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S:agllay%TracY heeqby Acowe CERTIFICATE OF LIABILITY INSURANCE JdCObS r L� 1s:4#.a9 63R?d 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 Willie Towers Watson Midwest, Inc. c/o 26 Century Blvd P.O. sox 305191 CONTACT Willis Towers Watson Certificate Center NA: INC.PHONE 1-877-945-7378 AIC.N.1: 1-888-467-2378 EAD-MAIL DRESS: cortificates@willia.com INSURERS AFFORDING COVERAGE NAIC# Nashville, IN 372305191 USA INSURERA: St.. Surplus Linea Insurance Company 13604 INSURED Centerra Group, LLC INSURER B: St— Indemnity S Liability Company 38318 1353D Dulles Technology Drive INSURER C: INSURERD: Suite 500 Herndon, VA 20171 INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: W25793937 REVISION NUMBER: 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 ADDLSUBR J= MD POLICY NUMBER POLICY EFF fMMUDDNYYYIMMIDD POLICY UP LIMITS X COMMERCIALGENERAL LIABILITY EACH OCCURRENCE $ 11000,000 X CLAIMS -MADE OCCUR TO PREMI PREMISES AMAGES(RENTEDEa occurrence) $ 1,000,000 MEO UP (Any one parson) IS A PERSONAL S ADV INJURY $ 11000,000 B080114907U21 11/01/2021 11/01/2022 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 11000,000 POLICYPRo- JECT LOC PRODUCTS-COMP/OP AGG $ 11000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO OWNED SCHUTOS EDULED AUTOS ONLY A BODILY INJURY (Per acddant) $ HIRED NON -OWNED AUTOS, AUTOS ONLY PROPERTY DAMAGE Par accident $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION$ $ B WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY YIN ANYPROPRIETORIPARTNEWEXECUTIVE No OFFICERIMEMBEREXCLUDED7 (Mandatory in NH) NIA 100 0001596 11/01/2021 11/01/2022 X PER OTH- STATUTE ER E.LEACHACCIDENT $ 1,000,000 EL DISEASE - EA EMPLOYEE $ 1, 000,000 If yes, describe under DESCRIPTION OF OPERATIONS he.. E.L. DISEASE - POLICY LIMIT $ 1, 000, 000 e Workers Compensation S 100 0001594 11/01/2021 11/01/2022 E.L. Each Accident: $1,000000 Employers Liability E.L. Disease -Ea Empl: $1,000:000 Pei Statue E.L. Disease-Pol lout: $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) SEE ATTACHED City of Santa Ana Police Department Firing Range 60 Civic Center Plaza Santa Ana, CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2016 ACORD ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD arsmwgev¢wuoa qI REVIEWED& APPROVED BY: T4"Cy aACOe7 SR In: 23018874 snrcR: 2655969