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Tracy Digitally signed by Tracy Jacobs Jacobs Date: 2022.09.01 ACORO® CERTIFICATE OF LIABILITY INSURANCE 09/01/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 62 Insurance Services 1426 Aviation Blvd, Suite 203 Redondo Beach, CA 90278 NAMECONTACT Nice LLorin FAX Nu, Ext: AIC, No) : (424)866-7660 . ADDRESS: nica@b2insumnce.com INSURER(S) AFFORDING COVERAGE NAIC# License #: 0122551 INSURER A: Mesa Underwriters Specialty Insurance Cc INSURED 16351 Go Designs LLC 16351 Gothard St INSURERB: Mercury COmercial Auto 38342 INSURERC: AmWins Access INSURER D: Ste C NSURERS: Huntington Beach, CA 92647-3633 INSURER F COVERAGES CERTIFICATE NUMBER: 00006370-0 REVISION NUMBER: 116 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE A INSO WVO POLICY NUMBER (MOLICF YYYY) PYE%P MMIDDIYYYVI LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I X I OCCUR Y Y MP0004016007539 08110/2022 0811012023 EACHOCCURRENCE $ 1,000,000 PREMISES (Ea occonencel $ 100,000 MEDEXP(Anyonepersan) $ 5,000 AGGREGATE LIMIT APPLIES PER POLICYLJ LJ jam, LOC OTHER PERSONAL &ADV INJURY $ 1,000,000 GEN'L �( GENERALAGGREGATE $ 2,000,000 PRODUCTS -COMPIOP AGG $ 2,000,000 $ B AUTOMOBILE Ix LABILITY ANY AUTO OWNED A X SCHEDULED AUTOS ONLY UTOS HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY Y Y BA040000070299 1010912021 10109/2022 1UNIBINEDSINGLEU(Ea accident) $ 1,000,000 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per acdtlarrc $ $ C X UMBRELLA LIAR EXCESS LIAR X OCCUR CLAIMS -MADE Y Y XS22030363 0811012022 08110/2023 EACH OCCURRENCE $ 2,006,000 AGGREGATE $ 2,000,000 DEp RETENTION$ NONE $ `NORKERSCOMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETORIPARTNERVEXECU'r- OFFICERIMEMBER EXCLUDED? ❑ (Mandatory In NH) If yes. describe under DESCRIPTION OF OPERATIONS below NIA STATUTE '�. ER E.LEACHACCIDEM $ E.L DISEASE - EA EMPLOYE $ EL DISEASE -POLICY LIMN $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) RE: Invoice #1300 -City of Santa Ana Bristol & 1st Tree Lighting The city of Santa Ana, its officers, employees, agents and representatives are Additional Insureds with respect to General Liability and Auto Liability per the attached endorsements or as required by written contract. Insurance is Primary and Non -Contributory CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana - Risk Management Division THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 4th Floor ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE M.WfflkattF*� Santa Ana, CA 92702 I<�••. i:�� ^ REVIEWEDSAPPROVm 61': ©1988-2015 ACORD COI Risk Management Anatyst ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Print