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PRU I L24 DATE41211221/2I021 A`oFro CERTIFICATE OF LIABILITY INSURANCE 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 endorsements . PRODUCER 877-242.9600 Central Insurance Agency, Inc. 93 East Main StreetINC. Smithtown, NY 11787 CONTNAMEACT Central Insurance Agency, Inc PHONE B77-242.9600 FAX g77.243-8995 No, Est): NC, No): E-MAIL 55 George Gavaris INSURJER(Sl AFFORDING COVERAGE NNC If INSURERA: Employers Assurance Company 25402 NSURED P°3merica Inc. PO#12a31 21350Q NOrdhoff St. 91041 Chatsworth, CA INSURER B: Infinity Select Insurance Company wsuRERc: ty P Y 20260 INSURER D: NSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: 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. INSR TYPE OF INSURANCE DOL UBR POLICY NUMBER POLICY EFF I- POLICY UP HOWDDYNY11 LIMITS COMMERCUILGENERAL LIABILITY CLAIMS -MADE ❑OCCUR EACH OCCURRENCE $ DAMAGE TO RENTED 8 MED UP An one arson PERSONAL S ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER: POLICY 0 PRO - JECT LOG GENERAL AGGREGATE PRODUCTS-COMP/OP AGG $ OTHER OTHER: C AUTOMOBILE LIABILITY ANYAUTO OWNED SCHEDULED AUTOS ONLY AUU�TTNOpSSVW�NEE X X 504610110722001 10/08/2020 10108/2021 COMBINED SINGLE LIMIT IEa accident) $ 1,000,000 X BODILY INJURY Per arson S BODILY INJURY Per accWent S Pere ER n AMAGE $ AUTOS ONLY AUTOS O $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION$ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERJUECUTIVE Y N 1MardERNEMBER EXCLUDED' Y ry in NH) If yes, describe under DESCRIPTIONOFOPERATIONSbel. NIA X EIG2562084-02 11 /06/2020 11/0612021 OTH- X PERTUTE E.L. EACH ACCIDENT 11000,000 E.L. DISEASE - EA EMPLOYE $ 1,000,000 E.L. DISEASE -POUCY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES )ACORD tat, Additional Remarks Schedule, may be attached if more space is required) The City of Santa Ana, its officers, employees, agents, and representatives are named as additional insured under the Commercial Auto Liability on this policy pursuant to written contract, agreement, or memorandum of understanding. Waiver of subrogation applies to the Workers Compensation per the attached endorsement. City of Santa Ana Risk Management Division 20 Civic Center Plaza Santa Ana CA 92702 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 REPRESENTATIVE8vnail°A p7�' REVIBv®6�n/wNtOVDJ Br. �� L I cif E_ %u YiCSJOx ACORD 25 (2015103) ©1988.2015 ACORD CC-�- The ACORD name and logo are registered marks of ACORD