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Digit signed To r i Pierson Datea21022.04.227b10:37:35e07 00' A� " CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 08124/2021 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 Linda Partida NAME: The Liberty Company Insurance Brokers HCNE. Ext : (818) 350-7479 a/c, No Lic #OD79653 E-MAIL Ipartida@libertycompany.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # 5955 De Soto Ave, Suite 250 Woodland Hills CA 91367 INSURERA: Sentinel Insurance Company 11000 INSURED INSURER B Barboza & Associates, INSURER C : 660 South Figueroa St Ste 1620 INSURER D : INSURER E : Los Angeles CA 90017 INSURER F : COVERAGES CERTIFICATE NUMBER: 21-22 GLI 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 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. INSR LTR TYPE OF INSURANCEAUULbUBK INSD WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE OCCUR DAMAGE TO RENTED PREM SES Ea o.urrrence $ 1,000,000 MED EXP (Any one person) $ 10,000 PERSONAL &ADV INJURY $ 2,000,000 A Y 72SBAAA9619 08/07/2021 08/07/2022 LAGGREGATE LIMITAPPLIES PERGENERAL AGGREGATE $ 4,000,000 POLICY ElPRO FX LOC JECT: MOTHER PRODUCTS-COMP/OPAGG $ 4,000,000 $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANYAUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accide nt) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LAB CLAIMS -MADE DED I I RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY Y / N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ElN OFFICER/MEMBER EXCLUDED? /A E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Santa Ana, its officers, officials, employees, and volunteers are included as Additional Insureds on General Liability per SS 00 08 04 05, (Business Liability Coverage form), subject to policy terms and conditions. General Liability is Primary and Non -Contributory per SS 00 08 04 05, (Business Liability Coverage form), subject to policy terms and conditions. Revises Cert Issued on 08/10/2021. CERTIFICATE HOLDER CANCELLATION City of Santa Ana Risk Management Division 20 Civic Center Plaza Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE t p„W cc i„ as REveam & APPROVED 9Yf CA 92701 CAWA44A. #U, � !�� at A?woo MW ©1988-2015ACORD aosiciwanagemens�rencaiwcne ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD