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Tori Pierson Digitally signed by TonPienon
<br />ogee: 2021.10.07 Me 2:36-07'00•
<br />AR O® CERTIFICATE OF LIABILITY INSURANCE
<br />OA-M(MM Gzt�
<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 pollcy(les) 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 endorsement($).
<br />PRODUCER
<br />Kingdom Global Insurance Solutions, LLC
<br />CNAIaEoT Shawn Jin, Managing Member
<br />FNc No: 562-275-3156
<br />pd -. SJin(Ltti;kgisus.com
<br />&-.U'�.Ly"n@kglsus.com
<br />780 N. Euclid Street Suite 208
<br />INSURERSAFFURDINGCOVENAGE
<br />NAICB
<br />Anaheim, CA 92801
<br />INSURER A: Mesa Underwriters Specialty Insurance Company
<br />36838
<br />INSURED
<br />INSURER Bt Infinity Select Insurance Company
<br />20260
<br />HYM Engineering, Inc.
<br />INSURER C t Scottsdale Insurance Company
<br />41297
<br />INSURER D: Cypress Insurance Company
<br />10865
<br />1559 W. Commonwealth Ave.,
<br />Fullerton, CA 92833
<br />INSURER E: Certain Underwriters at IJoyd's of London
<br />15642
<br />INSURER F
<br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />OCCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />HISR
<br />L R
<br />TYPE OF INSURANCE
<br />ADDL
<br />SUM
<br />POUCYNUMIER
<br />POUCYEFF
<br />NWoDrIYYvi
<br />POUCYEXP
<br />(MMIDONYYY1Laws
<br />X
<br />COMNIERCNLGENERALHABn
<br />GWMS- DE IX-1 OCCUR
<br />EACHOCCURRENCE
<br />S 1,000.000
<br />DIUMETORENTED
<br />PREMISES acavrmrce
<br />S 100.000
<br />MED EXP Any we m n
<br />5 5,000
<br />pERSONpLggpyMJURY
<br />S 1,000,0110
<br />A
<br />Y
<br />Y
<br />MPOO82001003113
<br />0212712021
<br />02127/2022
<br />GEdLAGGREGATELIMMAPPLIES PER
<br />X POLICY ❑ JEGT[71 LOC
<br />GENERALAGGREGATE
<br />S 2.000,000
<br />PRODUCTS-COMPIOPAGG
<br />5 2.000,000
<br />$
<br />OTHER:
<br />AUTOMOBILELMR.FrY
<br />COMBINED BINDLE LIMIT
<br />Ee eWdenl
<br />S 1.000,000
<br />BODILYINJURY(Perprt )
<br />S
<br />X
<br />ANYAUTO _
<br />B
<br />X
<br />0ULED
<br />HOWN
<br />' NLY sAUGioa
<br />IRED X ROWNED
<br />AUrOS ONLY AUroS ONLY
<br />Y
<br />Y
<br />504-61013-659MOI
<br />03/20/2021
<br />03/20/2022
<br />sOU1LY INJURY (Per accident)
<br />S
<br />PROPERTYOAMAGE
<br />Per eNdaM
<br />g
<br />f
<br />UMBRELLALIAe
<br />X
<br />OCCUR
<br />EIICHOCCURRENCE
<br />S 4,000,000
<br />C
<br />X
<br />EXCESS LIM
<br />CLAIMS -MADE
<br />Y
<br />Y
<br />XLS0115304
<br />O1
<br />02/27/2022
<br />AGGREGATE
<br />S 4,000,000
<br />DEO I I MEN'rX)MCI
<br />is
<br />D
<br />WORKERS COMPENSATION
<br />MID EMPLOYERS' LIABILITY
<br />O>FIERIMIEMBEREXCLUOE�7ECUr7VE Y❑
<br />(Mandateryln NH)
<br />NIA
<br />Y
<br />HYWG218785
<br />0610812021
<br />061OW022
<br />I X PER ER
<br />E,L EACH ACCIDENT
<br />$ 1,000,000
<br />E.L OISEgSE-FA EMPLOYEES
<br />1,000,000
<br />11 yae, describe under
<br />DESCRIPTION OF OPERIkMNS below
<br />E.L DISEASE -PODGY LIMIT
<br />S 1,000,000
<br />E
<br />Errors & Omission Liability/
<br />Professional Liability
<br />PF00206A20
<br />08117/2021
<br />08/17/2022
<br />Each Occurrence
<br />Aggregate
<br />$1,OD0,000
<br />$2,000.000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, ANdltlanal Ramarka Schedule, maY bo attached Ifmoro spew isrequlredt
<br />Re:16-2658 SA Zoo Giant River Otter & Primate Trails, City of Santa Ana, its officers, employees, agents and representatives are Additional Insureds w/
<br />respect to General end Auto Liability per the attached endorsements as required by written contract. Certificate Holder are all named as additional Insured as
<br />respects to CG 2033 0413 and CG 201 011 85. Waiver of Subrogation Is Included as respects to certificate holder and to CG 2404 10 93 and WC 99 041 0
<br />Primary and non-contributory endorsement Is Included as respects to CG 20 0104 13
<br />30 Days Notice of Cancellation with 10 Days Notice for Non -Payment in accordance with the policy
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEUVERED IN
<br />City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Risk Management Division, 41h Floor
<br />ORQEO REPRESENTATIVE
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92701 Mar �`IDIk°"
<br />aenearnsArrxwmer:
<br />©1988-20i5 CORD CC •a' %c<N«.,a„
<br />ACORD 25 (21116103) The ACORD name and logo are registered marks of ACORD w all, ,w,,,a"n—, 0"�' lode
<br />
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