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Tracy oi°ov t%� y Page 1 of 2 <br />A ie CERTIFICATE OF LIABILITY INSURANCE Jacob0ntea" m DATE <br />Bio3iz0�) <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 />Willis Towers Watson Insurance Services West, Inc. <br />c/o 26 Century Blvd <br />P.O. Box 305191 <br />CONTACT Willis Towers Watson Certificate Center <br />NAME: <br />PHONE 1-877-945-7378 1) No; 1-888-467-2378 <br />E-M IL certlEicatas®willie. com <br />ADDRESS: <br />Nashville, TN 372305191 USA <br />INSURERS AFFORDING COVERAGE <br />NAICp <br />INSURERA: National Fire Insurance Company of Hartfor <br />20478 <br />INSURED <br />INC Corporation <br />16485 Laguna Canyon Rd #300 <br />Valle <br />INSURER B: Y Forge Insurance Company <br />20508 <br />INSURERC: Continental Insurance Company <br />35289 <br />INSURER D: Hartford Fire Insurance Company <br />19682 <br />Irvine, CA 92618 <br />INSURER E: Lloyds Syndicate 2987 <br />C0978 <br />INSURER F : <br />COVERAGES CERTIFICATE NUMBER: W25600572 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 />ILTR <br />TYPE OF INSURANCE <br />ADDLSUSR <br />INSD <br />"D <br />POLICY NUMBER <br />POLICYEFF <br />MMIDIYVYY <br />POLICY EXP <br />MM/ODIYYYY <br />LIMITS <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS-MADE1XI OCCUR <br />EACH OCCURRENCE <br />$ 11000,000E <br />D T RENTED <br />PREMISES Ea occurrence <br />$ 11000,000 <br />MED EXP Any one person) <br />$ 151ODO <br />A <br />Y <br />7015251780 <br />07/31/2022 <br />07/31/2023 <br />PERSONAL& ADV INJURY <br />$ 11000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRO- <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />PRODUCTS-COMP/OP AGG <br />$ 2,000,000 <br />POLICY 0 JECT LOC <br />$ <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$ 110001000 <br />X <br />BODILY INJURY (Per person) <br />$ <br />ANY AUTO <br />B <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />Y <br />7015271690 <br />07/31/2022 <br />07/31/2023 <br />BODILY INJURY (Per accident) <br />$ <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />PROPERTYDAMAGE <br />(Par a. Idenl <br />$ <br />$ <br />O <br />X <br />UMBRELLA LIAB <br />X <br />OCCUR <br />EACH OCCURRENCE <br />$ 15,000,000 <br />AGGREGATE <br />$ 15,000,000 <br />E%CESS LIAB <br />CLAIMS -MADE <br />7015251746 <br />07/31/2022 <br />07/31/2023 <br />DED RETENTION <br />$ <br />D <br />WORKERS COMPENSATION <br />AND EMPLOY RV LIABILITY YIN <br />ANYPROPRIETOR/PARTNEWEXECUTIVE <br />OFFICERIMEMBEREXCLUDED7 11 <br />NIA <br />59 WE AL3MXU <br />06/01/2022 <br />06/01/2023 <br />X STATUTE I I ER <br />E.L. EACH ACCIDENT <br />$ 11000,000 <br />E.L. DISEASE - EA EMPLOYEE <br />$ 11000,000 <br />(Mandatory In NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT <br />$ 11000,00 0 <br />E <br />Student Professional <br />MPL3031022 <br />07/31/2022 <br />07/31/2023 <br />Per Claim <br />$2,000,000 <br />Liability <br />Per Aggregate <br />$4, 000, 000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be atlaahed If more space is required) <br />This Voids and Replaces Previously Issued Certificate Dated 08/02/2022 WITH ID: W25590565. <br />The City of Santa Ana and its officers, employees, agents, volunteers, and representatives are included as Additional <br />Insureds as respects to General Liability and Auto Liability if required by written contract. <br />General Liability and Auto Liability policies shall be Primary and Non-contributory with any other insurance in force <br />City of Santa Ana <br />Risk Management Division <br />20 Civic Center Plaza <br />Santa Ana, CA 92702 <br />ACORD 25 (2016103) <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 />I / V <br />©1988-2016 ACORD C v,�,Y._F <br />The ACORD name and logo are registered marks of ACORD MEMO <br />so m, 22913564 BATCH, 7619771 <br />