Item 22 - On -Call Welding Services Agreements

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AC � " � CERTIFICATE OF LIABILITY INSURANCE DATE (M11VDD/WYY) 12/23/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Next First Insurance Agency, Inc. PO Box 60787 Palo Alto, CA 94306 PHONE (g55) 222-5919 FAX A/C No Ext : A No): E-MAIL : su ADDRESSpport@roextinsurance.com INSURER(S) AFFORDING COVERAGE NA1C# INSURERA: State National Insurance Company, Inc. 12831 INSURED INSURER B VICON ENTERPRISE INC 5433 E Spyglass Way INSURER C 7 INSURER D: Anaheim, CA 92807 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 9440339 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IINSR TYPE INSURANCE AIJ )L $UBR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DD MMAD COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ ETORENTED DAMACLAIMS-MADr OCCUR 'EMI PREMISES Ea occurrei7ce $ MED EXP (Any ore person) $ PERSONAL & ADV INJJRY $ GEN`L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PROJECT LOC PRODUCTS - COMP/OP AGG $ $ OTHER: AUTOMOBILE LIABILITY COMBINEDSINGLELIMIT Ea accident $1,000,OD0.00 BODILY INJURY (Per person) $ ANY AUTO A OWNED X SCHEDULED AUTOS ONLY AUTOS X NXTR9H44QX-00-CA 09/28/2021 0W28/2022 BODILY INJURY (Per accident) $ A PROPERTY DAMAGE Pcr accident $ HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ WORKERSCOMPENSAT4CN AND EMPLOYERS LIABILITY Y / N PER OTH- STATUTE ER ANYF'ROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER,'MEMBER EXCLUDED? ❑ N/A E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATDONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate Hodder is an Additional Insured on the Commercial Automobiile pobcy per the Blanket Additional Insured Endorsement. All Certificate Holder privileges apply only ff required by written agreement between the Certificate Holder and the nsured, and are subject to policy terms and conditions. CERTIFICATE HOLDER CANCELLATION CLERK OF THE CITY COUNCIL CITY OF SANTA ANA 20 CIVIC CENTER PLAZA (M-30) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE PO Box 1988 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Santa Ana, CA 92702 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD