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Angie
<br />Digitally signed
<br />by Angie Acevedo
<br />r_%_4._.-%f%-%-% f%c -%�
<br />A �® CERTIFICATE OF LIABILITY AaweidQ v .-1108,�,00,
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON TVd 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 />PRODUCER
<br />Aon Risk Services Central, Inc.
<br />Philadelphia PA Office
<br />CONTACT
<br />NAME:
<br />(A/CN o. Ext): C866) 283-7122 C No.): (800) 363-0105
<br />E-MAIL
<br />ADDRESS:
<br />100 North 18th street
<br />15th Floor
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC #
<br />Philadelphia PA 19103 USA
<br />INSURED
<br />INSURER A: Indian Harbor Insurance Company
<br />36940
<br />Kanopy, Inc.
<br />781 Beach Street suite 2nd Floor
<br />San Francisco CA 94109-1254 USA
<br />INSURER B: The Continental Insurance Company
<br />35289
<br />INSURERC: Valley Forge Insurance Co
<br />20508
<br />INSURER D: National Fire Ins. Co. of Hartford
<br />20478
<br />INSURERE: Transportation Insurance Co.
<br />20494
<br />INSURER F.
<br />COVERAGES CERTIFICATE NUMBER: 570093500211 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. Limits shown are as requested
<br />LTR
<br />TYPE OF INSURANCE
<br />INSD
<br />WVD
<br />POLICY NUMBER
<br />MM/DD/YYYY
<br />MM/DD/YYYY
<br />LIMITS
<br />D
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />09 2023
<br />EACH OCCURRENCE
<br />$1, 000, 000
<br />CLAIMS -MADE X❑ OCCUR
<br />PREMISES Ea occurrence
<br />$1, 000, 000
<br />MED EXP (Any one person)
<br />i15,000
<br />PERSONAL& ADV INJURY
<br />$1,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />$2,000,000
<br />X POLICY ❑ PRO ❑ LOC
<br />JECT
<br />PRODUCTS - COMP/OP AGG
<br />$2,000,000
<br />OTHER:
<br />C
<br />AUTOMOBILE LIABILITY
<br />Y
<br />BUA 6080688817
<br />06/09/2022
<br />06/09/2023
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$1, 000, 000
<br />BODILY INJURY ( Per person)
<br />X ANY AUTO
<br />BODILY INJURY (Per accident)
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />HI RED AUTOS NON -OWNED
<br />PROPERTY DAMAGE
<br />ONLY AUTOS ONLY
<br />Per accident
<br />B
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />CUE6080688848
<br />06/09/2021
<br />06/09/2022
<br />EACH OCCURRENCE
<br />$15,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />AGGREGATE
<br />$15,000,000
<br />DED I X RETENTION $10, 000
<br />B
<br />WORKERS COMPENSATION AND
<br />WC680688820
<br />06/09/2022
<br />06/09/2023
<br />X I PER STATUTE I OTH-
<br />ER
<br />EMPLOYERS' LIABILITY Y/ N
<br />WC (ADS)
<br />E.L. EACH ACCIDENT
<br />$1, 000 , 000
<br />E
<br />ANY PROPRIETOR / PARTNER / EXECUTIVE
<br />WC6080688834
<br />06/09/2022
<br />06/09/2023
<br />OFFICER/MEMBER EXCLUDED?
<br />(Mandatory in NH)
<br />N/A
<br />WC (CA)
<br />E.L. DISEASE -EA EMPLOYEE
<br />$1, 000, 000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE -POLICY LIMIT
<br />$1, 000, 000
<br />A
<br />Cyber Liability
<br />MTP904130201
<br />07/09/2021
<br />07/09/2022
<br />Per Claim/Aggregate
<br />$5,000,000
<br />Tech E&O / Prof Liab
<br />SIR per Aggregate
<br />$750,000
<br />SIR applies per policy terns
<br />& condi
<br />ions
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required)
<br />City of Santa Ana, Risk Management, it's officers, employees, agents, representatives and volunteers are included as Additional
<br />Insured in accordance with the policy provisions of the General Liability and Automobile Liability policies. General Liability
<br />policy evidenced herein is Primary and Non -Contributory to other insurance available to an Additional Insured, but only in
<br />accordance with the policy's provisions. • Should any of the above policies be canceled or modified the certificate holder
<br />shall receive a 30 days prior written notice.
<br />CERTIFICATE HOLDER CANCELLATION
<br />City of Santa Ana
<br />Risk Management Division
<br />20 Civic Center Plaza, 4th floor
<br />Santa Ana CA 92702 USA
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
<br />EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE
<br />POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />©1988-2015 ACORD
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
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<br />Risk kluagment Division
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<br />REVIEWED & PROVED BY:
<br />Aeevaa
<br />'�--'Risk Management Specialist
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