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Digitally signed by Francine R.
<br />Francine R. Villareal Villareal
<br />ACCOR "® CERTIFICATE OF LIABILITY INSURANCE
<br />r�DATIE
<br />/07/202DDIYYYY)
<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 />MARSH USA INC
<br />1717 Arch Street
<br />CONTACT
<br />NAME:
<br />PHONE FAX
<br />A/C No Ext : A/C, No):
<br />E-MAIL
<br />ADDRESS:
<br />Philadelphia, PA 19103
<br />Attn: Philadelphia.certs@marsh.com / Fax: (212) 948-0360
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC #
<br />INSURER A: Lexington Insurance Company
<br />19437
<br />CN118025105-ALL-STAND-21-22
<br />INSURED Allied Universal Topco, LLC
<br />INSURER B : Greenwich Insurance Company
<br />22322
<br />INSURER C : XL Insurance America
<br />24554
<br />(See Attached for Additional Named Insureds)
<br />INSURER D : Indian Harbor Insurance Company
<br />36940
<br />161 Washington Street, Suite 600
<br />Conshohocken, PA 19428
<br />INSURER E : N/A
<br />N/A
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER: CLE-006703027-03 REVISION NUMBER: 11
<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 CONTRACT OR 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 />ADDL
<br />INSD
<br />SUBR
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM/DD/YYYY
<br />POLICY EXP
<br />MM/DDIYYYY
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />082695264
<br />01/01/2021
<br />01/01/2022
<br />EACH OCCURRENCE
<br />$ 10,000,000
<br />CLAIMS -MADE 1XI OCCUR
<br />DAMAGE TO
<br />PREMISES( a occurrDence
<br />$ 10,000,000
<br />X
<br />VIED EXP (Any one person)
<br />$
<br />CONTRACTUAL LIABILITY
<br />X
<br />SIR $1,750,000
<br />PERSONAL & ADV INJURY
<br />$ 10,000,000
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />$ 10,000,000
<br />POLICY ❑ PRO ❑ LOC
<br />JECT
<br />X
<br />PRODUCTS - COMP/OP AGG
<br />$ 10,000,000
<br />$
<br />OTHER:
<br />B
<br />AUTOMOBILE LIABILITY
<br />RAD9437818-04
<br />01/01/2021
<br />01/01/2022
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$ 5,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />X ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />BODILY INJURY (Per accident)
<br />$
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />HIRED NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />UMBRELLALIAB
<br />X
<br />OCCUR
<br />RES943799401
<br />01/01/2021
<br />01/01/2022
<br />EACH OCCURRENCE
<br />$ 10,000,000
<br />X
<br />AGGREGATE
<br />$ 10,000,000
<br />EXCESS LAB
<br />CLAIMS -MADE
<br />'EXCESS OF GENERAL LIABILITY
<br />DED RETENTION $
<br />$
<br />C
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y / N
<br />ANYPROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICER/MEMBER EXCLUDED? ❑N
<br />(Mandatory in NH)
<br />NIA
<br />RWD3001203-05(AOS)
<br />RWR3001204-05(WI)
<br />01/01/2021
<br />01/01/2021
<br />01/01/2022
<br />01/01/2022
<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 />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 1,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />The City of Santa Ana, its officers, employees, agents, volunteers and representatives are included as additional insured where required by written contract with respect to General Liability and Auto Liability.
<br />Liability coverage shall be primary and non-contributory where required by written contract. Waiver of subrogation is applicable where required by written contract.
<br />CERTIFICATE HOLDER CANCELLATION
<br />The City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />Risk Management Division THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />20 Civic Center Plaza ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Santa Ana, CA 92702
<br />AUTHORIZED REPRESENTATIVE
<br />of Marsh USA Inc.
<br />orta Risil:MwagemerdDi isilm
<br />Manashi Mukherjee 3kLor z,
<br />3, z REVIEWED & APPROVED BY:
<br />@ 1988-2016 ACORD C � '. F P V
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD �'' rusk Management Analyst
<br />
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