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AC�ORG)� CERTIFICATE OF LIABILITY INSURANCE
<br />D12/10I//200212/10
<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
<br />Willis Towers Watson Northeast, Inc.
<br />c/o 26 Century Blvd
<br />P.O. Box 305191
<br />CONTACT Willis Towers Watson Certificate Center
<br />NAME:
<br />AICNNo Ez, 1-877-945-7378 F No: 1-868-967-2378
<br />E-MAIL
<br />ADDRESS: certificates@Willi a. one
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC#
<br />Nashville, TN 372305191 USA
<br />INSURER A: ACE American Insurance Company
<br />22667
<br />INSURED
<br />Pitney Bowes Inc.
<br />3001 Sumner Street
<br />INSURERB: Commerce 6 Industry Insurance Company
<br />19410
<br />INSURER C: Indemnity Insurance Company of North Ameri
<br />43575
<br />INSURERD; ACE Fire Underwriters Insurance Company
<br />20702
<br />Stamford, CT 06926
<br />INSURER E: National Fire S Marine Insurance Company
<br />20079
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: W23052463 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 />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />SUBR
<br />POLICYNUMBER
<br />POLICY EFF
<br />MMI�DIY1YY
<br />LIMITS
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 2,000,000
<br />CLAIMS -MADE X OCCUR
<br />DAMAG TORENT
<br />PREMISES Es occurrenEDce
<br />$ 300,000
<br />VIED EXP (Any one person)
<br />$ 5,000
<br />A
<br />y
<br />HDO G72491075
<br />07/01/2021
<br />07/01/2022
<br />PERSONAL&ADV INJURY
<br />$ 2,000,000
<br />GENT AGGREGATE LIMIT APPLIES PERT
<br />GENERAL AGGREGATE
<br />$ 4,000,000
<br />X POLICY ❑ PRO- ❑ LOC
<br />ECT
<br />PRODUCTS-COMPIOP AGG
<br />$ 4,000,000
<br />$
<br />OTHER:
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />2,000,000
<br />$
<br />)(
<br />BODILY INJURY (Per person)
<br />$
<br />ANVAUTO
<br />A
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />ISA 925550511
<br />07/01/2021
<br />07/01/2022
<br />BODILY INJURY (Per accident)
<br />$
<br />HIRED NON -OWNED
<br />AUTOS ONLYPAUTOSONLY
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />B
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 5,000,000
<br />AGGREGATE
<br />$ 5,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />66323214
<br />07/01/2021
<br />07/01/2022
<br />DED RETENTION
<br />$
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />OFFICE MEMB R/PARTNERIE%ECUTIVE YIN
<br />OFFICEPRIET RIPARTERIEX No
<br />(Mandatory In NH)
<br />NIA
<br />WLR C67814630
<br />07/01/2021
<br />07/01/2022
<br />x I STATUTE I ERH
<br />E.L. EACH ACCIDENT
<br />$ 2,000,000
<br />E.L. DISEASE - FA EMPLOYEE
<br />$ 2,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE -POLICY LIMIT
<br />$ 2,000,000
<br />A
<br />Workers Compensation and
<br />WLR C67814678
<br />07/01/2021
<br />07/01/2022
<br />E.L. Each Accident
<br />$2,000,000
<br />Employers' Liability
<br />E.L. Disease -Ea Map.
<br />$2,000,000
<br />Per Statute
<br />E.L. Disease Policy
<br />$2,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
<br />This Voids and Replaces Previously Issued Certificate Dated 06/29/2021 WITH ID: W21417247.
<br />SEE ATTACHED
<br />City of Santa Ana
<br />Risk Management Division
<br />20 Civic Center Plaza
<br />Santa Ana,, CA 92702
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />114
<br />© 1988-2016 ACORD
<br />REVIEWED & APPP(R��;A4O�/,tV�ED BY.
<br />F`tAf,aN �. VWaRt
<br />Risk ManagementAnalyst
<br />ACORD 25 (2016103)
<br />The ACORD name and logo are registered marks of ACORD
<br />an Tn: 21927888 BATCH: 2336113
<br />
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