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ACORU® CERTIFICATE OF LIABILITY INSURAN E "�n <br />rno22 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS U N TE Hot . ER. IS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AF9nDED BY THE HA iLmedo <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE I UI U 3 0HIff 7ED <br />REPRESENTATIVE OR PRODUCE AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(ins) must have ADDITIONAL IN R D pmv elons or tv: enirc m2�dd.,,, <br />If SUBROGATION IS WANED, subject to the terms and conditions of the policy, certain policies may require an endoreemeAt A statemeil 606:50 -07' <br />this certificate tines not confer rt hts to the certificate holder In lieu of such endomoment s . <br />PRODUCER <br />ELMCO INSURANCE, INC. <br />1906 N. Main Street <br />CONTACT ELMCO INSURANCE, INC. <br />' <br />A/CNNo. Exl : (714) 973-1438 <br />No ; (71d) 973-0811 <br />Santa Ana CA 92706-2779 <br />EMAIL eomact@Elmwlnsumnee.com <br />ADDRESS <br />INSURER(S) AFFORDING COVERAGE <br />NAIC # <br />Agency Lica: 0509747 <br />INSURER A: SCOTTSDALE INSURANCE COMPANY <br />41297 <br />INSURED <br />CALIFORNIA BARRICADE RENTALS INC. <br />1550 E. SAINT GERTRUDE PLACE <br />INSURER B: INFINITY SELECT INSURANCE COMPANY <br />20260 <br />INSURER C: TRISURA SPECIALTY INSURANCE COMPANY <br />16188 <br />INSURER D: STATE COMPENSATION INSURANCE FUND <br />36076 <br />SANTA ANA CA 92705 <br />INSURER E: WESTCHESTER SURPLUS LINES INSURANCE CO <br />10172 <br />INSURER F: HISCOX INSURANCE COMPANY INC <br />10200 <br />GOVERAGES GERTIFICATE NOMRER: 7n949 REVISION NIJMRER- <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 SUCHPOLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADUL <br />1118111 <br />eUBR <br />IWO <br />POLICY NUMBER <br />POLICY EFF <br />DATE(MEUOD/Y11 <br />PDLIOY EXP <br />DATB(MM DNY) <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE OCCUR <br />X <br />X <br />BCS0039369 <br />07/01121 <br />07/01/22 <br />EACH OCCURRENCE <br />$ 1000000 <br />DAMAGE TO RENTED <br />PREMISES Ea ocrurancs <br />$ 100000 <br />MED EXP (Any one person) <br />g <br />PERSONAL a ADV INJURY <br />$ 1000000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />]q POLICY ❑ PRI E] LOC <br />OTHER: <br />GENERALAGGREGATE <br />$ 2000000 <br />PRODUCTS-COMP/OP AGG <br />$ 2000000 <br />EMPLOYEE BENEFITS <br />$ 1000000 <br />S <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />OWNED r7 SCHEDULED <br />AUTOS ONLY AUTOS <br />HIRED X NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />X <br />X <br />604-61015-8309-001 <br />07/01/21 <br />07101/22 <br />COMBINEDSINGLE LIMIT <br />g 1,000,000 <br />X <br />BODILY INJURY (Per person) <br />$ <br />BODILY INJURY (Per acdden0 <br />$ <br />X <br />PROPERTY DAMAGE <br />(Per ao iderd) <br />$ <br />It <br />C <br />UMBRELLA LIA <br />EXCESS LIAR <br />X <br />OCCUR <br />CWMS-MADE <br />1 <br />TXS0001452-02 <br />07/01/21 <br />07/01/22 <br />1 <br />EACH OCCURRENCE <br />$ 5,000,000 <br />X <br />AGGREGATE <br />It 5,000,000 <br />IDED1 IRETENTION $ <br />$ <br />D <br />WORKEPSCOMPOMT[ON <br />AND EMPLOYERS' LIABILITY <br />AtIYPROPRIETOR/PAaTNBRIEXECI1rrvE YIN <br />OFFICER/u MBai EXCLUDEDI <br />(uaww.'1nml) <br />IIm� r <br />DESCRI"MNOFCFE TIONSWI. <br />NIA <br />X <br />9063608-21 <br />07/01/21 <br />OTMW22 <br />X PE" oTw <br />E.L. EACH ACCIDENT <br />$ 1,000,000 <br />E.L DISEASE -EA EMPLOYEE <br />$ 1,000,000 <br />E.L.DISEASE POLICY LIMIT <br />$ 1.000,000 <br />E <br />F <br />POLLUTION LIABILITY <br />PROFESSIONAL LIABILITY <br />G73640124001 <br />MPL1863490.21 <br />07/01/21 <br />07/01/21 <br />07/01122 <br />07JO1122 <br />Each Pollution Conditic <br />Each Claim <br />n $1,000,000 <br />$2,000A00 <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If mare space la required) <br />See Attached Supplement <br />CERTIFICATE HOLDER <br />City of Santa An <br />Risk Management Division <br />20 Civic Center Plaza <br />4th Floor <br />Santa Ana, CA 92702 <br />Attention: <br />Certificate # <br />9 <br />.26 <br />01 <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY <br />lPRO/OVIS/IIOONSS <br />Richard CampoliLic # r <br />" Dh&zn <br />®1988-2015 ACORD C01%REYItwED & APPROVED Br.The ACORD name and logo are registered marks of ACORDA41u Aaa44 <br />Risk Management Specialist <br />