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<br />Ejhjubmmz!tjhofe!cz!Upsj!Qjfstpo! <br />Ebuf;!3133/14/19!26;64;34! <br />Upsj!Qjfstpo <br />.19(11( <br /> DATE(MM/DD/YYYY) <br /> 12/28/2021 <br />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. If <br />SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this <br />certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />CONTACT <br />PRODUCER <br />NAME: <br />Aon Risk Services South, Inc. <br />PHONE <br />FAX <br />(864) 241-1510(864) 241-1511 <br />(A/C. No. Ext): <br />(A/C. No.): <br />MSC# 17691 <br />PO Box 551343 E-MAIL <br />ADDRESS: <br />Atlanta GA 30355 USA <br />Holder Identifier : <br />INSURER(S) AFFORDING COVERAGENAIC # <br />INSURED National Fire Ins. Co. of Hartford20478 <br />INSURER A: <br />Grant Thornton LLP <br />The Continental Insurance Company35289 <br />INSURER B: <br />171 North Clark Street <br />INSURER C: <br />Suite 200 <br />Chicago IL 60601 USA <br />INSURER D: <br />INSURER E: <br />INSURER F: <br />570090873716 <br />COVERAGESCERTIFICATE NUMBER:REVISION NUMBER: <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 />Limits shown are as requested <br />INSR ADDL SUBRPOLICY EFF POLICY EXP <br /> TYPE OF INSURANCEPOLICY NUMBER LIMITS <br />LTRINSDWVD(MM/DD/YYYY)(MM/DD/YYYY) <br />A <br />07/31/202107/31/2022 <br />6081370470 <br />$1,000,000 <br />X COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE <br />General Liability <br />DAMAGE TO RENTED <br />$1,000,000 <br />OCCUR <br />CLAIMS-MADEX <br />PREMISES (Ea occurrence) <br />MED EXP (Any one person)$15,000 <br />PERSONAL & ADV INJURY <br />,000,000 <br />$1 <br />$2,000,000 <br />GENERAL AGGREGATE <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRO- <br />X <br />POLICYLOC <br />$2,000,000 <br />PRODUCTS - COMP/OP AGG <br />JECT <br />OTHER: <br />570090873716 <br />COMBINED SINGLE LIMIT <br />A 07/31/202107/31/2022 <br />6081373210 <br />AUTOMOBILE LIABILITY <br />$1,000,000 <br />(Ea accident) <br />Auto <br />BODILY INJURY ( Per person) <br />ANY AUTO <br />SCHEDULED <br />BODILY INJURY (Per accident) <br />OWNED <br /> AUTOS <br />AUTOS ONLY <br />PROPERTY DAMAGE <br />NON-OWNED <br />HIRED AUTOS <br />X <br />X <br />(Per accident) <br />AUTOS ONLY <br />ONLY <br />Certificate No : <br />B 07/31/202107/31/2022 <br />6081347562 <br />$5,000,000 <br />EACH OCCURRENCE <br />X <br />X UMBRELLA LIAB <br />OCCUR <br />Umbrella <br />$5,000,000 <br />AGGREGATE <br />CLAIMS-MADE <br />EXCESS LIAB <br />DED <br />RETENTION <br />WORKERS COMPENSATION AND <br />PER STATUTE <br />OTH- <br />ER <br />EMPLOYERS' LIABILITY <br />Y / N <br />ANY PROPRIETOR / PARTNER / EXECUTIVE <br />E.L. EACH ACCIDENT <br />N / A <br />OFFICER/MEMBER EXCLUDED? <br />(Mandatory in NH)E.L. DISEASE-EA EMPLOYEE <br />If yes, describe under <br />( <br />E.L. DISEASE-POLICY LIMIT <br />DESCRIPTION OF OPERATIONS below!! <br />( <br />! <br />( <br />!!! <br />( <br />! <br />((((((( <br />%! <br />&& <br />' <br />$$&"( <br />' <br />" <br />' <br />(((& <br />! <br />"" <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />#!'#! <br />$& <br />' <br />$$$$ <br />! <br />City of Santa Ana, its officers, officials, employees, and volunteers is added as Additional Insured as respects the General <br />( <br />!! <br />"" <br />Liability and Automobile Liability as required per written contract. Umbrella is a follow form. 30-day notice of cancellation <br />#!'# <br />& <br />'# <br />except 10 days for non-payment. General Liability is primary and non-contributory to other insurance available to the $$$ <br />!# <br />( <br />!! <br />" <br />certificate holder, but only to the extent required by written contract with the insured. A waiver of subrogation in favor of <br />#! <br />$"( <br />(#"#$('%!("!'#$$&('!$#(('!((!%!""(&##(%&$!!('(#(#%#!$&((#!!!(((((((!(!!!(!(!!( % <br />Additional Insured as respect the General Liability, Auto Liability and pursuant to a written contract. <br />$$$$($ <br />! <br />( <br />!!! <br />"($" <br />%# <br />($ <br /># <br />$$ <br />!# <br />( <br />! <br />"" <br />'#! <br />" <br /># <br />($& <br />!#### <br />( <br />CERTIFICATE HOLDERCANCELLATION <br />!!! <br />$"($" <br />'#% <br />$$ <br /># <br />$ <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />! <br />( <br />! <br />$""" <br />EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE <br />' <br />$" <br />#'#% <br />POLICY PROVISIONS. <br />$$ <br />!# <br />( <br />!! <br />"$ <br />! <br />( <br />City of Santa Ana <br />AUTHORIZED REPRESENTATIVE <br />!'!# <br />"""& <br />Risk Management Division <br /># <br />($ <br />'!!! <br />20 Civic Center Plaza, 4th Floor& <br />% <br />((""& <br />' <br />Santa Ana CA 92701 USA <br />& <br /># <br />($& <br />!!! <br />( <br />! <br />( <br />! <br />( <br />! <br />((((((((!(!(!(!!!((('"'"'!%&&("""!((''"(!!'$!%&&($!(&&$"#('($&!'#"!!($'%"&(("%($#""#!('$%"&"!#"(("""#!(%'#"%!'($'(&&"$!(%''#'("(((((((( <br />©1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03) <br />The ACORD name and logo are registered marks of ACORD <br /> <br /> <br />