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Tori Pierson oa9e,2022,0628;osa,;-07'00 <br />ACORO' CERTIFICATE OF LIABILITY INSURANCE <br />F DATE (MM'-Iy) <br />06122/2022 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES 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 certificate holder Is an ADDITIONAL INSURED, the pollty(les) must be endorsed. If SUBROGATION IS WANED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endoreemenl(s). <br />PRODUCER Ph r (714)973-143a Fax (714)973o811 <br />=Aor ELMCO INSURANCE, INC. <br />ELMCO INSURANCE, INC. <br />1905 N. MAIN STREET <br />SANTA ANA CA 92706-2779 <br />PRONE (714 973.1436 PA11 . (714) 973-0811 <br />nD ESfi contact@Elmcoinsumnce.com <br />INSURERS) AFFORDING COVERAGE <br />NAIC0 <br />INSURMA : SCOTTSDALE INSURANCE COMPANY <br />41297 <br />Agency UdF. 050B747 <br />CALIFORNIA BARRICADE RENTALS INC. <br />INSURERS : INFINITY SELECT INSURANCE COMPANY <br />20260 <br />1650 E. SAINT GERTRUDE PLACE <br />SANTA ANA CA 92706 <br />iNsuReRc : TRISURA SPECIALTY INSURANCE COMPANY <br />16188 <br />iNSURERo STATE COMPENSATION INSURANCE FUND <br />36076 <br />iReuRPAE : WESTCHESTER SURPLUS LINES INSURANCE CC <br />10172 <br />Wsunsl F : HISCOX INSURANCE COMPANY INC <br />10200 <br />COVERAGES CERTIFICATE NUMBER: 71107 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 OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />MR <br />TYPE OF INSURANCE <br />ADDL <br />MO <br />aUBriIn <br />IAIk/O <br />POLICY NUMBER <br />PouCY EPP <br />PWCY FJw <br />LIMBS <br />A <br />I X <br />COMMERCIALGENFJW.LMILITY <br />CLAIMS -MADE FXIOCCUR <br />Y <br />X <br />BCS0039983 <br />07/01/22 <br />07/01/23 <br />EACH OCCURRENCE <br />$ 1,000.000 <br />PREJAME9 sa oo . <br />$ 100,000 <br />MED. EXP(Any one pani <br />$ EXCLUDED <br />PERSONAL SADVINJURY <br />$ 1,000,000 <br />GENL AGGREGATE LIMIT APPLIES PER: <br />X POLICY PRO- <br />JECT F—] LOC <br />OTHER: <br />GENERAL AGGREGATE <br />S 2,000,000 <br />PRODUCTS - COMPIOP AGG <br />S 2,000,000 <br />EMPLOYEE BENEFITS <br />$ 1,000,000 <br />B <br />AerOMOSul <br />UAINUTY <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />HIRED AUTOS AUTO <br />NONWNED <br />HIRED AUTO$ X -O <br />AUTOS <br />Y <br />X <br />804-61015.8309-001 <br />07101/22 <br />07/01/23 <br />cokal"EoaxsLE uurt <br />(Eaemas,W <br />E 1,000,000 <br />X <br />X <br />BODILY INJURY (Per person) <br />$ <br />BODILY INJURY (Per eaitlent) <br />S <br />PROPIanYDAMAOE <br />s m <br />$ <br />8 <br />C <br />uuaaeua UAe <br />IXee99 Line <br />X <br />OCCUR <br />CLAIMAMADE <br />TX50001452-03 <br />07101122 <br />07101/23 <br />EACH OCCURRENCE <br />$ 5,000,000 <br />X <br />AGGREGATE <br />$ 5.000,000 <br />DED RETENTIONS <br />S <br />D <br />mum coMPeWsanoN <br />AND MPLOMS' UAaIUTY <br />ANY PROPRaTORRAIITNERIIXECUTNE YIN <br />OFFICERa1EMBER IXCWDED7 <br />Ixknamn Is NMIFl <br />nvas.IU MMunder <br />DEBCmPTION of OPERATIONS eebw <br />NIA <br />/� <br />831316422 <br />07/01/22 <br />07101123 <br />X eTATure <br />E.L. EACH ACCIDENT <br />$ 1,000,000 <br />E.L. DISEASE -EA EMPLOYEE <br />S 1,000,000 <br />E.L. DISEASE -POLICY LIMIT <br />E 1,000,000 <br />E <br />F <br />POLLUTION LIABILITY <br />PROFESSIONAL LIABILITY <br />GT3640124002 <br />MPL7863490.22 <br />07/01/22 <br />07/01122 <br />07101/23 <br />07101/23 <br />Each Pollution Condition $1,000,000 <br />Each Claim $2,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be aeamed If more space is required) <br />SEE SUPPLEMENTAL CERTIFICATE INFORMATION <br />CERTIFICATE HOLDER CANCELLATION <br />City of Santa Ana <br />Risk Management Division <br />20 Civic Center Plaza <br />4th Floor <br />Santa Ana, CA 92702 <br />Attention: <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 />The ACORD name and logo are registered marks of ACORD <br />RbkMi. lgNtm <br />RENFN3)6 NRiUYEDBy: <br />(��\, �.. <br />Risk Mann -1 9enerp UniUlPiAe <br />