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Tori Pierson o� zonue.tla ion:807DV <br />,acoRO CERTIFICATE OF LIABILITY INSURANCE <br />DATE IMMIDDA I <br />1 <br />08/12/2021 <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 <br />CONTA T Ashley Greenberg <br />Cornerstone Specialty Insurance Services, Inc. <br />PHONE (714) 731-7700 FAX (714) 731-7750 <br />EANo Ext : <br />14252 Culver Drive, A299 <br />Ashley@cornerstonespecialty.com <br />ADDRESS: <br />INSURER(S) AFFORDING COVERAGE <br />NAIC# <br />INine CA 92604 <br />INSURERA: Continental Casualty Company <br />20443 <br />INSURED <br />INSURER a : American Cas.Co. of Reading PA <br />CAP Architecture <br />INSURER C: RLI Insurance Company <br />13056 <br />8700 Warner Avenue <br />INSURER D: <br />Suite 280 <br />INSURER E: <br />Fountain Valley CA 92708 <br />INSURER F: <br />GUVCRAGES CERTIFICATE NIIMRFR• zIIZZ CUVtRAGES uevrevau u, umvo. <br />THIS IS TO CERTIFY THATTHE 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 MAYBE 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 />IN O <br />MD <br />POLICY NUMBER <br />MMIDIOIYYYY <br />MMNO�Y <br />LIMITS <br />X <br />COMMERCIAL GENERALLIABILITY <br />EACH OCCURRENCE <br />$ 2,000.000 <br />CLAIMS � <br />-MADE OCCUR <br />PREMISES Ea omuneres <br />S 1.000,000 <br />X <br />VIED EXP (An one person) <br />Is 10,000 <br />ADDT'L INSURED / PRIMARY <br />A <br />Y <br />5094175320 <br />05/18/2021 <br />05/18/2022 <br />X <br />BLNKT WVR OF SUBRO <br />PERSONAL GADV INJURY <br />$ 2,000,000 <br />GEN'L AGGREGATE LIMITAPPLIES PER: <br />GENERAL AGGREGATE <br />S 4,000,000 <br />POLICY JECOT <br />LOC <br />PRODUCTS -COMPIOPAGG <br />$ 4,000,000 <br />$ <br />OTHER: <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$ 1,000,000 <br />BODILY INJURY (Per person) <br />$ <br />ANYAUTO <br />AOWNED <br />SCHEDULED <br />AUTOS ONLY AUTOS <br />5094175320 <br />O5/18I2021 <br />05/18/2022 <br />POMOBILE <br />BODILY INJURY Per accident <br />( ) <br />$ <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />$ <br />X <br />UMBRELLA LIAR <br />X <br />OCCUR <br />EACH OCCURRENCE <br />$ 1,OK000 <br />A <br />EXCESS LIAB <br />CLAIMS -MADE <br />5094854763 <br />05/18/2021 <br />05/18/2022 <br />AGGREGATE <br />$ <br />DED <br />RETENTION S <br />$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' <br />_ <br />X STATUTE I ERH <br />LIABILITY YIN <br />E.L. EACH ACCIDENT <br />$ 1,000,000 <br />B <br />ANY PROPRIETORIPARTNENEXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />NIA <br />5094854715 <br />05/18/2021 <br />05/18/2022 <br />(Mandatory in NH) <br />E.L. DISEASE - EA EMPLOYEE <br />S 1,000,000 <br />dyes, describe under <br />E.L. DISEASE -POLICY LIMIT <br />$ 1,000.000 <br />DESCRIPTION OF OPERATIONS below <br />Professional Liability <br />Each Claim: <br />$1,000,000 <br />C <br />Claims Made <br />RDPOM369 <br />05/18/2021 <br />05/18/2022 <br />Annual Aggregate: <br />$2,000,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />RE: Agreement No. A-2020-230-09 <br />The City of Santa Ana, its officers, employees, agents, volunteers and representatives are named Additional Insured for General Liability but only if required <br />by written contract with the Named Insured prior to an occurrence and as per attached endorsement. Coverage is subject to all policy terms and conditions. <br />*30 days notice of cancellation, except for 10 days notice for non-payment of premium. For Professional Liability coverage, the aggregate limit is the total <br />insurance available far all covered claims reported within the policy period. <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />City of Santa Ana Risk Management Division ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 Civic Center Plaza, 4th FI <br />AUTHORIZED REPRESENTATIVE ryilt Ml%assad D. <br />Santa Ana CA 92702 <br />'7eu pic:uon <br />n 19AA.2015 ACfTRD � RakMarwJenerrt OavalAde <br />IIIv <br />ACORD 25 (2076I03) The ACORD name and logo are registered marks of ACORD <br />