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<br />MGTOFAM-O7
<br />ACORO DATE IMMm CERTIFICATE OF LIABILITY INSURANCE omrYlslzalzo2l
<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 lien of surH o..n...eem—oi.%
<br />PRODUCER
<br />Earl Bacon Agencyy, Inc.
<br />Post Office Box 12039
<br />Tallahassee, FL 32317
<br />INSURED
<br />MGT of America, LLC
<br />MGT of America Consulting, LLC
<br />4320 West Kennedy Blvd.
<br />Tampa, FL 33609.2118
<br />r.nVPRAr:CS
<br />THIS
<br />INDICATED.
<br />CERTIFICATE
<br />EXCLUSIONS
<br />INSR
<br />_ --- "'"'
<br />IS TO CERTIFY THAT THE POLICIES
<br />NOTWITHSTANDING ANY REQUIREMENT,
<br />MAY BE ISSUED OR MAY
<br />AND CONDITIONS OF SUCH
<br />TYPE OF INSURANCE
<br />"'^"
<br />OF
<br />PERTAIN,
<br />POLICIES.
<br />ADOL
<br />INSURANCE
<br />SUBR
<br />""'•'��^•
<br />LISTED BELOW HAVE BEEN
<br />TERM OR CONDITION OF
<br />THE INSURANCE AFFORDED BY
<br />LIMITS SHOWN MAY HAVE BEEN
<br />POUCYNUMBER
<br />ISSUED
<br />ANY CONTRACTOR
<br />THE POLICIES
<br />REDUCED BY
<br />POLICY EFF
<br />TO THE INSURED
<br />OTHER
<br />DESCRIBED
<br />PAID CLAIMS.
<br />POLICY EXP
<br />REVIS ON NUMBER
<br />NAMED ABOVE FOR THE
<br />DOCUMENT WITH RESPECT
<br />HEREIN IS SUBJECT
<br />UMR9
<br />POLICY PERIOD
<br />TO WHICH THIS
<br />TO ALL THE TERMS,
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CH OCCURRENCE
<br />DAMAGE TO RENTED
<br />g 11000,000
<br />5 300,000
<br />CLAIMS -MADE X OCCUR
<br />X
<br />X
<br />5095130327
<br />7/112021
<br />7/112022
<br />MED EXP (Am one Persorl
<br />15,000
<br />PERSONAL B ALAI INJURY
<br />S 11000,000
<br />GENL AGGREGATE LIMIT APPUES PER:
<br />POLICY j LOC
<br />OTHER
<br />GENERAL AGGREGATE
<br />PRODUCTS -COMPgPAGO
<br />S 2,000,006
<br />2,000,000
<br />COMBINED SINGLE LIMIT
<br />BODILY INJURY Per coon
<br />BODILY
<br />S 1,000,000
<br />S
<br />s
<br />A
<br />JX
<br />AUTOMOBm UABILRY
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUUpTI�O.pSS EE
<br />ALTOS ONLY X AUTOSON,L�
<br />XX
<br />2093563501
<br />711/2021
<br />711/2022
<br />5
<br />OPERNJURYAGEazciaent
<br />TY
<br />Per acr�tlenl
<br />g
<br />EACH OCCURRENCE
<br />A RE TE
<br />S
<br />S 6,000,000
<br />g 5,000,000
<br />C
<br />UMBRELLA UAS X OCCUR
<br />EXCESS LIAe CLAIMS -MADE
<br />NIA
<br />X
<br />2093563 995
<br />O111086788
<br />71112D21
<br />711/2021
<br />71112022
<br />7/112022
<br />DED X RETENTIONS 10,000
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETO"ARTNERIEXECUTIVE IN
<br />OFFIC /MEMBIER EXCLUDED)
<br />JoChi Dry In NH)
<br />Cris Mgmit Expen
<br />X PER OER TH-
<br />300,000
<br />EL. EACH ACCIDENT
<br />g 1,000,000
<br />D
<br />B
<br />ifyyes nescnbe antler
<br />DESCRIPDON OF OPERATIONS W.
<br />Cyber Liability
<br />Professional and
<br />H21NGP208777.00
<br />652348448
<br />71112021
<br />711/2021
<br />7I1/2 222
<br />71112022
<br />EL SEASE-EA EMPLOYE
<br />S 1,000,000
<br />EL DISEASE LIMIT
<br />OCC & AGG
<br />E & O Liability
<br />S 1,000,0D0
<br />5,000,000
<br />61000,000
<br />DESCRIP
<br />ONS I 11
<br />f Blanket Additional Insured per aTttached forms BlanketRD tWaiver of 3 broROOMgation par attachbe ed orms Nof MOMttceeof Cancellation to Certificate Holders per attached
<br />forms
<br />Stop Gap Liability Coverage for Ohio and Washington 500,0001500,000l6o0,0go
<br />THE CITY OF SANTA ANA, IT'S OFFICERS. EMPLOYEES, AGENTS, AND REPRESENTATIVE ARE NAMED AS ADDITIONAL INSURED IN REGARDS TO
<br />GENERAL LIABILITY PER ATTACHED CNA74879XX & CNATS079XX BLANKET ADDITIONAL INSURED FORMS.
<br />SEE ATTACHED ACORD 101
<br />CPRTIPICATR Uni MCR
<br />City of Santa Ana
<br />Risk Management
<br />20 Civic Center Plaza (M•30)
<br />ACORD 25 (2016103)
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES SE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROM
<br />AUTHORIZED REPRESENTATIVE - xek tPNOOM
<br />ReneAE06Arraw®Ev
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<br />rtaxma,,,yamn om�Iaa�
<br />©1988-2015 ACORD CC
<br />The ACORD name and logo are registered marks of ACORD
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