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Francine R.
<br />Digitallysignedby
<br />Francine R. Villareal
<br />Villareal
<br />Date: 2022.01.28
<br />14:47:13-08'00'
<br />CERTIFICATE 4F LIABILITY INSURANCE
<br />ATE(MM1
<br />MO22
<br />Gtmno2x
<br />F
<br />THIS CERTIFICATE IS ISSUED AS A
<br />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 BELOW.
<br />THIS CERTIFICATE OF INSURANCE
<br />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
<br />an ADDITIONAL INSURED, the poliay(ies) must have ADDITIONAL INSURED provisions or be endorsed. if
<br />SUBROGATION IS WAIVED, subject to
<br />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 />Philadel hia PA Dffice
<br />CONTACT
<br />M
<br />a2HN , ; (866) 283-7122 FAIIC Nc a (600) 363-0105
<br />E-MAIL
<br />ADDRESS:
<br />100 North 18th street
<br />15th Floor
<br />INSURER(S) AFFORDING COVERAGE
<br />NAiC v
<br />Philadelphia PA 19103 USA
<br />INSURED
<br />INSURERA: National Fire Ins. Co. of Hartford
<br />20479
<br />Kanopy, Inc.
<br />781 Beach Street Suite 2nd Floor
<br />San Francisco CA 94109-1254 USA
<br />INSURERB: Indian Harbor insurance company
<br />36940
<br />INSURER C: The continental Insurance company
<br />35289
<br />INSURER D: Transportation Insurance CO.
<br />20494
<br />INSURERB: Valley Forge insurance Co
<br />120508
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER_ 5/0U913tT14hh REVISION NLIMRER_
<br />THIS 1S 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 />INSR
<br />TYPE OFINSURANC€
<br />ADDL
<br />SUER
<br />POLICY POLICY EFF
<br />PQLICY EXP
<br />LOAM
<br />A
<br />X
<br />COMMERCIAL GENERALLtABILRY
<br />Y
<br />608OG88803
<br />0 10
<br />V0295a
<br />EACH OCCURRENCE
<br />$1,000,000
<br />CLAIMS•MAOE X OCCUR
<br />DAMAGETORENTED
<br />PREMIS S Ea ocwrrenca
<br />000
<br />$1, 000 ,
<br />MED EX? (Any one person)
<br />$15 , 000
<br />..
<br />PERSONAL&ADVIN[A)hY
<br />$1,000,000
<br />GENLAGGREG(ATTE—L�IMITAPPLIES PFR
<br />GENERAL AGGREGATE
<br />$2,000,000
<br />X POLICY I IPAO. JECT �LOC
<br />I --I
<br />PRODUCTS -COMPIOPAGG
<br />$2,000,000
<br />OTHER:
<br />E
<br />AUTOMOBILE LULBILLTY
<br />Y
<br />BUA 6080688817
<br />06/09/2021
<br />06/09/2022
<br />COMBINEDSINrmt1mIT
<br />$1,(i00,Q0(i
<br />BODILY INJURY ( Per person)
<br />X ANYAUTO
<br />BODILY INJURY (Par acddent)
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />HIREDAUfOS NON.OWNED
<br />PROPERTYDAMAGE
<br />Per accident
<br />ONLY AUTOS ONLY
<br />C
<br />X
<br />UMBRELLA L[AB
<br />X OCCUR
<br />CUE6080688848
<br />06/09/2021
<br />06/09/2022
<br />EACH OCCURRENCE
<br />$15,000,000
<br />AGGREGATE
<br />$15 , 000 , 000
<br />EXCESS LtAB
<br />CLAIMS -MADE
<br />ICED X RETENTION $10,000
<br />C
<br />WORKFRSCOMPENSAY10MAXD
<br />WC680688920
<br />06/09/2021
<br />06/09/2022
<br />X
<br />I PER STATUTE
<br />OTN
<br />EMPLOYERS' LIABL TY YIN
<br />WC (ADS)
<br />E.L.EACH ACCIDENT
<br />$1,000,000
<br />D
<br />PROPIRMTOR PARTNER 7 xECUTiVE N
<br />O
<br />WC680689834
<br />06/09/2021
<br />06/09/2022
<br />FI ER1M BM"CLU EDI
<br />{Mandatory In NH)
<br />NIA
<br />WC (CA)
<br />E.L. D:SEASE-EA EMPLOYEE
<br />$1,000,000
<br />If ye3. OESCRIunder
<br />PT ON OF OPERATIONS below
<br />E.L. DrSEASE-POLICY LIMIT
<br />11,000,000
<br />B
<br />Cyber Liability
<br />MTP904130201
<br />07/09/2021
<br />07/09/2022
<br />Per Claim/Aggregate
<br />$5,000,000
<br />Tech E&0 / Prof Liab
<br />SIR per Aggregate
<br />$750,000
<br />SIR applies per policy ter I
<br />ns & condi
<br />ions
<br />DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101. AddMonal Remarks Schedule, may he attached a 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 Noncontributory to other insurance available to an Additional Insured, but onlyy '
<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 Tft
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
<br />EXPIRATION DATE THEREOF, NOTICE WILL. BE DELIVERED rN ACCORDANCE WITH THE
<br />POLICY PROVISIONS.
<br />city of Santa Ana AUTHORIZED REPRESENTATIVE
<br />Risk Management Division
<br />20 civic Center Plaza, 4th floor r llr�
<br />Santa Ana CA 92702 USA C✓..1�
<br />01988.2015 ACORD CO
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
<br />Risk Management Divilsbn
<br />,F RE1/IEWED & APPROVM BY.
<br />�, ,'
<br />I'MT!� Risk Management Analyst
<br />
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