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ACORD 25 (2016/03)
<br />An gie-3 Digitally sign ^ __
<br />II�Rn CERTIFICATE OF LIABILITY INSURA CE by An I�gTE(MM/DDY—
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS I ((,r��ggTTIIF_�ICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALT R% O ER G'._ AFY1tldn BY THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE Isil!!;:ir9NSin;FRLS.1�•pUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. GG�AILLLL UO LLLL
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must haV DITIOP,AI- i_Nsu__REJ7ecT5W4ffQA14orsed.
<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 riohts to the certificate holder in lieu of such endorsementlsl-
<br />PRODUCER
<br />HILL INSURANCE SERVICES
<br />14301 N 87th Street S# 115
<br />International
<br />Twin Dolphin Dr, Ste 150
<br />wood City, CA 94065
<br />rnt¢DAr Ce reenerrnTe uluaoee.
<br />RSUI Indemnity Co
<br />Certain Underwriters at
<br />Kinsale Insurance Coml
<br />Houston Casualty Co
<br />Scottsdale Insurance CI
<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 OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR
<br />JZILMM
<br />TYPE OF INSURANCE
<br />ADDL
<br />SUER
<br />POLICY NUMBER
<br />POLICY EFF
<br />DD YYY)
<br />POLICY EXP
<br />(MMIODNYM
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS-MADEEX] OCCUR
<br />X
<br />X
<br />EN4ML00530221
<br />08/01/2022
<br />08/01/2023
<br />EACH OCCURRENCE
<br />$ 1.000,000
<br />DAMAGE TO RENTED
<br />$ 100,000
<br />X
<br />MED EXP An one erson
<br />$ 5,000
<br />C
<br />D
<br />Prof Llab CM
<br />PLC-00603-00-$2 MIL AG/CL
<br />0100085841.3-$3 MIL XS
<br />04/13/2022
<br />O4113/2022
<br />04/1312023
<br />04/13/2023
<br />X
<br />x/s Prof Liab CM
<br />PERSONAL & ADV INJURY
<br />$ 1,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICY [X]jEo LOG
<br />GENERALAGGREGATE
<br />2,000,000
<br />PRODUCTS-COMP/OPAGG
<br />$ 2,000,000
<br />OTHER'.
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />COM61NEeD SINGLE LIMIT
<br />$ 1,000,000
<br />BODILY INJURY PerPerson)
<br />$
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTO.SpS
<br />X
<br />X
<br />EN4ML00530221
<br />08/01/2022
<br />08/01/2023
<br />BODILY INJURY Peregcidenl
<br />$
<br />X
<br />PeOr a ERTY DAMAGE
<br />$
<br />pp
<br />ALT OS ONLY X AUTOS ON�Y
<br />A
<br />UMBRELLA LIAR
<br />X
<br />OCCUR
<br />EACH OCCURRENCE
<br />S 5,000,000
<br />X
<br />AGGREGATE
<br />$ 5,000,000
<br />EXCESS LIAR
<br />CLAIMS41ADE
<br />EN4C000520221
<br />08/0112022
<br />08/01/2023
<br />DIED I I RETENTION$
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITYI
<br />ANY PROPRIETORIPARTNEREXECUTNE YIN
<br />OFFICER/MEMBER EXCLUDED? FN�
<br />(Mandatory in NH)
<br />If yes, descdtm under
<br />DESCRIPTION OF OPERATIONS lm w
<br />N 1 A
<br />X
<br />EN4WC00371221
<br />08/01/2022
<br />08/01/2023
<br />XI PER OTH-
<br />STATUTE
<br />E.L. EACH ACCIDEM'
<br />$ 1,000,000
<br />E.L.DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />E.L. DISEASE - POLICY LIMIT
<br />1,000,000
<br />E
<br />Cyber Liab
<br />H21NGP206843-01
<br />03/01/2022
<br />03/01/2023
<br />Cyber Agg
<br />5,000,000
<br />B
<br />x/s Umb
<br />LHA254217
<br />08/01/2022
<br />08/01/2023
<br />Xs Umb Ag
<br />4,000,000
<br />DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached 9 more space is required)
<br />Carrier F: EKS3420084-0310112022 to 2023-xis Cyber Umb-$5 Mil ARM. CONSULTANTS. CITY OF
<br />SANTA ANA, ITS OFFICERS, OFFICIALS, EMPLOYEES, AGENTS AND VOLUNTEERS ARE
<br />NAMED AS ADDL INSURED WITH RESPECTS TO THE GL & AUTO PER WRITTEN CONTRACT.
<br />COVERAGE IS PRIMARY NON- CONTRIBUTORY. WAIVER OF SUBROGATION APPLIES WITH
<br />RESPECST TO THE GL, AUTO & WC. 30-DAY NOTICE OF CANCELLATION APPLIES.
<br />SANT-11
<br />CITY OF SANTA ANA
<br />RISK MANAGEMENT DIVISION
<br />20 CIVIC CENTER PLAZA
<br />SANTA ANA, CA 92702
<br />© 1988-2015 ACORD
<br />The ACORD name and logo are registered marks of ACORD
<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 />REvIEwED & APPRDVm BY:
<br />iig Aa 4t°
<br />Risk Management Speaalist
<br />
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