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Francine R. wylully rly�ea errrar,d�ea y'II Nllareal STAGPLU`-�flal w�r021InTERRYHILI '41cc>H v CERTIFICATE OF LIABILITY INSURANCE DA10/202021Y) 10/20/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NONTtCT 151rthrtysn venueervICBS, Inc. North Tustin A Suite 500 A.oFAX CN. Eat): (714) 505-5550 u , No :(714) 975-8966 MASS. Santa Ana, CA 92705 INSURERS AFFORDING COVERAGE NAIC e INSURERA: Ohio Security Insurance Company 24082 INSURED INSURERS: American Fire and Casualty Company 24066 INSURER C : Stage Plus, Inc. INSURER D: P.O. Box 11060 Santa Ana, CA 92711 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER- RFVIAInm sluknRFw. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEDTO THE INSURED NAMEDABOVE FORTHE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENTWITH RESPECTTO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. VIER LTRTYPE OF INSURANCE ADULSUBR POLICY NUMBER POLICY EFF POLICY EXP 7/29/2022 LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE [X] OCCUR X X BKS58241997 7/29/2021 EACH OCCURRENCE S 1,000,000 DAMAGETOERENTED caPREMISES 500,000 NED EXP (Myone erson 15,000 PERSONALSADV INJURY 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER X POLICY jECQT LOC GENERAL AGGREGATE 2,000,000 PRODUCTS - COMP/OP AGG 1 2,000,000 OTHER: AUTOMOBILE LIABILITY COMBIINEED SINGLE LIMIT $ BODILY INJURY Par arson $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUUTTO{S� BODILY INJURYPeraccitlenl $ Pe�aaclEant AMAGE $ � AUTOS ONLY AUTOS ObF B LIAR X OCCUR EACH OCCURRENCE 1,000,000 IUMBRELLA AGGREGATE 11000,000 EXCESS LIAB CLAIMS -MADE ESA58241997 10/2012021 7/29/2022 X I DED I I RETENTION$ 0 WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY Y N AANY PROPRJETDRPARTNERIEXECUTIVE REXCLUDED? NIA PER OTH- S ATUTE E. EACH ACCIDENT $ E.L DISEASE -EA EMPLOYE (MandaWMEB K Yes. describe under DESCRIPTION OF OPERATIONS below E.L DISEASE -POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Santa Ana, officers, agents, employees, and volunteers are named as additionally insured in regards to General Liability per attached CG8810 0413 pursuant to Written contract, agreement, or memorandum of understanding. Such insurance as is afforded by this policy shall be primary, and any insurance carried by City shall be excess and noncontributory. 30 Days' notice of Cancellation EXCEPT 10 Days' Notice for non-payment of premium. Please note that the CG2037 Completed Ops Endorsement has been ordered from Liberty Mutual Insurance. UMBRELLA POLICY IS FOLLOWING FORM City of Santa Ana Risk Management Division 20 Civic Center Plaza Santa Ana, CA 92702 ACORD 25 (2016/03) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE RiskMaragameniDivision t ReAEwED n APPROVED Or © 1986.2 )15 ACORD Clfti� The ACORD name and logo are registered marks of ACORD Risk Management Analyst