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ligi <br />ally <br />Samantha M. Samanthasigned.Lam <br />Samantha M. Lambert <br />n.,e. ama nc n ».ar m <br />-07'00'-__- <br />ACORV CERTIFICATE OF <br />DATE IMM DDAYYY <br />LIABILITY IksUMCE 5/1/2023 <br />4/29/2022 <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 certificatedoes not confer rights to the certificate holder in lieu of such endorsements . <br />PRODUCER Lockton Companies <br />3280 Peachtree Road NE, Suite #250 <br />Atlanta GA 30305 <br />(404)460-3600 <br />CONTACT <br />PHONE FAX <br />INC. NoEad. H' <br />AIO ' <br />Ea L <br />"D <br />INSURERS AFFORDING COVERAGE <br />NAIC9 <br />INSUR A: The Continental Insurance Company <br />35289 <br />INSURED NV 5, Inc. <br />1491108 163 Technology Drive <br />IBsumpt B: National Fire Insurance Co of Hartford <br />20478 <br />INsustERc:Trans ortation Insurance Company <br />20494 <br />NsunR D: National Fire and Marine Insurance Co <br />20079 <br />Suite 100 <br />Irvine CA 92618 <br />INSURER E <br />INSURER F <br />COVERAGES Irvine CERTIFICATE NUMBER: 17540928 REVISION NUMBER: XXXXXXX <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 />INTSR <br />R <br />TYPE OF INSURANCE <br />ADOL <br />BUBB <br />POLICY NUMBER <br />POLICY EFF <br />POLICY EXP <br />LIMITS <br />A <br />X <br />COMMERC W, GENERAL LIABILITY <br />CLAIMS -MADE O OCCUR <br />Contractual Liab <br />Y <br />N <br />7014856125 <br />5l 1 /2022 <br />5,12023 <br />EACH OCCURRENCE <br />S 1,000,000 <br />DAMAGE TO RENTED <br />5 1,000,000 <br />X <br />MFD EXP (An nne ) <br />S 15,000 <br />X1 <br />Cross Lib Incl <br />PERSONAL S ADV INJURY <br />S 1,000,000 <br />GENt <br />AGGREGATE LIMIT APPLIES PER <br />POLICY O JEa F LOC <br />OTHER <br />GENERAL AGGREGATE <br />S 2000000 <br />PRODUCTS - COMPIOP AGO <br />$ 2,000,000 <br />$ <br />H <br />AUTOMOBILEOABILRY <br />X ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY �, AUTOS <br />HIRED NON -OWNED <br />_ AUTOS ONLY AUTOS ONLY <br />Y <br />N <br />7014842659 <br />5/12022 <br />5/1/2023 <br />COMBINED SINGLE UNI <br />S ] 000000 <br />BODILY INJURY (Per pemon) <br />S j XY_3()()(j( <br />BODILY INJURY(Per&.*dent) <br />S XXXXXXX <br />PROPER DAMAGE <br />S XXXXXXX <br />S XXJQC= <br />A <br />UMBRELLA LAB X OCCUR <br />EXCESS LAB CLAIMS -MADE <br />N <br />N <br />7014841883 <br />5A2022 <br />51/2023 <br />EACH OCCURRENCE <br />S 20ON000 <br />AGGREGATE <br />S 20 000 000 <br />DEE) <br />I X I RETENTIONS SO <br />S <br />B <br />C <br />WORNENS COMPENSATION <br />AN1UUERS COMPENSATION <br />ANY PROPRIETORIPARTNERElECUTNE Y/N <br />OFFICERrMEMBER EXCLUDED& FN <br />(Mandatory In NH) <br />li pes. Eesa0 under <br />DESCRIPTION Of OPERATIONS below <br />NIA <br />N <br />70148428244((ADS) <br />7014842810(CA) <br />5i1/2022 <br />5/1/2022 <br />5.!1/2023 <br />5/1/2023 <br />PER OTH- <br />X <br />E.L EACH ACCIDENT <br />4 1,000,000 <br />E.L. DISEASE - EA EMPLOYEE <br />S ] 000 000 <br />ELDISEASE -POLICY LIMIT <br />S <br />D <br />A <br />A <br />Pro6Poll Liab <br />Bus Per Prop <br />Leased/Rented Equip <br />N <br />N <br />42-EPP-32132MI <br />7014856125 <br />7014900785 <br />5212022 <br />51[2022 <br />5/1/2022 <br />51:2023 <br />5: 1,2023 <br />51,2023 <br />Ea. Claim/Agg.$I ONUS20M <br />Limit$18,016.286 <br />Limit$100,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addalonal Remark. Schedule, may ba aaached If more space is r"ulred) <br />17540928 <br />City of Santa Ana <br />Risk Management Division <br />20 Civic Center Plaza, <br />4th Floor Santa Ana CA 92701_ <br />SHOULD ANY OF THE ABOVE DESCRIBED <br />THE EXPIRATION DATE THEREOF, N <br />ACCORDANCE WITH THE POLICY PROVISI <br />AUTHORIZED <br />n <br />' U $Aw.awifA 1w.�a.7 <br />All riahts reserved <br />ACORD 25 (2016/03) <br />The ACORD name and logo are registered marks of ACORD <br />