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��- CERTIFICATE OF LIABILITY INSURANCE <br />D0.T2(MMdDD/YYYY) <br />12/22/2021 <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 INSLRER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pol5c:y(ies) must have ADDITIONAL INSURED provisuons 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 />ACT <br />NAME, Carl Davidson Insurance Agency <br />AHON <br />E. Ex : (661) 222-7319 ,,, , (661) 222-7212 <br />Carl Davidson Insurance Agency <br />E-MAIL ,ADDRESS: carl@cdavidsoninsurance.com <br />25060 Avenue Stanford Ste. 270 <br />WSURER(S) AFFORDING COVERAGE <br />51AIC# <br />Valencia, CA 91355 <br />INSURLR,A: Kinsale Insurance Company <br />38920 <br />INSURED <br />Vicon Enterprises Incorporated <br />INSURER B <br />INSURER C: <br />INSURERD: State Fund <br />35076 <br />5433 E Spyglass Way <br />Anaheim, CA 92807 <br />INSURER E: <br />INSURER F : <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAWED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM CR CONDITICN OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS CIF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />ADOL <br />SUBR <br />POLICY EFF <br />POLICY EXP <br />LTR <br />TYP£ OFINSURANCE <br />IN5D <br />POLY'YNUMB.ER <br />(MMDD <br />MM/DD <br />LIM-ITS <br />XCOMMERCIALGEN <br />ERALLIABILITY <br />EACH OCCURRENCE <br />$ 1,000,000 <br />X <br />DAMAGE TO RENTED <br />PREM ISES(Ea occurrence) <br />100 000 <br />$ , <br />CLANS -MADE OCCUR <br />MED EXP (Anyone person) <br />$ <br />A <br />X <br />0100160438-0 <br />8/19/2021 <br />8/19/2022 <br />PERSONAL B ADV INJURY <br />$ <br />GEN'LAGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />❑ PEA ❑ <br />2,000,000 <br />POLICY LOC <br />PRODUCTS-COMP/OPAGG <br />$ <br />$ <br />OTHER: <br />AUTCMCSILELIABILITY <br />CO M RNEDSINGLEUMIT <br />$ <br />(Ea accident) <br />BODILY INJURY (Per person) <br />$ <br />ANYAUTO <br />CNNED SCHEDULED <br />BODILY INJURY (Per accident) <br />$ <br />AUTOSONLY AUTOS <br />PROPERTY DAMAGE <br />$ <br />H RED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />(Per accident) <br />$ <br />OCCUR <br />EACH OCCURRENCE <br />$ 2,000,000 <br />A <br />CLAIMS -MADE <br />X <br />0100169118-0 <br />11/3/2021 <br />11/3/2022 <br />AGGREGATE <br />$ <br />?![HETENTI.N <br />$ <br />$ <br />WORKERS COMPENSATION <br />X// FcR OTH- <br />AND EMPLOYERS' LIABILITY Y <br />^ STATUTE ER <br />E.L. EACH ACCIDENT <br />$ 1,000,000 <br />D <br />ANY PR OPRIETOR/PARTNER/EXECUTIVE <br />N/A <br />9304121 <br />8/21/2021 <br />8/21/2022 <br />1,000,000 <br />OFFICER/MEMBER EXCLUDED? <br />ID <br />(Mandatory in NH) <br />E.L. DISEASE - EA EMPLOYEE <br />$ <br />Ayes, describe under <br />1,000,000 <br />DESCRPTION OF OPERATIONS bel— <br />E.L. DISEASE- POL\;Y LIMIT <br />$ <br />Dt5C RIPTION OF Cp'ERATnNS / LOCATIONS / VEH ICLE5 (ACORD 101, AddAmal Remarks Schedule, maybe attached if r—e space is requxed) <br />The City of Santa Ana, its officers, officials, employees, and volunteers are named as additional insureds on the CGL policy with respect to <br />liability arising out of work or operations performed by or on behalf of the Contractor including materials, parts, or equipment furnished in <br />connection with such work or operations. <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 />Clerk of the City Council <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />City of Santa Ana <br />20 Civic Center Plaza (M-30), P.O. Box 1988 <br />AUTHORIZED REPRESENTATIVE <br />Santa Ana, CA 92702-1988 <br />C) <br />Gn1988-2016ACORDCORPORATION. All rights reserved. <br />ACORD25 (2016103) The ACORDname and logo are registered marks ofACORD <br />