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GATE (MMIDDNYYY) ® ACORD lk.y CERTIFICATE OF LIABILITY INSURANCE ACCt#:2807366 06129/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endomement(s). PRODUCER LOCKTONAFFINITY,LLC P.O. BOX 879610 CONTACT NAME: LOCKTONAFFINITY, LLC PHONE (AO, No, Ext): FAX (AIL, No): 913452-7599 ADDRESS: KANSAS CITY, MO 64187-9610 INSURERS AFFORDING COVERAGE NAIC R INSURER A: Old Republic Insurance company 24147 INSURED INSURER B Cannon Corporation INSURER C : 1050 Southwood Dr INSURER D: San Luis Obispo, CA 93401-5813 INSURER E: INSURER I: rEIVIP Cil rFRTIFIrATF NIIMRFR: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE IDO INS. SUBR WVD POLICY NUMBER AMI��IYWY) (MMI010 LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS- OCCUR DAMAGE TO RENTED PREMISES Ea occurre c $ MED EXP (My onePurest) $ PERSONAL &ADV INJURY $ AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ GEN'L PRODUCTS -COMPIOPAGG $ OLICY PRO- DOC FCT $ THER: A AUTOMOBILE LIABILITY X X L315536-21 09101/2021 09/01/2022 Ee eccidenl $1,000,000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED PROPERTYDAMAGE $ AUTOS ONLY AUTOS ONLY UMBRELLALIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED I I RETENTION$ $ I WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN STATl1TE I I ER E.L. EACH ACCIDENT $ YPROPRIETOMPARTNERAE ECUTIVE FFICEWMEMBER EXCLUDED? NIA (Mandatory in Ni E.L. DISEASE- EA EMPLOYEE If yes, reasoning under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remargs Schedule, may be attached if more space is required) GPBR: 2FL5 POLICY PROVIDES PROTECTION FOR ANY AND ALL OPERATIONSIJOBS PERFORMED BY THE NAMED INSURED WHERE REQUIRED BY WRITTEN CONTRACT. CERTIFICATE HOLDER IS AN ADDITIONAL INSURED WHERE REQUIRED BY WRITTEN CONTRACT. WAIVER OF SUBROGATION INCLUDED BY WRITTEN CONTRACT, INSURANCE 15 PRIMARY AND NON-CONTRIBUTORY. R. Well 29 R.obllNanon Improvements Constmc0on Menapolentand Inspection Services RFP No.21-135 City of Santa Ana, Its o((an, employees, agent., volunteers and reprasentathec are named an n additional Insured as respects auto liability ae mqulnd par wdMn contract or agreement. Commons of Insurance shall provide thirty (30) day prior written notice of cancellation City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED Attn: Risk Management Division BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 Civic Center Plaza, 41h Floor ACCORDANCE WITH THE POLICY PROVISIONS. Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE WitMmSmrad OMgm wm BY: ['�REvlease&App n %pTG I[aTaau © 1988-2016 ACORD 'awain' ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD