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Digitally signed by Francine R. Francine R. Villareal Vdiareal ACCO & CERTIFICATE OF LIABILITY INSURANCE DAM MM2D2ry�) 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 Arthur J. Gallagher & Co. Insurance Brokers of CA Inc. LIC #0726293 21820 Burbank Blvd. Suite 175 Woodland Hills CA 91367 CONTACT Erika Sokolik PHONE Fax 818-534-3558 A/C 1o:818-316-0990 AoorsesS, Erika Sokolik a' .com INSURER 8 AFFORDING COVERAGE NAIL# INSURER A: West American Insurance Company 44393 INSURED Downey Vendors, Inc. DBA: Premier VendGroup INSURER B: Insurance Company of the West 27847 INSURER c: Travelers Property Casualty Co of America 25674 INSURERD: 6814 Suva Street Bell Gardens CA 90201 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 286429888 REVISION NUMBER - THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO 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. ILTR TYPE OF INSURANCE ADDLSUBR INSO MID POLICY NUMBER POLICY EFF MWDO POLICY EXP MWDO LIMITS A X COMMERCIAL GENERAL ABILITY CLAIMS -MADE Iq OCCUR Y BKVM585014 4/1/2D21 4/1/2022 EACH OCCURRENCE $1.000,000 DAMAGE TO RENTEG PREMISES Ea occunenca $100,000 GEN'L X MED EXP (Any mm pcinem) $10,000 PERSONAL&ADV INJURY $1,000,000 AGGREGATE LIMIT APPLIES PER POLICY PRO- ❑ LOC JECT OTHER: GENERALAGGREGATE $2,000,000 PRODUCTS-COMP/OP AGG $2,000,000 $ AUTOMOBILELIABILITY ANY AUTO OWNED SCHEDAUTOS ULED AUTOS ONLY HIRED NON -OWNED AUTOS ONLY AUTOS ONLY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ BODILY INJURY Perawitlant) ( $ PROPERTY DAMAGE Per accide t $ C _Xj UMBRELLA LAB EXCESS LIAB X OCCUR CLAIMS -MADE ZUP16N7899421NF 4/1/2021 4/1/2022 EACH OCCURRENCE $10,000.000 AGGREGATE $10,000,000 DEG 'X RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBEREXCLUDED? (Mandatory in NH) If yes, descdbe under DESCRIPTION OF OPERATIONS below NIA VWE503733306 7/26/2021 7/26/2022 X PER OTH- STATUTE Eft E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE -EA EMPLOYEE $1,000,000 E.L. DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Addillonal Remarks Schedule, may be attached if more space is required) City of Santa Ana is named Additional Insured with respects to General Liability coverage per attached form CG 8810 0413. 30 days Notice of Cancellation Applies. CERTIFICATE HOLDER City of Santa Ana Risk Management Division 20 Civic Center Plaza, 4th floor 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 WdrMv&App LLDtWYm REVIEWED6APPRovecfir ©1988.2015 ACORDC a"' tc�3 f4m',' P, V&A'At The ACORD name and logo are registered marks of ACORD Risk Management Analyst