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4COR0 ULH I IhII:A I t UI- LIAUILI I Y IN,UHANUL <br />o�izrl�zozi <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 BELOW. <br />THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE <br />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. If <br />SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate <br />does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER CONTACT <br />PAYCHEX INS AGENCY INC <br />150 SAWGRASS DR <br />ROCHESTER, NY 14620 <br />INSURED <br />AMERICA ON TRACK <br />600 W SANTA ANA BLVD <br />STE 710 <br />SANTA ANA, CA 92701 <br />8?2-8921 <br />I INSURER(S) AFFORDING COVERAGE I NAIC p <br />: TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA <br />E: <br />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 INDICATED. <br />NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE <br />ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF <br />SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />NSTR <br />TYPE OF INSURANCE <br />ADDL <br />INSD <br />SUBS <br />MD <br />POLICY NUMBER <br />POLICY EFF <br />(MM/DD/YYYY) <br />POLICY EXP <br />(MM/OO/YYYY) <br />LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />OLAIMSMADE OCCUR <br />GREGATE LIMIT IES PER: <br />POLICY O JECT PRO- ❑ LOC <br />OTHER: <br />EACH OCCURRENCE <br />DAMAGE TO RENTED <br />PREMISES (Ea occurrence) <br />MED EXP(Any one person) <br />PERSONALS ADV INJURY <br />GENERAL AGGREGATE <br />PRODUCTS -COMP/OP AGO <br />AUTOMOBILE <br />UASILDY <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />BODILY INJURY (Per Person) <br />BODILY -INJURY (Per accident) <br />PROPERTY DAMAGE <br />(Per accident) <br />$ <br />UMBRELLA LIAR OCCUR <br />EXCESS LIAB CLAIMS -MADE <br />DEO ❑ RETE $ <br />EACH OCCURRENCE <br />AGGREGATE <br />$ <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANY PROPRIETO"ARTNER/EXECUTIVE VM <br />FFICERlMEMBER EXCLUDED? <br />amlbtery in NH) ❑ <br />Ifyes, describe under <br />ESCRIPTION OF OPERATIONS below <br />N/A <br />UB-31-272199-21-42 <br />01/01/2021 <br />01/01/2022 <br />X <br />PER <br />STATUTE <br />OTH- <br />ER <br />E. L EACH ACCIDENT <br />$1,000,000 <br />E.L DISEASE - EA EMPLOYEE <br />$1,000,000 <br />E.L. DISEASE -POLICY LIMIT <br />$1,000,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached B more space is required) <br />CERTIFICATE HOLDER CANCELLATION <br />CITY OF SANTA ANA <br />20 CIVIC CENTER PLAZA <br />M25 <br />SANTA ANA, CA 92701 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br />BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />�,,.,wti� tact mvcgenn¢utwmK <br />o REwevyED 6APPRov®r. B <br />Fvia," 4 Z WaAwL <br />RUk Management Analyst <br />