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ACORO® CERTIFICATE OF LIABILITY INSURANCE <br />`.� <br />DATE (MM/DDIYYYY) <br />10/05/2021 <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 />CONTACT NAME: Automatic Data Processing Insurance Agency, Inc. <br />Automatic Data Processing Insurance Agency, Inc. <br />IPA No Eat : 1-800-524-7024 ue, No); <br />E-MAIL <br />ADDRESS: <br />1 Adp Boulevard <br />INSURER(S) AFFORDING COVERAGE <br />NAIC if <br />Roseland NJ 07068 <br />INSURERA: Employers Assurance Company <br />25402 <br />INSURED Argo Enterprises Inc <br />INSURERS: <br />INSURER C : <br />DBA: DBA Respond Systems <br />INSURER D <br />599 4th Street <br />INSURER E : <br />San Femando CA 91340 <br />1 INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 2138468 REVISION NUMBER: <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 <br />LTR <br />rypE OF INSURANCE <br />ADDLSUBR <br />POLICY NUMBER <br />POLICY SEE <br />MMIDDIYYYY <br />POLICY EXP <br />MMIDDIWYY <br />LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE OCCUR <br />EACH OURRENCE <br />$ <br />r <br />PREMISES Ea occurrence) <br />$ <br />MED EXP (Any one person) <br />$ <br />PERSONAL 8 ADV INJURY <br />$ <br />GEN'L <br />AGGREGATE LIMIT APPLIES PER: <br />POLICY r PRO- <br />JECT LOC <br />OTHER: <br />GENERAL AGGREGATE <br />$ <br />PRODUCTS-COMPIOP qGG <br />$ <br />$ <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />HIRED NON -OWNED <br />AUTOS ONLY H AUTOS ONLY <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$ <br />BODILY INJURY (Per person) <br />$ <br />(Per accident) <br />BODILY INJURYPidt ( ) <br />$ <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />UMBRELLA LRB <br />EXCESS LIAR <br />OCCUR <br />CLAIMS -MADE <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />DED RETENTION$ <br />$ <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETORIPARTNFIVEXECUTIVE <br />OFFICERIMEMBER EXCLUDED? 171 <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />NIA <br />INEIG111702613 <br />10/15/2021 <br />10/15/2022 <br />X1 PER T - <br />STAT UTE ER <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,DOD,000 <br />DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />CITY OF SANTA ANA, Attn: RISK MANAGEMENT DIVISION, <br />45TH FL. <br />20 CIVIC CENTER PLAZA <br />Santa Ana <br />CA 92702 <br />Lafelcrn�twp\$ LPL' <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 REVIeliIDRyL Mar:agow�t <br />6 AwRo✓m <br />COMM <br />V 78tit1-ZI AL;UKU LA - <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD 14 <br />