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A h ry ; ^ DigitgPyFsigned. In. ono <br />CERTIFICATE OF LIABILITYANVAJRAN1VL. Angle DATE(MM/DO/YV Y)`v <br />07122/2022 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONF 5/IP(evN�T CATE HOLDER, THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY <br />OR NEGATIVELY AMEND, EXTEND LAY{{{ At[D�F•ORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE Ic AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. 2022 08.22 <br />_ <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) u be endase'a. If SUBj2QG,p IS VJI I subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A staterrit Yn this certili3te dds'hot`E6n�rights to the <br />certificate holder In lieu of such endorsements .- <br />PRODUCER <br />Loomis Insurance Services <br />CONTACT <br />NAME: Roberta R Roses <br />C0 t:951.685-7478 FAX <br />ac Na: 951.685-0665 <br />PO BOX 3128 <br />Riverside, CA 92519 <br />Michael J Runner <br />AD ` S: rrosas@loomis4insurance.com <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />INSURER A: Northfield Insurance Com an <br />27987 <br />INSURED International, LLC <br />Ve <br />3951AdleVernonn Avenue <br />INSURER B: <br />INSURER C: <br />Rive <br />Riverside, CA 92509 <br />INSURER D : <br />INSURER E: <br />INSURER F <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER• <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 OFSUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />wsR <br />LTR <br />TYPE OF NICE <br />ABDL <br />sus <br />POLICYNUMBER <br />MOLICYY� <br />POLICYEXP <br />LIMITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ 2,000,00 <br />A <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE FX7 OCCUR <br />X <br />WS5505395 <br />08/0812022 <br />08/08/2023 <br />75TMA_G_E_T­0_RERI <br />PREMISES fEa occurrence <br />$ 100,00 <br />MED EXP(Anyone person) <br />$ S,OO <br />PERSONAL&ADV INJURY <br />$ 2,000,00 <br />GENERAL AGGREGATE <br />$ 2,000,00 <br />GEML AGGREGATE LIMIT APPLIES PER: <br />X POLICY PRO LOD <br />PRODUCTS - COMP/OP AGG <br />$ EXCLUDED <br />g <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />Ea accident <br />ANY AUTO <br />BODILY INJURY(Per person) <br />$ <br />ALLOWNED SCHEDULED <br />AUTOS AUTOS <br />BODILY INJURY (Per accident) <br />$ <br />HIRED AUTOS NON -OWNED <br />AUTOS <br />PROPERTY DAMAGE <br />PER ACCIOENT) <br />$ <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED RETENTION $ <br />$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETOrVPARTNEWEXECUTIVE <br />OFFICER/MEMSER EXCLUDED? <br />NIA <br />WCSTATU- I OTH- <br />TORYLMTS ER <br />E.L. EACH ACCIDENT <br />$ <br />E.L. DISEASE - EA EMPLOYE <br />$ <br />(Mandstory in NH) <br />Ifyes, describe under <br />E.L. DISEASE -POLICY LIMIT <br />$ <br />OE$CRIPTION OF OPERATIONS below <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) <br />The City of Santa Ana, its officials, officers, employees, agents, <br />volunteers & representatives are named as Additional Insured. Coverage is <br />Primary & Non -Contributory, 30 day Notice .of Cancellation applies except for <br />10 day Notice for Non-payment of Premium. <br />The City of Santa Ana <br />20 Civic Center Plaza <br />`Santa Ana, CA 92701 <br />ACORD 25 (2010105) <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 />Qiobe�. <br />0 ACORD CO <br />The ACORD name and logo are registered marks of ACORD <br />. <br />s <br />o @`` <br />Ali ! ' <br />fft <br />WBkMmRgtmeakU[WaiDq <br />REMEWED&APPROVEDSY.. <br />€t ev <br />-��� <br />RIzk. Klan, Bement sjtcoaptpt <br />F fix, <br />