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oiga ly munm by mn Tori Pierson M'W" xoxz0a.xa /- N PROTE24 OP ID: RR '4`� CERTIFICATE OF LIABILITY INSURANCE DATE 022 oan 5nozz 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 endorsemen s . PRODUCER 877-242-9600 Central Insurance Agency, Inc. 93 East Main Street Smithtown, NY 11787 George Gavaris CONTACT Central Insurance Agency, Inc PHONE 877-'lag-9600 FAX 877-243-8995 A/C, No, EXt : AIC, No E-p AIL INSURERS) AFFORDING COVERAGE NAIC N INSURER A: Employers Compensation Ins. 11512 JNSURED "isPPO#11PO#1. ion America Inc.20313 P INSURERB; PeleusInsurance Company 34118 INSURER C: Sentinel Insurance Company11000 21350 Nordhoff St # 104C Chatsworth, CA 91311 United Financial Casualty INSURER 0: Y 11770 NSUREft E: NSURER F: COVERAGES CERTIFICATE NUMBER- RFVIRlnN MIIMRPR- 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. INSR TYPE OF INSURANCE DOL NSD UBR Mn POLICY NUMBER POLICY EFF 09119/2021 POLICY EXPIJJL 09/1912022 LIMITS B X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE [X] OCCUR Errors & Omission X X GLV0001152 EACH OCCURRENCE 1,000,000 DAMAGE TO RENTED Ea occurrence) 100,00PREMISES $ X X GEN'LAGGREGATE MEO EXP An one erson 5,000 Assault & Battery PERSONAL 8 AOV INJURY 1,000,000 LIMITAPPLIES PER: POLICY JELQT LOC OTHER: GENERALAGGREGATE 2,000.000 PRODUCTS-COMP/OP AGO 2,000,000 D AUTOMOBILE X X LIABILITY ANY TO OWNED OWNED SCHEDULED AUTOS ONLY AUTOS U��OppWN pp ONLY 041698621 04108/2022 10/08/2022 COMBINED SINGLE LIMIT 1 000 000 BODILY INJURY Per erson BODILY INJURY Per accitlenl QAMAGE IOaciiATOS UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE AGGREGATE DED F I RETENTION$ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNEWEXECUTIVE YIN Wan'SERIMEMggEqq E%CLUDEDP �Y (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA EIG2562084-04 11/06/2021 11/0612022 X PERTUTE OTH- E.L EACH ACCIDENT 1,000,000 E.1- DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMITC 1,000,000 Property 91SBAVL2993 04/26/2021 0412612022 Contents 10,000 DESCRIPTION OF OPERATIONS I LOCATIONS [VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) See page 2 for additional information CTYSTAN City of Santa Ana Risk Management Division 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. AUTHORIZED REPRESENTATIVE n"'s, RbrkMeugenvdIXWdon L7Jf i.., `g RenLv�eAmeax�8r. ACORD 25 (2016103) ©1988-2015 ACORD CC"----"�-" The ACORD name and logo are registered marks of ACORD