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Digitally signed by Tori Pierson Tori Pierson Date: 2021.12.2109:9 A] -owoo' CERTIFICATE OF LIABILITY INSURANCE DaT2/15/2021 *c �� 12/15/2021 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 endorsement(s). PRODUCER CONTACT NAME: NICOIB Hardin Advanced Brokers Insurance Services 360 N El Camino Real 1A PNDNE . (858)436-7999 FAX AIc No: (858)436-7998 E-MAIL seN!ce@advancedbrokeminc.com @advancedbrokersinc.com INSURERS AFFORDING COVERAGE NAIC A Encinitas CA 92024 INSURER A: Liberty Mutual Insurance Co 23043 INSURED INSURER B : AXIS Surplus Insurance Company 26620 Eco/Nomics, Inc. lithe Ecal/nomics, Inc. INSURER C: 832 Camino Del Mar Ste2 INSURER D: INSURER E Del Mar CA 92014 INSURER F: COVERAGES IJtKIIHILA It NUMHER' oevlelnM au Iaaecm. 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 INSURANCEiNsn ADDLSUBR wynPOLICY NUMBER MMIOp EFF MM UCOP LIMITS X COMMERCIALGENERALUABILIY EACH OCCURRENCE $ 1,000,000 �/ CLAIMS -MADE /� OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 500,000 MED EXP(Any one person) $ 15,000 PERSONAL& ADV INJURY $ 1,000,000 A X X BKS57048355 12/09/2021 12/09/2022 AGGREGATE LIMIT APPLIES PER PRO- GENERAL AGGREGATE $ 2,000,000 GEN'L X PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY ECT LOC $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000, 000 ANY AUTO BODILY INJURY (Per person) $ A` OWNED SCHEDULED AUTOS ONLY AUTOS X X BKS57048355 12/09/2021 12/09/2022 BODILY INJURY(Pe. accident) $ X HIRED X NON -OWNED AUTOS ONLY /� AUTOS ONLY PROPERTY DAMAGE Per accident $ LlUMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 2,000,000 A X EXCESS LIAB CLAIMS -MADE ESA (22) 57048355 12/09/2021 12/09/2022 OED RETENTION$ $ WORKERS COMPENSATION PER OTHR - AND EMPLOYERS' LIABILITY YIN STATUTE E I E.L. EACH ACCIDENT NT $ ANY PROPRIETORIPARTNER/EXECUTIVE OFFICERJMEMBER EXCLUDED? NIA E.L. DISEASE -EA EMPLOYE $ (Mandatory In NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS below Professional Liability Each Claim $1,000,000 B Pollution Liability X X EMP19001661-03 10/01,2021 10/01/2022 Aggregate $2,000,000 Deductible $5,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORO 101, Additional Roneelm Schedule, maybe attached if more space is required) City of Santa Ana, its officers, employees, agents, and representatives are Additional Insureds with respect tD General Liability, Professional and Pollution Liability per the attached endorsements or as required by written contract. Insurance is Primary and Non -Contributory. *30 Days' Notice of Cancellation with 10 days' notice of Non -Payment of premium in accordance with the policy provisions. Operations of the insured covered under the above policies. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Risk Management Division, 4th floor AUTHORIZED REPRESENTATIVE �1)bk tAlply� 20 Civic Center Plaza a _ RinsewED&A avBJBr: Santa Ana CA 92702 vr�-� 1 76tc P;r. V lBtltl-LUU AGOKD C( ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD