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<br />ACC) i® CERTIFICATE OF LIABILITY INSURANCE
<br />DATE/(MWDD 2YY)
<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 />Alliant Insurance Services, Inc.
<br />701 B Street 6th Floor
<br />San Diego CA 92101
<br />CONTACT
<br />NAME: Norma Figueroa
<br />PHONE
<br />bvC.N . 619-849-3871 ac 4o:619-699-2163
<br />nDURESS, nfi ueroa@alliant.com
<br />INSURERS AFFORDING COVERAGE
<br />NAIL#
<br />INSURER A: Executive Risk Indemnity Inc
<br />35181
<br />LicenseM OC36861
<br />INSURED BYROINC-02
<br />Inc.
<br />13220Byrom-DaveyEEvening
<br />13220 Evening Creek Drive, Suite 103
<br />INSURER e: AXIS Surplus Insurance Company
<br />26620
<br />INSURER C: Federal Insurance Company
<br />20281
<br />INSURER D: Allied World National Assuranc
<br />10690
<br />San Diego CA 92128
<br />NSURER E:
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: 1780266619 REVISION NUMRFR-
<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 />ILTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />SUBS
<br />POLICYNUMBER
<br />POLICYEFF
<br />MM/DDIYYVY
<br />POLICY EXP
<br />MMIDD
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE T OCCUR
<br />Y
<br />54303294
<br />10/31/2021
<br />10/31/2022
<br />EACH OCCURRENCE
<br />$1,000,000
<br />DAMAGE TO RENTED
<br />PREMISES Ee accunence
<br />$100.000
<br />MED EXP (Airy onepa,son)
<br />$5,000
<br />PERSONAL a ADV I NJURV
<br />$1,000,000
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />POLICY Z JECT LOC
<br />GENERALAGGREGATE
<br />$2,000,000
<br />PRODUCTS-COMP/OP AGG
<br />$2,000,000
<br />I DEDUCTIBLE: SUED
<br />$5.000
<br />OTHER:
<br />I
<br />C
<br />AUTOMOBILE
<br />LIABILITY
<br />Y
<br />54303293
<br />10/31/2021
<br />10/31/2022
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$1,000,000
<br />X
<br />ANY AUTO
<br />BODILY INJURY (Per Person)
<br />$
<br />I
<br />OWNED SCHFOULED
<br />AUTOS ONLY AUTOB
<br />BODILY INJURY (Panitlenl
<br />aw )
<br />$
<br />X
<br />HIRED X NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />0
<br />UMBRELLALIAB
<br />X
<br />OCCUR
<br />03104015
<br />10/31/2021
<br />10/31/2022
<br />EACHOCCURRENCE
<br />$11.000,000
<br />AGGREGATE
<br />$11,000,000
<br />X
<br />EXCESB LIAR
<br />CLAIMS -MADE
<br />DED RETENTION$
<br />PRODUCTS-COMP/OPAGG
<br />$11,000,000
<br />C
<br />WORKERSCOMPENSATION
<br />AND EMPLOYERS' LIABILITY Y/N
<br />Y
<br />54303295
<br />10/31/2021
<br />10/31/2022
<br />X
<br />STATUTE ERH
<br />E.L. EACH ACCIDENT
<br />$1,000,000
<br />ANYPROPRIETORIPARTNERIEXECUTIVE
<br />OFFICERIMEMSEREXCLUDED?
<br />NIA
<br />E.L. DISEASE -EA EMPLOYE
<br />$1,000,000
<br />(Mandatory In NH)
<br />If yea, describe under
<br />E.L. DISEASE -POLICY LIME
<br />$1,000,000
<br />DESCRIPTION OF OPERATIONS below
<br />B
<br />Professional B Pollution
<br />Liability
<br />CM002961-04-2021
<br />10/31/2021
<br />10/31/2022
<br />Each Claim
<br />Aggregate
<br />Se Insured Retentio
<br />$3,000.000
<br />$3.000.000
<br />$25,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS [VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required)
<br />Re: #2209, Project #19-7527, Santa Anita Park New Synthetic Soccer Field and Park Improvements, 300 S. Figueroa Street, Santa Ana, CA 92704.
<br />The City of Santa Ana, its officers, employees, agents, volunteers and representatives are included as Additional Insureds on primary and non-contributory
<br />basis, waiver of subrogation applies.
<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 />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD V
<br />
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