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<br />�+�K" CERTIFICATE OF LIABILITY INSURANCE �HOLDR.
<br />THIS CERTIFICATE IS ISSUED AS A MATTER.OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICCERTIFICATE DOE$ 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 cortfflcate holder Is an ADDITIONAL INSURED,. the policy(les) must have ADDITIONAL INSURED proVisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the term a and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the oertificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />- o
<br />PHONEMarsh USAIna Jeckfea.maMslaresntrgleivl0o�lo
<br />1717 Arch Strsel 2152461
<br />Philadelphia, PA 19103-2797 hlgrsh.com Ndf:
<br />12152451399
<br />AIm:NBCU.Gerlmquest@marsRcom FaxN2-946.5143
<br />INSURER 5 AFFORDING COVERAGE NAIC N
<br />......D 03516-NBC0.GAWUW21- INSURER A: ACE American lnsumme Company 2Z667
<br />wsuRE
<br />NBCUnharsal Media, UC :INSURER 8: ln&mnl!y Ins Co Of North. America: 43575
<br />a fully owned subsidiary of Comcast Corporation INSURERC: ACE. Property GOSVaItV Ins CA 20098
<br />30 Rockefeller Plus -
<br />Now York, NY f0H2 INSURER D: ACE N Undervmlers his. Co. 20702
<br />INSURERS:
<br />INSURER F:.
<br />COVFRAr4FS ......
<br />THIS
<br />INDICATED.
<br />CERTIFICATE
<br />N EXCLUSIONS
<br />ILTR
<br />A
<br />--
<br />IS TO CERTIFY THAT THE POLICIES
<br />NOTWITHSTANDING ANY REQUIREMENT,
<br />MAY BE ISSUED OR MAY
<br />AND CONDITIONS OF SUCH
<br />TYPEOFINSURANee
<br />X COMMERCIALGENEftALDABILiTY
<br />C00,0W MADE �OCCUR
<br />X SIR:$100;000
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<br />OF
<br />PERTAIN,
<br />POLICIES.
<br />INSURANCE
<br />Hit!
<br />LISTED BELOW HAVE BEEN
<br />TERM OR CONDITION OF ANY
<br />THE INSURANCE AFFORDED BY
<br />WN MAY HAVE BEEN
<br />LIMITS SHOxW
<br />POLICY NUMBER
<br />XSL G72400922
<br />o.Pova
<br />ISSUED TO
<br />CONTRACTOR
<br />THE POLICIES
<br />REDUCED BY
<br />POLICVEFF
<br />12MI12021
<br />THE INSURED
<br />OTHER
<br />DESCRIBED
<br />PAID CLAIMS.
<br />MOLIICDrcEXPY
<br />12101(2O22
<br />HCVISION NUMBER;
<br />NAMED ABOVE FOR THE
<br />DOCUMENT WITH RESPECT
<br />HEREIN IS SUBJECT TO
<br />LIMAS
<br />EA HOCCURRENCE
<br />6
<br />POLICY PERIOD
<br />TO WHICH THIS
<br />ALL THE TERMS,
<br />-.._14,800,000
<br />AL. sES r:e cr,
<br />MEDEXP - 0. -Mon
<br />$. 14,90g,W0
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<br />S 10,000
<br />PERSONALAADV-INJURY
<br />S 14,900,000
<br />GENLAOGREGATELIMITAPPUES PER;
<br />X POLICY ❑ JEOT El LOCIGENERALgGGREOATE
<br />60,000,000
<br />RODUCTS-COMP/OP AGO
<br />S 16.000,000
<br />A
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<br />AUTOMOBILE LIABILITY
<br />X ANYAur
<br />AifIW$ONLY AUTOS
<br />HIRED NON -OWNED
<br />ONLY AUTOS ONLY
<br />18AH25542964
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<br />12MIQ022
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<br />AGE
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<br />X UMea6LLALIAa X OCCUR
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<br />NfA
<br />XEU G27924540007
<br />WLR C609 78 3 05AAND )
<br />WLRC6B917980(CA,MA)
<br />8CFC68918066(WI)
<br />12O112021
<br />12101M1021
<br />120112➢21
<br />12NV2022
<br />N1. 2
<br />12N112022
<br />1210U2022
<br />NCE
<br />tAGORRGATE
<br />s 10,00Q0t10
<br />10,000,000
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<br />EMPLOYERS' LIABILM
<br />ANYPROPRIETOWPARTNEWEXECUTIYE
<br />OFFICEO EMBEREXCLUOEDI N
<br />4MandatoryleM
<br />yos, describe in er
<br />DESCRIPTION OF OPERATIONS below
<br />Exeess:Workars G.em�ensaibn _..._.--
<br />OTH-
<br />E.L. EACH ACCIDENT
<br />2,W0,00D
<br />EIL.DIBEASE-EAEMPLO E
<br />$ 2,000,W0
<br />EL. DISEASE -POLICY
<br />LIMIT
<br />$ 2,000,000
<br />A
<br />__
<br />WCU084100294WA)- - _____42N1021--42MlM2--
<br />Sa AmlDls pnpbyce0s Polio-
<br />--2,000;000-
<br />:SIR
<br />5,000,000
<br />DESCRIPTION OPOPERATIONer LOCATIONS I VEHIOLES (ACORD 01,: AddIIAm.I Siemens Sckedula, maybe aaeM:od irmore spaze Is required)
<br />Re: RastasPakias 2D22,
<br />CllyufSants Ana, officers, olficlals, agents employees, and volunteers am Included as additional Insured (e)(cePfworkers'compensallon) wham required by wdllen Dontractwitn the Named Insured, This
<br />Insurance Is primary and nor westrlbutory over my existing insurance and Ilmlled to liability arising Out of tie Operations of the named Insured and where required by wdlim contract Walverof subro ialian B
<br />applicable where required by wditen contract
<br />CFRTIFICATF U!N DIbD
<br />.City al Santa Ana Risk Management Million SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL DE DELIVERED IN
<br />20 to Ana, CA Plaza ACCORDANCE WITH THE POLICY PROVISIONS,
<br />Santa Ana, CA 92702
<br />AUTHORIZED REPRESENTATIVE
<br />®1988-2016 ACORD PO DbWm
<br />g a
<br />ACORD 25 (2016108) The ACORD name and logo are registered marks of ACORD REVIEWEDF:APPROVEDBV,?Ba■NDura['.T �, ��
<br />r
<br />Risk Mananement Analyst
<br />
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