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Samantha Digitally signed by
<br />5amantha A Lambert Page 1 of 2
<br />bA I i_, Date: 20220331
<br />ACORO I3a5e11-07W'
<br />`R CERTIFICATE OF LIABILITY INSURANCE
<br />DATE IMMMDNYYY)
<br />03/17/2022
<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 lieu of such endorsement(s).
<br />PRODUCER
<br />Willis Towers Watson Northeast, Inc.
<br />c/o 26 Century Blvd
<br />P.O. Box 305191
<br />CONTACT Nancy Ewong
<br />NAME:PHONE
<br />877-945-7378 FAX 1-888-467-237e
<br />.
<br />Nashville, IN 372305191 USA
<br />INSURERS AFFORDING COVERAGE
<br />NAIC9
<br />INSURERA: Hartford Underwriters, Insurance Company
<br />30104
<br />INSURED
<br />Blender Beloo Electric, Inc.
<br />INSURERS: Eaztford Fire Insurance Company
<br />19682
<br />INSURER C: Navigators Insurance Company
<br />42307
<br />14320 Albers Way
<br />Chino, CA 91710
<br />INSURER D: Sentinel Insurance Company Ltd
<br />11000
<br />INSURER E: tQarkel Insurance Company
<br />38970
<br />INSURER F: Indian Harbor Insurance Company
<br />36940
<br />CUVtKAGEB CERTIFICATE NUMBER: M4171498 SiPwRinki NIIMIRFG•
<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 />ILTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />JNM
<br />SUBS
<br />VIVO
<br />POLICY NUMBER
<br />POLICY EFF
<br />MWDD
<br />POLICY EXP
<br />MMIDO
<br />LIMITS
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />DtAIM$-MADE X OCCUR
<br />EACHOCCURRENCE$
<br />1,000,000
<br />DREMIAMAG ES RENTED
<br />PREMISES Ea occurrence)
<br />$ 300,000
<br />MEO EXP (Any one peman)
<br />$ 10,000
<br />A
<br />y
<br />y
<br />10 USA HF1471
<br />11/01/2021
<br />11/01/2022
<br />PERSONAL A ADV INJURY
<br />$ 1,000,000
<br />AGGREGATE LIMIT APPLIES PER:
<br />POLICY Z JEC LOC
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />GEN'L
<br />PRODUCTS-COMP/OP AGG
<br />$ 2,000,000
<br />$
<br />OTHER:
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />Ea eceldent
<br />$ 1,000,000
<br />X
<br />ANY AUTO
<br />BODILY INJURY (Par person)
<br />$
<br />H
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />y
<br />y
<br />IOUEAHF1837
<br />11/01/2021
<br />11/01/2022
<br />BODILY INJURY Per accrued)
<br />( )
<br />$
<br />HIRED NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />C
<br />UMBRELLA LIAR
<br />X
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 5,000,000
<br />AGGREGATE
<br />g 5,000,000
<br />X
<br />EXCESS LIAR
<br />CLAIMS -MADE
<br />IS21EXC910906IV
<br />11/01/2021
<br />11/01/2022
<br />DED RETENTIONS
<br />$5,000,000 Part of
<br />$ 10,000,000
<br />D
<br />COMPENSATION
<br />AND
<br />REMPLOYERS'LABILITY YIN
<br />ANYPROPRIETOWPARTNEWEXECUTIVE
<br />OFFICER/MEMBEREXCLUDEDT
<br />(Mandetory in NH)
<br />If yes, descnba under
<br />N/A
<br />y
<br />10 MA AA6V06
<br />11/Ol/2021
<br />11/Ol/2022
<br />X SERS
<br />TATUTE ERI+
<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 />I $ 1,000,000
<br />DESCRIPTION OF OPERATIONS be.
<br />E
<br />Excess Liability
<br />PIIU.MIEUE100578
<br />11/01/2021
<br />11/01/2022
<br />$5, 000,000 part o£
<br />$10,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required)
<br />Certificate Holder is included as an Additional Insured as respects to General Liability and Auto Liability.
<br />General Liability and Auto Liability shall be Primary and Non-contributory with any other insurance in force for or
<br />which may be purchased by Additional Insured.
<br />SEE ATTACHED
<br />City of Santa Ana
<br />Risk Management Division, 4th Floor
<br />20 Civic Center Plaxa
<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 />©1
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
<br />as ID: 22343213 m+*ca: 2450760
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