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Client#: 688055 <br />Francine R. Dig itally signed by Francine R. <br />vile. I <br />ADMINSUREI Villareal D.b, 2022.01.0616.2631-08'00' <br />ACORDTM CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MM/DD/YYYY) <br />1/04/2022 <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 any rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />CONTACT Angela Lin <br />Marsh & McLennan Agency LLC <br />HONN <br />949 540-6959 FAX <br />Marsh & McLennan Ins. Agency LLC <br />, Ext : No): <br />E-MAIL ADDRESS: occerts@marshmma.com <br />1 Polaris Way #300 <br />INSURER(S) AFFORDING COVERAGE <br />NAIC # <br />Aliso Viejo, CA 92656 <br />INSURER A: National Fire Insurance Co of Hartford <br />20478 <br />INSURED <br />INSURER B: The Continental Insurance Company <br />35289 <br />AdminSure, Inc. <br />Argonaut Insurance Company <br />INSURER C : 9 P Y <br />19801 <br />3380 Shelby Street <br />United States Fire Insurance Company <br />INSURER D : p Y <br />21113 <br />Ontario, CA 91764 <br />t Lloyd's s London <br />INSURER E : Underwriters aY <br />1555555 <br />INSURER F <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <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 CONTRACTOR OTHER DOCUMENT WITH 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 />LTR <br />TYPE OF INSURANCE <br />ADDLSUBR <br />INSR <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />MM/DD/YYYY <br />POLICY EXP <br />MM/DD/YYYY <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />7018013763 <br />01/01/2022 <br />01/01/2023 <br />EACHOCCURRENCE <br />$2,000,000 <br />CLAIMS -MADE [* OCCUR <br />PREMI6ESOEa oNcurrDence <br />$1 ,000,000 <br />MED EXP (Any one person) <br />$10,000 <br />PERSONAL & ADV INJURY <br />$2,000,000 <br />GEN'L <br />AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />$4,000,000 <br />PRO - <br />POLICY X JECT LOC <br />PRODUCTS-COMP/OPAGG <br />$4,000,000 <br />$ <br />OTHER: <br />B <br />AUTOMOBILE <br />LIABILITY <br />7018013777 <br />01/01/2022 <br />01/01/202 <br />COEaMBINED identSINGLE LIMIT <br />acc <br />1r 000r 000 <br />BODILY INJURY (Per person) <br />$ <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />BODILY INJURY (Per accident) <br />$ <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />X <br />HIRED NON -OWNED <br />AUTOS ONLY X AUTOS ONLY <br />B <br />X <br />UMBRELLA LIAB <br />X <br />OCCUR <br />7018013813 <br />01/01/2022 <br />01/01/2023 <br />EACH OCCURRENCE <br />$6 OOO 000 <br />AGGREGATE <br />s6,000,000 <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED RETENTION $ <br />$ <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? � <br />N / A <br />7018013794 <br />01/01/2022 <br />01/01/2023 <br />X PER OTH- <br />STATUTE ER <br />E.L. EACH ACCIDENT <br />$1 ,000,000 <br />E.L. DISEASE - EA EMPLOYEE <br />$1 ,000,000 <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE -POLICY LIMIT <br />$1 ,000,000 <br />C <br />Professional Liab <br />ML42618561 <br />01/01/2022 <br />01/01/2023 <br />$5,000,000 Claim/Agg <br />D <br />Crime <br />6260386428 <br />01/01/2022 <br />01/01/2023 <br />$2,000,000/Ded Varies <br />E <br />C ber Liability <br />CY100852022 <br />01/01/2022 <br />01/01/202 <br />$2,000,000theftfraud ry <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />The City, and their respective officers, agents and employees are included as additional insured as respects <br />to General Liability per attached endorsements. Primary and Non -Contributory Wording applies per attached <br />endorsement. <br />CERTIFICATE HOLDER CANCELLATION <br />City of Santa Ana <br />Risk Management Division <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 Civic Center Plaza <br />Santa Ana, CA 92702-0000 AUTHORIZED REPRESENTATIVE <br />© 1988-2015 ACORD <br />ACORD 25 (2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD <br />#S9169176/M9169038 <br />cF RiskManagmentDMsian <br />�40 x REVIEWED & APPROVED BY: <br />\'v <br />--� R(sk Mtanagennent Analyst <br />