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Dlgltally signed by Ton Pierian <br />Tori PiersonDzte:2022D405092421 <br />-070V <br />A�� CERTIFICATE OF LIABILITY INSURANCE <br />DATD/YYYYJ <br />3/21/221/2022 <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 />CONTACT <br />NAME: <br />DAWOOD INSURANCE AGENCY <br />18800 Delaware St #304 <br />Huntington Beach, CA 9264$ <br />PHONE g49 417-0204 Fac No: 714 842-9791 <br />EDDRIE katO dawoodinsurance.com <br />INSURERS AFFORDING COVERAGE <br />NAICN <br />INSURERA: ADMIRAL INSURANCE COMPANY <br />24856 <br />INSURED <br />INSURER B : <br />Pyramid Group International, Inc. <br />INSURER C: <br />25771 Rapid Falls Road <br />INSURER D: <br />Laguna Hills, CA 92653 <br />INSURER E: <br />INSURER F : <br />•Lw. V0r:0 r,r_r<nriCAIt INUMtltN: REVISION NUMBER' <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE <br />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 />TYPE OF INSURANCE <br />ADDL <br />SUER <br />POLICY NUMBER <br />MMIDDY <br />MM/DD/YEPF YYV <br />LIMITS <br />COMMERCIAL GENERAL LVIBILITY <br />X ❑OCCUR <br />EACH OCCURRENCE <br />$ 1000000 <br />ITAMAGE TO TED <br />CLAIMS -MADE <br />PREMISES (Ea occurrence) <br />$ 50000 <br />MED UP IAny one person) <br />$ 5,000 <br />PERSONAL &ADVINJURY <br />$ 1000000 <br />A <br />X <br />FEI-ECC-28399-01 <br />3/2212022 <br />3/22/2023 <br />AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />$ 2000000 <br />GEML <br />PRODUCTS - COMP/OPAGG <br />$ 2000000 <br />POLICY JET LOC <br />$ <br />OTHER: <br />I <br />I <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMBANY <br />E... ident <br />$ <br />O <br />BODILY INJURY (Per person) <br />$ <br />OWNED <br />OWNED SCHEDULED <br />BODILY INJURY (Per accident) <br />$ <br />AUTOS ONLY AUTOS <br />HIRED NON S NED <br />AUTOS ONLY AUTOS <br />PROPERTY DAMAGE <br />Peraccident <br />$ <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED I I RETENTIONS <br />I$ <br />WORKERS COMPENSATION <br />PER OTH- <br />AND EMPLOYERS' LIABILITY ,SIN <br />STATUTE ER <br />E.L. EACH ACCIDENT <br />$ <br />ANY PROPRIETORIPARTNEIBEXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />NIA <br />E.L. DISEASE -EA EMPLOYE <br />$ <br />(Mandatory In NH) <br />If yes, describe under <br />E.L. DISEASE -POLICY LIMIT <br />$ <br />DESCRIPTION OF OPERATIONS be. <br />Ocurrence <br />2,000,000 <br />A <br />PROFESSIONAL LIABILITY <br />X <br />FEI-ECC-28399-01 <br />3122/2022 <br />3/22/2023 <br />Agregate <br />2,000,000 <br />Claim Expense <br />1,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached U more space is required) <br />This Certificate of Insurance names: City, its City Council, officers, employees, agents and volunteers are <br />named as additional insureds. <br />Primary/Non-Contributory Endorsement form must be provided in addition to the Certificate of insurance for <br />General Liability included and it will follow upon the issuance of the policy. <br />ADDITIONAL INSURED <br />CITY OF SANTA ANA <br />20 CIVIC CENTER PLAZA, <br />SANTA ANA ,CA 92702 <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 />©1988-2015 ACI <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />< '^w RWI MarNge�lD&Wgn <br />r, ,� Re�6APPRCN®BY: <br />I ial �%rt+raort <br />�' "Riwrmr�gea..,ra�vlAide <br />