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Tori Pierson Dateazlo2in.6bRs6:aleoebP
<br />MGTOFAM-07
<br />CRYSTAL
<br />onrE 1 s124/2021
<br />za/zozl
<br />,a►coRO CERTIFICATE OF LIABILITY INSURANCE
<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 endorsements .
<br />PRODUCER
<br />Earl Bacon Agency, Inc.
<br />Post Office Box 12039
<br />CQf9TAOT
<br />P
<br />PHONE FA%
<br />uc, Nn, EA); (850) 878-2127 M. Ne :(850) 878-2128
<br />Tallahassee, FL 32317
<br />INSURERS AFFORDING COVERAGE
<br />NAIC #
<br />INSURER A: American Casualty Company of Reading, PA
<br />20427
<br />INSURED
<br />INSURER a: Continental Casualty Comp nv
<br />20443
<br />INSURER c:Transportation Insurance Company
<br />20494
<br />MGT of America, LLC
<br />MGT of America Consulting, LLC
<br />4320 West Kennedy Blvd.
<br />INSURER u:Houston Casualty Company
<br />INSURERS:
<br />Tampa, FL 33609-2118
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER' REVISION NIIMRFR-
<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 CONTRACTOR 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 />TYPE OF INSURANCE
<br />ADDLSUSR
<br />POLICY NUMBER
<br />POLICY EFF
<br />POLICY EXP
<br />LIMITS
<br />A
<br />X
<br />COMMERCIALGENERAL LIABILITY
<br />CLAIMS -MADE [X] OCCUR
<br />X
<br />X
<br />5095130327
<br />71112021
<br />711/2022
<br />EACH OCCURRENCE
<br />1,000,00O
<br />'PRE' MGET ISSERENTI
<br />300,000
<br />MED EXP An one erson
<br />15,000
<br />PERSONAL&ADV INJURY
<br />1,000,000
<br />AGGREGATE LIMIT APPLIES PER:
<br />POLICY 0 JEQ F-1 LOC
<br />GENERALAGGREGATE
<br />2,000,000
<br />GEN'L
<br />PRODUCTS - COMPIOP AGO
<br />2,000,000
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />EOMBINEd.DSINGLE LIMIT
<br />$ 1,000,000
<br />BODILY INJURY Per erson
<br />$
<br />ANY AUTO
<br />X
<br />X
<br />2093563501
<br />7/112021
<br />711/2022
<br />BODILY INJURY Per acddent
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOpSWN
<br />X
<br />Paraccidant SAGE
<br />AUTOS ONLY X Al01TNOS ONLY
<br />B
<br />X
<br />UMSRELLAUAB
<br />X
<br />OCCUR
<br />EACHOCCURRENCE
<br />5,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />2093563496
<br />7/1/2021
<br />7/112022
<br />AGGREGATE
<br />5,000,000
<br />DIED X RETENTION$ 10,000
<br />Cris Mgmt Expen
<br />300,000
<br />C
<br />WORMERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETORJPARTNERIEXECUTIVE YIN
<br />pFFICERIMEMBEqq E%CLUDEDT
<br />'Mandatary in Nil)
<br />If yas, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />NIA
<br />X
<br />3011086788
<br />7/1/2021
<br />7/112022
<br />PER OTH-
<br />XSTATUTE I E
<br />E.L. EACH ACCIDENT
<br />1,000,000
<br />E.L DISEASE - EA EMPLOYE
<br />1,000,000
<br />E.L. DISEASE - POLICY LIMB
<br />1,000,000
<br />D
<br />Cyber Liability
<br />H21NGP208777-00
<br />711/2021
<br />Ill/2022
<br />OCC&AUG
<br />5,000,000
<br />B
<br />Professional and
<br />652348448
<br />7/112021
<br />711/2022
<br />E & O Liability
<br />6,000,000
<br />DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES ACORD 101, AddlHonal Remarks Schedule, may be aaachad If more space Is required)
<br />Blanket Additional Insured per attached forms lanket Waiver of Subrogation attached farms Notice of Cancellation to Certificate Holders
<br />per per attached
<br />forms
<br />Stop Gap Liability Coverage for Ohio and Washington 500,000/500,0001500,000
<br />THE CITY OF SANTA ANA, IT'S OFFICERS, EMPLOYEES, AGENTS, AND REPRESENTATIVE ARE NAMED AS ADDITIONAL INSURED IN REGARDS TO
<br />GENERAL LIABILITY PER ATTACHED CNA74879XX & CNA75079XX BLANKET ADDITIONAL INSURED FORMS.
<br />SEE ATTACHED ACORD 101
<br />City of Santa Ana
<br />Risk Management
<br />20 Civic Center Plaza (M-30)
<br />ACOKU 25 (2016103) ©1988-2015 A'
<br />The ACORD name and logo are registered marks of ACORD
<br />
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