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DATE(MMIDD/YYYY) <br /> A�" CERTIFICATE OF LIABILITY INSURANCE <br /> 0 311 3/2 0 24 <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 policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. <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 rights to the certificate holder in lieu of such endorsement(s). <br /> PRODUCER CONTACT Vicki Rodriguez <br /> NAME: <br /> Insurance Incorporated aCONN. Ext: (877)898-9333 IX No: (951)300-9332 <br /> 3400 Central Ave E-MAIL vrodriguez@insuranceinc.com <br /> ADDRESS: <br /> Suite 220 INSURER(S)AFFORDING COVERAGE NAIC# <br /> Riverside CA 92506 INSURERA: CompWest Insurance Company 12177 <br /> INSURED INSURER B: <br /> Diversified Waterscapes,Inc. INSURER C: <br /> 27324 Camino Capistrano#213 INSURER D: <br /> INSURER E: <br /> Laguna Niguel CA 92677 INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 23 24 WC 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 CONTRACTOR 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 TYPE OF INSURANCE POLICY EFF POLICY EXP <br /> LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS <br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ <br /> CLAIMS-MADE OCCUR PREM IS (Ea occurrence)DAMAGE TO t <br /> $ <br /> MED EXP(Any one person) $ <br /> PERSONAL&ADV INJURY $ <br /> GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ <br /> POLICY ❑ PRO ❑ LOC PRODUCTS-COMP/OP AGG $ <br /> JECT <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> Ea accident <br /> ANYAUTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS <br /> HIRED NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY Per accident <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED I I RETENTION $ $ <br /> WORKERS COMPENSATION X1 <br /> SPER TATUTE EORH <br /> AND EMPLOYERS'LIABILITY YIN 1,000,000ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ <br /> A <br /> OFFICER/MEMBER EXCLUDED? NIA Y CWWCP10006137602 10/01/2023 10/01/2024 <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 <br /> If yes,describe under 1,000,000 <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> *30-Day Notice of Cancellation with the exception of 10-day notice of <br /> cancellation provided due to nonpayment of premium. <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN <br /> City of Santa Ana ACCORDANCE WITH THE POLICY PRO) <br /> Risk Management Division RisleManagementDiviaian <br /> Civic Center Plaza,4 flo AUTHORIZED REPRESENTATIVE i REVIEWED/y T'&APPROVED BY: <br /> 20 1-If�l,-I-LAY T f>� av <br /> do <br /> Santa Ana CA 92702 <br /> — Risk Management Specialist <br /> ©1988-2015 ACOF <br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD <br />