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<br />.d►�oizn CERTIFICATE OF jPRANCr= OATE8/20�/YYY)
<br />r - e 22
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND�FERS NO RIGHTS' IP -) THE CCFI ATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE Cr VEf. ERTIYTHE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONS UTE A CONTRACT BETW N THE Ib, IIING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDE ' rr �1I ^
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURE , th t II��p�oV:slons or �e endorse .
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain poll. 1pP may requ/r�tatl dqr�� t. pn
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). G L,—�
<br />PRODUCER rciAo�JACT Janette Fompignano
<br />The Fedeli Group PHONE FA%
<br />5005 Rockside Road, Fifth Floor AIC, No, Ext: (216) 643-6657 tvc, No :(216) 328-8081
<br />Independence, OH 44131 1 1'oo"aIESS:JPompignano@thefedeligroup.com
<br />INSURED
<br />Blue Technologies Smart Solutions LLC
<br />5885 Grant Ave
<br />Cleveland, OH 44105
<br />COVERAGES CERTIFICATE NUMRFR- nFvlclnu NI IMRRO:
<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 SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR LTR
<br />TYPE OF INSURANCE
<br />INSO
<br />BWV13 URR
<br />POLICY NUMBER
<br />M POLICY EFF
<br />POLICY EXP
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS-MADELAj OCCUR
<br />X
<br />7014859669
<br />5/112022
<br />5/112023
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />PPREMISESO REME Be
<br />100 ggg
<br />15,000
<br />MEDEXP An one son
<br />PERSONALW
<br />RY
<br />1,000,000GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />� jSOT LOC
<br />GENERALA
<br />2,000,000POLICY
<br />PRODUCTSAGG
<br />2,000,000OTHER:
<br />$B
<br />AUTOMOBILE
<br />LIABILITY
<br />' ANY AUTO
<br />SCHEDULEDAUTOS ONLY AUTSBOpDILY
<br />ONLY AIOITNOSONLYPPeOacGe
<br />7014859672
<br />5/112022
<br />5/112023
<br />COMBBIIN�EEDIT
<br />$ 1.�000�0D0X
<br />BODILY INJson
<br />$OWNED
<br />INJident
<br />$AUTOS
<br />$
<br />C
<br />X
<br />UMBRELLA LIAB
<br />EXCESS LIAB
<br />OCCUR
<br />CLAIMS -MADE
<br />70W59686
<br />5/112022
<br />51112023
<br />EACH OCCURRENCE
<br />$ 5,000,000
<br />AGGREGATE
<br />5,000,000
<br />DED I X I RETENTION$ 10,000
<br />A
<br />WORKERS
<br />ND EMPLOYERS' LIABILITY
<br />YPROPRIETORIPARTNERIEXECUTNE YIN
<br />pFFICERIMEMggE�, EXCLUDED?
<br />in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />MIA
<br />7014859669
<br />5/112022
<br />51112023
<br />PER STATUTE X ER
<br />E.L. EACH ACCIDENT`Mandatory
<br />1,g0g,000
<br />E.L. DISEASE -EA EMPLOYEE
<br />$ 1,000,000
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 1,000,000
<br />D
<br />D
<br />Technology E&O
<br />Cyber Liability
<br />652335893
<br />652335893
<br />51112022
<br />5/112022
<br />511/2023
<br />511/2023
<br />Third Party
<br />Limit
<br />5,000,000
<br />5,000,000
<br />DESCRIPTION OF OPERATIONS LOCATIONS VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />City of Santa Ana, officers, agents, employees, and volunteers are included as additional insureds as required by written contract. Policy is primary and
<br />non-contributory and includes 30 day notice of cancellation.
<br />City of Santa Ana
<br />Risk Management Division
<br />20 Civic Center Plaza, 4th Floor
<br />Santa Ana, CA 92701
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />04
<br />ACORD 25 (2016/03) ©1988-2015 ACORD
<br />The ACORD name and logo are registered marks of ACORD
<br />liialeMawgemmtD[vislwt
<br />VREVIEWED&APPRW®BY:
<br />®' Risk Management SperrAht
<br />OF
<br />
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