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<br />Ejhjubmmz!tjhofe!cz!Upsj!Qjfstpo! <br />Ebuf;!3133/15/16!1:;35;32! <br />Upsj!Qjfstpo <br />.18(11( <br />DATE (MM/DD/YYYY) <br />CERTIFICATE OF LIABILITY INSURANCE <br />3/21/2022 <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 rights to the certificate holder in lieu of such endorsement(s). <br />CONTACT <br />PRODUCER <br />NAME: <br />FAX <br />PHONE <br />(714)842-9791 <br />DAWOOD INSURANCE AGENCY(949)417-0204 <br />(A/C, No): <br />(A/C, No, Ext): <br />E-MAIL <br />18800 Delaware St #304kato@dawoodinsurance.com <br />ADDRESS: <br />Huntington Beach, CA 92648 INSURER(S) AFFORDING COVERAGENAIC # <br />INSURER A :ADMIRAL INSURANCE COMPANY24856 <br />INSURED <br />INSURER B : <br />Pyramid Group International, Inc.INSURER C : <br />25771 Rapid Falls Road INSURER D : <br />Laguna Hills, CA 92653 INSURER E : <br />INSURER F : <br />COVERAGESCERTIFICATE 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 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 />ADDLSUBR <br />INSRPOLICY EFFPOLICY EXP <br />TYPE OF INSURANCELIMITS <br />POLICY NUMBER <br />LTR(MM/DD/YYYY)(MM/DD/YYYY) <br />INSDWVD <br />COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE$ <br />1,000,000 <br />DAMAGE TO RENTED <br />CLAIMS-MADEOCCUR$ <br />50,000 <br />PREMISES (Ea occurrence) <br />MED EXP (Any one person)$ <br />5,000 <br />3/22/20223/22/2023 <br />PERSONAL & ADV INJURY$ <br />AXFEI-ECC-28399-011,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$ <br />2,000,000 <br />PRO- <br />POLICYLOCPRODUCTS - COMP/OP AGG$ <br />2,000,000 <br />JECT <br />$ <br />OTHER: <br />COMBINED SINGLE LIMIT <br />AUTOMOBILE LIABILITY$ <br />(Ea accident) <br />ANY AUTO <br />BODILY INJURY (Per person)$ <br />OWNEDSCHEDULED <br />BODILY INJURY (Per accident)$ <br />AUTOS ONLYAUTOS <br />NON-OWNED <br />HIREDPROPERTY DAMAGE <br />$ <br />(Per accident) <br />AUTOS ONLYAUTOS ONLY <br />$ <br />UMBRELLA LIAB <br />EACH OCCURRENCE$ <br />OCCUR <br />EXCESS LIAB <br />CLAIMS-MADEAGGREGATE$ <br />$ <br />DEDRETENTION$ <br />PEROTH- <br />WORKERS COMPENSATION <br />STATUTEER <br />AND EMPLOYERS' LIABILITY <br />Y / N <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />E.L. EACH ACCIDENT$ <br />N / A <br />OFFICER/MEMBER EXCLUDED? <br />(Mandatory in NH) <br />E.L. DISEASE - EA EMPLOYEE$ <br />If yes, describe under <br />E.L. DISEASE - POLICY LIMIT$ <br />DESCRIPTION OF OPERATIONS below <br />Ocurrence2,000,000 <br />Agregate2,000,000 <br />3/22/20223/22/2023 <br />AXFEI-ECC-28399-01 <br />PROFESSIONAL LIABILITY <br />Claim Expense 1,000,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />CERTIFICATE HOLDERCANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ADDITIONAL INSURED ADDITIONAL INSURED <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />CITY OF SANTA ANA <br />20 CIVIC CENTER PLAZA, <br />AUTHORIZED REPRESENTATIVE <br />SANTA ANA ,CA 92702 <br />© 1988-2015 ACORD CORPORATION. All rights reserved. <br /> <br />ACORD 25 (2016/03)The ACORD name and logo are registered marks of ACORD <br /> <br />