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ACQ CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD)YYYY)
<br />`� 03/08/2021
<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 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 be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endomement(s).
<br />PRODUCER NAME- S ILV I CHA
<br />INSURANCE LAND INSURANCE SERVICES PHONE 213_3SS-550 FAx 213-�$$-']14-8
<br />IC, No. Extl: _ _ �A C NNoj _. — . -
<br />4032 WILSHIRE ]3LVD ADDRESS: INSURANCELAND@GMAIL.COM - —
<br />SUITE 309 --
<br />INSURERS} AFFORDING COVERAGE NAIC N
<br />LOS ANGELES —CA 90010 INSURER A:EVANSTON INSURANCE COMPANY 35378
<br />INSURED INsuRER B :STATE FARM — 117 7 0
<br />VALLEY MAINTENANCE CORPORATION INSURER C. UNITED STATES LIABILITY INS. CO. 2$895
<br />INSURER D : ICW GROUP 27847
<br />11759 TELEGRAPH ROAD INSURER rm: TRAVEL19RS CASUALTY AND SURETY CO. 19038
<br />SANTA FE SPRINGS CA 90670 1 INSURERF: -- —
<br />COVERAGES CERTIFICATE NUMBER: 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 />7R TYPE OF INSURANCE iADDLlpjqnI - R; - — -- _ --
<br />POLICY EFF POLICY M
<br />VAM POLlCYNUMBER MMlDDrYYYY DI MMIDYYYY LIMITS
<br />COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 11000,000
<br />3AA414169 08/13/2020 08/13/2021 pAMAGE TE❑ CLAIMS © OCCUR
<br />_PREMISES [Ea occum3nCa $ 100,000
<br />PRIMA'RV unu-rt1MTRTarrrnnr, — - -
<br />PA
<br />G E N'L AGGREGATE LIMITAPPLIES PER-
<br />V1POLICY E] JET II LOC
<br />i AUTOMOBILE LIABILITY
<br />1-7
<br />1 ANY AUTO SCHEDULED
<br />—
<br />B AUTOS ED -- AUTOSALL O
<br />NON-OWNED
<br />HIREDAUTOS j� AUTOS
<br />UMBRELLA LIAR + + OCCUR
<br />C EXCESS LIAB IIHI! rl Aluc
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y 1
<br />ANY PROPRIETORIPARTNERIEXECUTIVE
<br />D OFFICEWMEMBER EXCLUDED? Y
<br />(Mandatory in Nil)
<br />I If ves- describe under
<br />MED EXP (Any one person)
<br />s 5,000
<br />PERSONAL&ADVINJURY
<br />X
<br />x
<br />$ 110001000
<br />GENERALAGGREGATE
<br />$ 2,000,000
<br />PRODUCTS -COMPlop AGG
<br />$ INCLUDED
<br />$ $25,000
<br />683B202C15-75 9/15/202D
<br />9/15/2021
<br />C MBINED SEN LE LIMIT
<br />Ea accident].
<br />S 2,000,000
<br />S 11000, 000
<br />BODILY INJURY (Per person)
<br />7L
<br />R
<br />BODILY INJURY (Per accidwQ
<br />$ 11000,000
<br />PRQPERIY DAMAGE
<br />[Peraccident)
<br />$ 11000,000
<br />S 1,000,000
<br />AGGREGATE
<br />I XL1578400C 05/02/2020
<br />os/02/2021
<br />CH_OCCURREN_CE_
<br />tGREGATE
<br />$ 51 000, 000
<br />.
<br />_
<br />$ 5,000,000
<br />PRODUCTS-COH/OP AGG
<br />$ 11000,000
<br />I
<br />I WSA 5037498 03 0e/13/20201
<br />08/13/2021
<br />ER
<br />TATUTE j ERN
<br />NIA x E-L-EACH ACCIDENT 1 S 1,000,000
<br />E.L. DISEASE - EA E M PLOY E El S 1,000,000
<br />E.L. DISEASE -POLICY LIMIT $ 1,000,000
<br />105620659 05/24/2020 05224/20211THIRD PARTY $1, 000, 000
<br />DESCRIPTION OF OPERATIONS I LOCATION 51 VEHICLES (ACORD 101, Additional Remarks Scheftle, may be attached If more space is required)
<br />ty of Santa Ana, Risk Management, it's officers, employees, agents, representatives, and volunteers
<br />additional inured,
<br />rtificate of Insurance shall provide thirty (30) day prior written notice of cancellation
<br />CERTIFICATE HOLDER CANCELLATION
<br />(CITY OF SANTA ANA RISK MANAGEMENT DIVISION
<br />20 CIVIC CENTER PLAZA, 4TH FLOOR
<br />SANTA ANA
<br />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
<br />I4911i C
<br />u T SBU-ZUT4 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014101 ) The ACORD name and logo are registered marks of ACORD
<br />
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