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Digitally signed by Francine <br />Francine R. <br />R. Villareal <br />Villareal Date: 2021.11.09 11:46:42 <br />08'00' <br />CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MM/DD/YYYY) <br />09/20/2021 <br />1 <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. If <br />SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this <br />certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />Aon Risk Services Northeast, Inc. <br />New York NY Office <br />CONTACT <br />NAME: <br />(A/C.o. Ext): (866) 283-7122 A/C No : (800) 363-0105 <br />E-MAIL <br />ADDRESS: <br />One Liberty Plaza <br />165 Broadway, suite 3201 <br />New York NY 10006 USA <br />INSURER(S) AFFORDING COVERAGE <br />NAIC # <br />INSURED <br />INSURER A: Hartford Fire Insurance Co. <br />19682 <br />Hanson Bridgett LLP <br />425 Market Street <br />INSURERB: Hartford Casualty Insurance Co <br />29424 <br />INSURER C: <br />26th Floor <br />San Francisco CA 94105 USA <br />INSURER D: <br />INSURER E: <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: b/UU89249U23 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. Limits shown are as requested <br />LTR <br />TYPE OF INSURANCE <br />INSD <br />WVD <br />I POLICY NUMBER <br />MM/DD/YYYY <br />MM/DD/YYYY <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />10UUNDD1980EACH <br />OCCURRENCE <br />$1, 000, 000 <br />CLAIMS -MADE X❑ OCCUR <br />Commercial Package <br />PREMISES Ea occurrence <br />$300,000 <br />MED EXP (Any one person) <br />$10 , 000 <br />PERSONAL& ADV INJURY <br />$1, 000, 000 <br />GEN'LAGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />$2,000,000 <br />POLICY ❑ PRO ❑ LOC <br />JECT <br />PRODUCTS - COMP/OP AGG <br />$1,000,000 <br />OTHER: <br />A <br />AUTOMOBILE LIABILITY <br />1000NDD1980 <br />Commercial Package <br />08/26/2021 <br />08/26/2022 <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$1, 000, 000 <br />BODILY INJURY ( Per person) <br />ANY AUTO <br />BODILY INJURY (Per accident) <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />X HI RED AUTOS X NON -OWNED <br />ONLY AUTOS ONLY <br />PROPERTY DAMAGE <br />Per accident <br />B <br />X <br />UMBRELLALIAB <br />X <br />OCCUR <br />1OXHUDH9540 <br />08/26/202108/26/2022 <br />EACH OCCURRENCE <br />$5,000,000 <br />EXCESS LIAB <br />CLAIMS -MADE <br />umbrella <br />AGGREGATE <br />$5,000,000 <br />DED I RETENTION <br />WORKERS COMPENSATION AND <br />PER STATUTE I OTH- <br />EMPLOYERS' LIABILITY y / N <br />ER <br />E.L. EACH ACCIDENT <br />ANY PROPRIETOR / PARTNER / EXECUTIVE ❑ <br />OFFICER/MEMBER EXCLUDED? <br />A N <br />/ <br />E.L. DISEASE -EA EMPLOYEE <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />I <br />I <br />I <br />E.L. DISEASE -POLICY LIMIT <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />a� <br />w <br />N <br />O <br />v <br />00 <br />O <br />O <br />O <br />Z <br />O <br />R <br />V <br />U <br />CERTIFICATE HOLDER CANCELLATION 5�i <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE <br />POLICY PROVISIONS. <br />City of Santa Ana AUTHORIZED REPRESENTATIVE <br />20 Civic Center Plaza (M-30) <br />P.O. Box 1988 <br />Santa Ana, CA 92702-1988 USA <br />iLdDfG cam/ �NORANc RAMwagmerdOivisilm <br />©1988-2015 ACORD CO z REVIEWED & APPROVED BY: <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD VSA44a <br />Risk Management Analyst <br />