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KINCA-1 <br />OP ID: CW <br />A�W R CERTIFICATE OF LIABILITY INSURANCE <br />DATE 4/2022Y) <br />03/14/2022 <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 endorsements . <br />PRODUCER 314-746-4700 <br />Digital Insurance LLC <br />formerly Huntlelgh McGehee <br />8236 Fors h Boulevard, #1200 <br />Clayton, 0 83106 <br />Daniel L. Stevens <br />033 JACT Daniel L. Stevens <br />PHoNEo 314-746.4700 pAX 314-889-3700 <br />A/C N, Ext: IA/C, No): <br />,�� ass• <br />INSURERS AFFORDING COVERAGE <br />NAIC# <br />INSURERA: Service American Indemnity CO <br />39152 <br />KinggL�om Causes Inc dba City Net <br />King <br />INSURERS; <br />INSURERC: <br />4608 Atlantic Avenue <br />Long Beach, CA 90807.1602 <br />INSURER D <br />INSURER 9, <br />INSURER F; <br />COVERAGES CFRTIFICATE r4IIMRFR• REV!91OM MUBBO eo. <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 7' 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 />I�TR <br />TYPE OF INSURANCE ObL <br />UBR <br />p <br />POLICY NUMBER <br />PbLlp EPF <br />POLICY EXP <br />I <br />LIMITS <br />_ <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE OCCUR ! <br />I <br />EACIi OCCURRENCE <br />DAMAGE_ TO RENTED-- <br />PREMISES Ea eccarence <br />_ <br />MED EXP An one arson <br />_ <br />I $ <br />PERSONAL& ADV INJURY <br />AGGREGATE U MIT APPLIES PER: <br />POLICY j pq' LOC <br />GENERALAGGREGATE <br />$ <br />BERL <br />PRODUCTS COMPIOPAGG <br />$ <br />_ <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />EO..I Ident) ED SINGLE I�IMIT <br />BODILY INJURY Per pamend$ <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />BODILY INJURY Per aooldent <br />pp <br />AUTOS ONLY A�TOS ONLY <br />P 01` FRJ nt AMAGE <br />_ <br />$ <br />$ —.. <br />UMBRELLA LAB <br />OCCUR <br />EACH OCCURRENCE <br />AGGREGATE <br />$ <br />EXCESS LIAB <br />jCLAIMS-MADE <br />DED RETENTION <br />A <br />WORKERSCOMPENSATION <br />ANYCPRNOPREIE7g0�RqIPARTNEPJEXECUTIVE YIN <br />l <br />I antlatcry In NH EXCLUDED? <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />N f A <br />Y <br />SATISO488700 <br />03/01 @022 <br />03/0112023 <br />X PTTUTS EF <br />E.L. EACH ACCIDENT <br />1 000,000 <br />r <br />E.L. DISEASE, FA EMPLOYE <br />FA EMPLOYES <br />�__ 1,090,000 <br />E.L. DISEASE - POLICY LIMIT <br />1,000,900 <br />17 <br />1 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACCORD 101, Additional Remarks Schedu to, may be attached If more apace Is required) <br />Blanket Waiver of Subrogation applies where required by written contract. <br />City of Santa Ana <br />Risk Management Division <br />20 Civic Center Plaza, 4th FL <br />Santa Ana, CA 92701 <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 <br />q.n L <br />ACORD 26 (2016/03) ©1988-2015 ACORD <br />The ACORD name and logo are registered marks of ACORD <br />� yBen REVIEWER& APPRn32emeMBlon <br />WEDOVm BY: <br />t � 8°PW+�9 rfQ$VA6�} <br />Rhlc Mana{IemmTt SDeclaUst <br />LLi .s .........nnn,.nr ... . ,v,.....p <br />