JECT LOC. GENERALAGGREGATE $ 15,000,000 PRODUCTS - COMPIOPAGG $ OTHER: Retro 3/31/2017 Retention Per Claim $ 250,000 AUTOMOBILE LIABILITY GLE LIMIT COMBINED SINEa accident) $ BODILY INJURY(Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per aedtlent $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY YIN STATUTE ER E.L. EACH ACCIDENT $ ANY PROPRIETORMARTNEWEXECUTIVE OFFICERIMEMBER EXCLUDED? NIA E.L. DISEASE - EA EMPLOYEE S (Mandatory In NH) If yes, describe untler EL.DISEASE-POLICY LIMIT 8 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may beattached if more space is required) Professional Services include Insurance Agent/Broker, Claims Administration, HR Consultant, Benefits Administrator, Enrollment Services and Third Party Administrator. The definition of an Insured in this policy includes both the company and individuals in their roles as Principals, employees, sub -agents, sub -brokers and independent Contractors of the Insured. These individuals are automatically insured for covered Professional Services when they are performed on behalf of and at the direction of the Insured. City of Santa Ana 20 Civic Center Plaza (M-24) Santa Ana ACORD 25 (2016/03) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. CA 92702 ©1988.20' The ACORD name and logo are registered marks of ACORD RlakMlmaganent Division A T rR�EMEWED&APPROVED BY: Risk Management Analyst 00