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Francine R. Digitally signed by
<br />Francine R. Villareal
<br />Date: 2022.02.02
<br />Villareal
<br />09:48:27-08'00'
<br />CERTIFICATE OF LIABILITY
<br />DATE(
<br />I
<br />INSURANCE
<br />2IDDNY
<br />1007aO21
<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 endom ment(s).
<br />PRODUCER
<br />ADDNAME:
<br />inns i OH cesOff Northeast, Inc.
<br />Cincinnati
<br />Ci4Cl Monti OH Office
<br />8044 Montgomery Road
<br />Suite 405
<br />CONTACT
<br />INC. j
<br />o. Eery: (866) 283-7122 rc. xa.l: (800) 363-0105
<br />E-MAIL
<br />ADDRESS:
<br />Cincinnati OH 45236-2919 USA
<br />INSURERISI AFFORDING COVERAGE
<br />NAICN
<br />INSURED
<br />Greyhound Lines, Inc.
<br />350 N St Paul Street
<br />INSURERA: AGE Property & Casualty Insurance Co.
<br />20699
<br />INSURER B: National union Fire Ins Co of Pittsburgh
<br />19445
<br />Dallas TX 7S201 USA
<br />INSURER C: AIL Insurance Company
<br />19399
<br />INSURERD:
<br />NSURERS:
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: 570090547909 R
<br />EVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR
<br />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
<br />HEREIN IS SUBJECTTO ALL THE TERMS,
<br />Limits shown are as requests
<br />IDOL SUER POLICY EXPI
<br />iR TYPE OF INSURANCE MMIOOryYYY1
<br />INSO WVO POLICY NUMBER 1 IMMIDD/YYYY I UNITS
<br />a
<br />Y
<br />65472U1
<br />lO 21 2O 1
<br />041u1120ZZ
<br />EACHOCCURRENCE
<br />$10,000,00
<br />CI -AIMS -MADE [ OCCOR
<br />jCOMMEROALGENERALLOSILITY
<br />PREMISES IEa Monrenc,
<br />$5,000,UU
<br />MEO EXP IAny one pe,wnl
<br />PERSONAL a AOV INURY
<br />$101000100
<br />GEN'L AGGREGATE LIMIT APPLIES PER
<br />X PRO_
<br />POLICY ❑JECT ❑ LOC
<br />GENERALAGGREGATE
<br />$10,000,00
<br />PRODUCTS - COMP/OP AGO
<br />$lU, UUU, UU
<br />OTHER:
<br />a
<br />AUTOMOBILE LIABILITY
<br />Y
<br />7031017
<br />10/21/202104/01/2022
<br />COMBINED SINGLE UMn
<br />ADS
<br />IEaamdeml
<br />$10,000100
<br />BODILY INJURY I Perpe,Sonl
<br />B
<br />X ANY AUTO
<br />7031018
<br />10/21/2023
<br />04/01/2022
<br />OWNED CREIXILED
<br />AUTCrA
<br />VA
<br />POORLY INJURY(Per a¢peN)
<br />B
<br />AUTOS ONLY
<br />NON
<br />7031019
<br />10/21/2021
<br />04 O1 2022
<br />PROPERTY
<br />LIREOAUIOS -OWNED
<br />oxLY AUTOS ONLY
<br />MA
<br />DAMAGE
<br />(Per a«amN
<br />A
<br />%
<br />UMBRELLALwB
<br />X
<br />XEUG72512832001
<br />04/01/2021
<br />04/01/2022
<br />EACH OCCURRENCE
<br />$5, Door 000
<br />Ho
<br />SIR applies per policy terns
<br />& condi
<br />ions
<br />AGGREWTE
<br />E5,000, 000
<br />EXCESS LIAR
<br />CLAIMbMAOE
<br />OED
<br />I X IRETENTION
<br />L
<br />WORKERS
<br />O ERSCOIYERS'ABILTTYION AND
<br />WC65885824
<br />10/21/202104/01/2022
<br />X
<br />PER STATUTE
<br />lx
<br />ANY EXECUTIIVE OEFHMCCEWMEMBERN
<br />N/A
<br />WE5885825
<br />10/21/2021
<br />04/Ol/2022
<br />EL EACHACCIDENT
<br />$3,000,000
<br />lManEarre In N nl
<br />deacdhe
<br />JAO:L
<br />NY
<br />E L DISEgBE£A EMPLOYEE
<br />$3,000, 000
<br />D S
<br />OEBLRIPTION OF OPERATIONS EeIow
<br />OF
<br />EA_ DISEASE -POLICY LIMIT
<br />$3,000,00U
<br />DESCRIPTION OF OPERATIONS ILOCATIONS I VEHICLES IACORD 101, Ad Ulleal ReDI Schetlule. may Le allacMN N,mre sp... le'Reen,
<br />RE: RFP No. 15-089- BUS Passenger Services- Santa Ana Regional Transportation Center. City of Santa Ana, officers,
<br />agents,
<br />employees, and volunteers are included as Additional Insured in accordance with the policy provisions of the General Liability
<br />and Automobile Liability policies. General Liability and Automobile Liability policies evidenced herein are Primary and
<br />Non -Contributory to other insurance available to Additional Insured, but only in accordance with the policy's provisions.
<br />Should General Liability policy be cancelled before the expiration date thereof, the policy provisions of each policy will
<br />how
<br />govern notice of cancellation may be delivered to certificate holders in accordance with the policy.
<br />CERTIFICATE HOLDER CANCELLATION
<br />City of Santa Ana
<br />Risk Management Division
<br />20 Civic Center PlaZa
<br />Santa Ana CA 92702 USA
<br />©1988-2016 ACORD CORPOI
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
<br />SHOULD ANY OF THE ABOVE OESaRI8EO POLICIES BE CANCELLED BEFORE THE EXPIRATION
<br />DATE THEREOF. NOTICE WILL BE OE WEREO IN ACCORDANCE WRH THE POLICY PROVISIONS.
<br />✓LOTS Vff.E1W�V/R ilk lllI,,,,,.,.,, .,,,,,.�..,.��.T,
<br />D
<br />N REVIEWE•& APPROVED
<br />BY-
<br />RiskManageOnentAnayst
<br />00
<br />
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