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<br />Lw DATE (MM/DD/YYYY)
<br />A`"'R" CERTIFICATE OF LIABILITY INSURANCE
<br />07/12/2024
<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 riahts to the certificate holder it i;-�u_af such endorsoment(s). -
<br />PRODUCER
<br />Willis Towers WatsAncue
<br />east, Inc. •
<br />c/o 26 Century BlvP.O. Box 305191
<br />Nashville, TN 37
<br />INSURED
<br />Pitney Bowes Inc.
<br />3001 Summer Street
<br />Stamford, CT 06926
<br />c e v e o
<br />CAVFRAnFS
<br />CFRTIFICATF NII'dRFR- W3429
<br />A/C, No Ext : 1 E877-945"i378 A%C, No : 1-888-467-2378
<br />E-M L • 'cates@wtwco.com
<br />AD
<br />SURER(S) AFFORDING COVERAGE NAIC #
<br />INSURERA: !T American Insurance Company 22667
<br />ce & Industry Insurance Company 19410
<br />INSURERC: Indemnity Insurance Company of North Ameri 43575
<br />i n e w 'te s surance Company 20702
<br />• • •
<br />INSURER E
<br />NIIMRFR-
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSUI1_.4CE 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 />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />INSD
<br />SUBR
<br />WVD
<br />POLICYNUMBER
<br />POLICY EFF
<br />MM/DD
<br />POLICY EXP
<br />MM/DD
<br />LIMITS
<br />X
<br />COMMERCIAL GENERALLIABILRY
<br />EACH OCCURRENCE
<br />$ 2,000,000
<br />CLAIMS -MADE �X OCCUR
<br />DREMM AGE S( RENTED
<br />PREMISES Ea occurrence)$
<br />2,000,000
<br />MED EXP (Any one person)
<br />$ 5,000
<br />A
<br />Y'
<br />Y
<br />HDO G48899213
<br />07/01/2024
<br />07/01/2025
<br />PERSONAL & ADV INJURY
<br />$ 2,000,000
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />$ 4,000,000
<br />POLICY PRO-
<br />JECT ❑ LOC
<br />X
<br />PRODUCTS - COMP/OPAGG
<br />$ 4,000,000
<br />$
<br />OTHER:
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$ 3,000,000
<br />X
<br />BODILY INJURY (Per person)
<br />$
<br />ANY AUTO
<br />A
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />Y
<br />Y
<br />ISA H10823377
<br />07/01/2024
<br />07/01/2025
<br />BODILY INJURY (Per accident)
<br />$
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />HIRED NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />L
<br />$
<br />X
<br />UMBRELLALIAB
<br />X
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 5,000,000
<br />AGGREGATE
<br />$ 5,000,000
<br />EXCESS LAB
<br />CLAIMS -MADE
<br />Y
<br />Y'
<br />BE 020407666
<br />07/01/2024
<br />07/01/2025
<br />DED x RETENTION $ 25, 000
<br />$
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y / N
<br />ANYPROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICER/MEMBER EXCLUDED? No
<br />(Mandatory in NH)
<br />N/A
<br />Y'
<br />WLR C55519122
<br />07/01/2024
<br />07/01/2025
<br />X PER OTH-
<br />STATUTE ER
<br />E.L. EACH ACCIDENT
<br />2,000,000
<br />$
<br />E.L. DISEASE - EA EMPLOYEE
<br />2,000,000
<br />$
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />2,000,000
<br />$
<br />A
<br />Workers Compensation and
<br />y
<br />WLR C55519031
<br />07/01/2024
<br />07/01/2025
<br />E.L. Each Accident
<br />$2,000,000
<br />Employers' Liability
<br />E.L. Disease - EA t$2,000,000
<br />Per Statute
<br />E.L. Disease-Pol L$2,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required)
<br />This Voids and Replaces Previously Issued Certificate Dated 07/08/2024 WITH ID: W34259891.
<br />SEE ATTACHED
<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 />ACCORDANCE WITH THE POLICY PRC
<br />% orz,N�F RAMougmumtDivisian
<br />AUTHORIZED REPRESENTATIVE z REVIEWED
<br />�ny&APPROVED BY.
<br />City of Santa Ana
<br />20 Civic Center Plz n 6L -11% t 1u t`fLel e
<br />Santa Ana, CA 92702 `J� ® Risk Management Specialist
<br />© 1988-2016 ACORD
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />SR ID: 26164858 BATCH: 3537596
<br />
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