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A-2021-165-01 eHEALMAN-01 Digitally,
<br />.4`oRo CERTIFICATE OF LIABILI E by MjlirDD/YYYY)
<br />_ y / 12022
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON TH'. CL)'(.Fe ®ER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND CCCCCC���J ALTER THE COVERA F AFFG.-OED BY THE POLICIES
<br />REPRESENTATIVE IS CERTIFICATE OF OR PRODUCER,INSURANCE AND THE CERTIFICATE EES THOLDER'. A CONAgre>�f;l ler�ls� 0.`E)--.L9a1MT2°21ff$ 13
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) musthaveADDITIONAL �VSURED p'��iCliCts�5rt7 o 7 eo�760o
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may r<4uire an endorsement.' at
<br />on
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsemeni
<br />PRODUCER
<br />rho son Flanagan Executive Liability Group
<br />i26 W. Jackson Blvd. 5th Floor
<br />7hicaoo. IL 60661
<br />INSURED
<br />Health Management Associates, Inc.
<br />120 N. Washington Square, #705
<br />Lansing, MI 48933
<br />I jA)c No E%U: (312) 239-2812 1 (m"c. N.A312) 263-1551
<br />rnVPRArce renrro
<br />_—_--.-... •—•••—•-"•••"�••• RGVIJIVK NUMULK:
<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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAYBE 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 />—DI
<br />INSRLTR
<br />TYPE OF INSURANCE
<br />AD
<br />INSO
<br />SUER
<br />POLICY NUMBER
<br />POLICY EFF
<br />MDD
<br />4/1512022
<br />POLICY Up
<br />MM
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE �X OCCUR
<br />Owner's & Contractor
<br />X
<br />X
<br />630-SP53244A
<br />4TA'SIM3
<br />EACH OCCURRENCE
<br />1,000,000
<br />DAMAGETo RENwD
<br />300,000
<br />S, OOO
<br />X
<br />Le
<br />MED EXPAn one arson
<br />X
<br />XCU included
<br />PERSONAL& ADV INJURY
<br />$ 1,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICY [:] PRO ❑X LOC
<br />GENERAL AGGREGATE
<br />2,000;ODO
<br />PRODUCTS-COMPIOPAGG
<br />2,OOQ000
<br />COMBINED SINGLE LIMB idi
<br />$ 1;0003'000
<br />$
<br />B
<br />OTHER:
<br />AUTOMOBILE LIABILITY
<br />ANYAUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTO�{JS�yyry
<br />X AUTOS ONLY X AUTOS ONLY
<br />BA-8P532647
<br />4/15/2022
<br />4/1512823
<br />BODILY INJURY Par arson
<br />BODILY INJURY Per accident)
<br />120PERN AMAGE
<br />Per acatlent
<br />$
<br />""000,000Excess
<br />B
<br />X �MBRELLALFAB X OCCUR
<br />LIAB CLAIMS -MADE
<br />CWP-SP533005
<br />4YI5/2022
<br />4'/15/2023
<br />10000,000OLD
<br />RETENTION$
<br />B
<br />WORKERS COMPERSAIRON
<br />AND EMPLOYERS' LIABILRYANY PROPRIEfOR/PARTNERIEXEGUTIVE YINUB-8P532740
<br />inN RE%CLUDEOP
<br />ateryin and
<br />Nunder
<br />OF OPERATIONS below
<br />NIA
<br />411512022
<br />4/1512023
<br />ARRENRENCE
<br />OriER
<br />IDENT
<br />1,000,000(MandaOFFIGERry
<br />-EA EMPLOYE
<br />1,000,000Ifyes,
<br />$Dyes,RIPTI
<br />POLICY LIMrr
<br />1,000,000DESCRIPTION
<br />C
<br />Pr'of-Liability
<br />0312-1907
<br />1/13/2022
<br />471Z2023
<br />Limit
<br />5,Wf80,0'80
<br />DESCRIPTION OF OPERATIONS I LOCATIONS VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
<br />The City of Santa Ana, its officers, officials, employees, and volunteers are to be covered as additional insureds on the CGL policy with respect to liability
<br />arising out of work or operations performed by or on behalf of the Contractor including materials, parts, or equipment furnished in connection with such
<br />work or operations. For any claims related to this contract, the Contractor's insurance coverage shall be primary coverage at least as broad as ISO CG 20
<br />01 0413 as respects the Entity, its officers, officials, employees, and volunteers. Any insurance or self-insurance maintained by the Entity, its officers,
<br />officials, employees, or volunteers shall be excess of the Contractor's insurance and shall not contribute with it.
<br />SEE ATTACHED ACORD 101
<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 />City of Santa Ana AUTHORIZED REPRESENTATIVE
<br />Community Development Agency RIAMonalianii2Center Plza X�®.antaAREVEWED
<br />ACORD 25 (2016/03) ©1988-2015 ACORD I®; A'F`b"s Ac4v4io
<br />The ACORD name and logo are registered marks of ACORD Risir Management speoalist
<br />
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