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DATE IMMIDONYYYI y� AC pRD® 0910212021 CERTIFICATE OF LIABILITY INSURANCE ACCt#:21107366 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER LOCKTON AFFINITY, LLC P.O. BOX 879610 CONTACT NAME: LOCKTON AFFINITY, LLC PHONE INC. No, Ext). 888-828-8365 FAX INC. No): 913E524599 E-MAIL ADDRESS: KANSAS CITY, MO 64187-9610 INSURERS AFFORDING COVERAGE NAIC# INSURER A. Old Republic Insurance Company 24147 INSURED Cannon Corporation INSURER B 1060 Southwood Dr INSURER C: INSURER D: San Luis Obispo, CA 93401.581 J INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR1 ADDL.SUBRI POLICY EFF POLICY E%P LTR TYPE OFINSURANCE INSDI WVD POLICY NUMBER 1(MMIODMTTY) (MM)DDIYYYY) LIMITS COMMERCIAL GENERAL LIABILITY I EACH OCCURRENCE S "', DAMAGE TO RENTED ;� iT] CLAIMS- OCCUR ac 5 1 MED EXP Anyoneperson) . 5 PERSONAL 8 ADV INJURY S GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL ASI S POLICY nPRO- �cc LJ.IECT PRODUCTS-COMPIOP AGO 1 S OTHER S A 1 AUTOMOBILE LIABILITY X X I L315536-21 i09101/2021 0911112021 INED IN L LIMIT1 $ 1,Ooo,coc _ ! Ea accident FS ANY AUTO BODILY INJURY IPerperson) OWNED '. SCHEDULED iBODILY INJURY (Per accidten AUTOS ONLY _ AUTOS ) 5 HIRED NON -OWNED ;PROPERTY DAMAGE 5 AUTOS ONLY AUTOS ONLY UMBRELLA DAe OCCUR EACH OCCURRENCE EXCESS DAB �— CLAIMS -MADE AGGREGATE S S DEC 1 RETENTION $ vVORKERS COMPENSATION PER OTH- AND EMPLOYERSLIABILITY YIN _ I STATUTE ER ANYPROPRIEfORIP.ARTNER/EXECUDV E E.L. EACH ACCIDENT OFRCERIMEMBER EXCLUDED' NIA PV (Mandatory in NH) EL. DISEASE - EA EMPLOYEE If yes, describe under DESCRIPTION OF OPERATIONS below EL DISEASE -POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule, may be amached A more seen, is required) GPBR:f2FL5 POLICY PROVIDES PROTECTION FOR ANY AND ALL OPERATIONSIJOW PERFORMED By THE NAMED INSURED WHERE REQUIRED BY WRITTEN CONTRACT. CERTIFICATE HOLDER IS AN ADDITIONAL INSURED WHERE REQUIRED BY WRITTEN CONTRACT. WAIVER OF SUBROGATION INCLUDED BY WRITTEN CONTRACT. INSURANCE IS PRIMARY AND NON-0ONTRIBUTORY.City of Santa Ana, its ofcaba, agents and repdaenno— are Additional barrels withrespect to Auto Liability as required by women contract. Insurance is lenders and Non -Contributory. 300ays' Notice of Cancellation with 10 Days' Notice for Not -Payment of Premium In accordance enthrall, provisions. Project 9420194174-03. Cannon 0190815, City of Santa Ana Risk Management Division, 4th Floor 20 Civic Center Plaza Santa Ana, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ��'�(///. �R C( © 1988-2016 ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 76u Prkeddn �RidMarsagertesm Oa+iralNtle 00