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Tori Pierson 202s2g.N.9b1yT103cod <br />1010 3 <br />A4ir CERTIFICATE OF LIABILITY INSURANCE <br />DAM(MM/OD/YYYY) <br />4/15/2022 <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 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 <br />AssuredDesign Professionals Insurance Services, LLC <br />3697 Mt. Diablo Blvd Suite 230 <br />Lafayette CA 94549 <br />CONTACT <br />NAME: Marie SwaneyPartners <br />PHONE . 626-696-1890 we Ne: <br />E-MAIL <br />ADDRess: CertSDesi nPro AssuredPartners.com <br />INSURERS AFFORDING COVERAGE <br />NAIC If <br />INSURER A: Travelers Property Casualty Company of America <br />25674 <br />Licenselt: 6003745 <br />INSURED PROJPAR-01 <br />Project <br />t Partners <br />949 852-9300 <br />INSURER Is: The Travelers Indemnity Company of Connecticut <br />25662 <br />INSURER c: US Specialty Insurance Company <br />29599 <br />INSURER D: <br />23195 La Cadena Drive, Suite 101 <br />Laguna Hills CA 92653 <br />INSURER E: <br />INSURER F <br />COVERAGES CERTIFICATE NUMBER: 716733997 RFVIBIr1N NIIMRPR- <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 />ILTR <br />TYPE OF INSURANCE <br />ADOL <br />Man <br />SUBR <br />WV0 <br />POLICY NUMBER <br />POLICY EFF <br />MM/DDA'YYY <br />POLICY EXP <br />POLICY <br />LIMITS <br />B <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE X OCCUR <br />V <br />Y <br />680DJ543236 <br />4/18/2022 <br />4/18/2023 <br />EACH OCCURRENCE <br />$2.000,000 <br />DAMAGE TO RENTED <br />PREMISES Ea occurrence <br />$1,000,000 <br />X <br />MED EXP (Any one person) <br />$10,000 <br />Contractual Liab <br />I XCU Included <br />PERSONAL B ADV INJURY <br />$2.000,000 <br />X <br />GEN'L <br />AGGREGATE LIMIT APPLIES PER: <br />PRO- <br />POLICV [XI JECT LOG <br />GENERAL AGGREGATE <br />$4.000,000 <br />PRODUCTS-COMPIOPAGG$4,OKOOO <br />$ <br />OTHER: <br />B <br />AUTOMOBILE <br />LIABILITY <br />Y <br />Y <br />BA6R856630 <br />4/18/2022 <br />4/18/2023 <br />COMBINED SINGLE -LIMIT <br />Ea accident <br />$1,O0D,000 <br />BODILY INJURY (Par person) <br />$ <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />P$ <br />BODILY INJURY (Par accident) <br />$ <br />HIRED X NON -OWNED <br />ONLY AUTOS ONLY <br />X <br />PROPERTY DAMAGE <br />Persecutent <br />XAUTOS <br />NaOwradAutas <br />1 <br />1 <br />$ <br />A <br />X <br />UMBRELLALIAB <br />X <br />OCCUR <br />Y <br />Y <br />CUP8833Y649 <br />4/18/2022 <br />4/18/2023 <br />EACH OCCURRENCE <br />$1,000,000 <br />AGGREGATE <br />$11000,000 <br />EXCESS LIAB <br />CLAIMS -MADE <br />DEO I X RETENTION $ in <br />$ <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y/ N <br />ANYPROPRIETOR/PARTNERlEXECUTIVE <br />OFFICERIMEMBEREXCLUDED7 <br />NIA <br />Y <br />UB3J809976 <br />4/18/2022 <br />4/18/2023 <br />X STATUTE 10 <br />ERH <br />E.L. EACH ACCIDENT <br />$1,000,000 <br />E.L. DISEASE - EA EMPLOYEE <br />$11000,000 <br />(Mandatory in NH) <br />If yes, describe under <br />E.L. DISEASE -POLICY LIMIT <br />$1,000,000 <br />DESCRIPTION OF OPERATIONS below <br />C <br />Professional Liability <br />USS2232805 <br />4/18/2022 <br />4/18/2023 <br />Per Claim <br />$2,000,000 <br />Aggregate Limit <br />$2,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />AM Best's Rating for all policies listed are: A/XII or greater. Insured owns no company vehicles; therefore, hired/non-owned auto is the maximum coverage that <br />applies. Umbrella policy is follow -form to its underlying Policies: General Liability/Auto Liability/Employers Liability. <br />Re: Agreements: A-2018-213, A-2019-117-01, A-2020-153-04 -- <br />The City of Santa Ana, its officers, employees, agents, volunteers and representatives are named as additional insured as respects general and auto liability as <br />required per written contract or agreement. General Liability is Primary/Non-Contributory per policy form wording. Insurance coverage includes waiver of <br />subrogation per the attached endorsemenl(s). <br />City of Santa Ana <br />Risk Management Division <br />20 Civic Center Plaza, 4th Floor <br />Santa Ana CA 92702 <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 plsk MM�gygpyyyq <br />FIn RE�nPLED6AvvItOJ®BY: <br />01QAA-9n15 ACr1Rn Cr Rhk Maru9emengmul Aide <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD v N <br />