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A� o® CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MMIDD1YYYY) <br />s/2212021 <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 Bolton & Company <br />3475 E. Foothill Blvd., Suite 100 <br />Pasadena, CA 91107 <br />CONTANAME: CT <br />PHONE 626 799700o FAX 626 583-2117 <br />Eb AIL <br />ADDRESS: <br />INSURERS AFFORDING COVERAGE <br />NAIC# <br />www.boltonco.com 0008309 <br />INSURER A: VI ilant Insurance Company <br />20397 <br />INSURED <br />Atkinson, Andelson, Loya, Ruud & Romo <br />12800 Center Court Drive #300 <br />INSURER B: Federal Insurance Company <br />20281 <br />INSURER C: <br />INSURER D: <br />Cerritos CA 90703 <br />INSURER E: <br />INSURER F: <br />COVERAGES CERTIFICATE NIIMRFR- 99ng9n On omfi Clnm Milan.... <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. <br />INSR <br />LTR <br />rypE OF INSURANCE <br />ADOLSUBR <br />POLICYNUMBER <br />POLICY EFF <br />MMlDD1YYYY <br />POLICY E%P <br />MMDD <br />LIMITS <br />A <br />1/ <br />COMMERCIALGENERAL LIABILITY <br />CLAIMS -MADE lzl OCCUR <br />35344557 <br />4/1/2021 <br />4/1/2022 <br />EACH OCCURRENCE <br />$1000000 <br />PREMISES RENTEDGE TO ISES Ea occummue <br />$1000000 <br />MED EXP (Any one person) <br />$10 000 <br />PERSONAL&ADV INJURY <br />$1000,000 <br />GEN'L <br />AGGREGATE LIMIT APPLIES PER: <br />POLICY PRO- <br />JECT Fz] LOC <br />OTHER: <br />GENERA -AGGREGATE <br />$2,000,000 <br />PRODUCTS - COMP/OP AGO <br />$Included <br />$ <br />B <br />POMOBILELIABILITY <br />ANY AUTO <br />OWNED SCHEDULEDgO01LV <br />AUTOS ONLY AUTOS <br />NON -OWNED <br />AUTOS ONLY ✓ AUTOS ONLY <br />73508514 <br />4/1/2021 <br />4/1/2022 <br />OMBINED1SINGLE LIMIT$1000000 <br />BODILY INJURY(Par Person) <br />$ <br />INJURY Peractldenl <br />( )HIRED <br />$ <br />PROPERTY DAMAGE$ <br />Per accident) <br />$ <br />B <br />✓ <br />UMBRELLALIAS <br />EXCESS LIAB <br />,/ <br />OCCUR <br />CLAIMS -MADE <br />79757104 <br />4/1/2021 <br />4/1/2022 <br />EACH OCCURRENCE <br />$15000000 <br />AGGREGATE <br />$15 000 000 <br />DED I I RETENTION$ <br />$ <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y/N <br />ANVPROPRIETOWPARTNEMEXECUTIVE <br />OFFICERIMEMBEREXCLUDEDY ❑N <br />(Mandatory In NH) <br />If yes, tlescribe antler <br />DESCRIPTION OF OPERATIONS below <br />NIA <br />71732870 <br />4/1/2021 <br />4/1/2022 <br />,/ STATUTE ERH <br />E.L. EACH ACCIDENT <br />$1 000 000 <br />E.L. DISEASE -EA EMPLOYE <br />$ <br />E.L. DISEASE -POLICY LIMIT <br />$1000000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule, may be smashed U more space is required) <br />Re: Client #0302, AALRR-Cerritos.000302.10086, Reference #N-2021-066. <br />Client #0302 <br />CITY OF SANTA ANA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />RISK MANAGEMENT DIVISION ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 CIVIC CENTER PLZ <br />SANTA ANA CA 92701 /}// <br />AUTHORIZED REPRESENTATNE � / y WriMmgened Disides <br />�4l/•/'l//L/1, REMBPm61VPRo,�Bhc <br />BY: <br />William A. Lewis 8;. 7ou P4udn <br />V 1988-ZU15 ACORD Ct <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />62435494 1 AALRA 1 21-22 Master Certificate I Bolton Certificate Pioceaaing 16/22/2021 11:31:31 AM (PDT) I Page 1 of 1 <br />