Item 19 - Site License Agreement for Bus Passenger Services

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Accwz a CERTIFICATE OF LIABILITY INSURANCE [0210212024 1:41 PM 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 INSURERjS), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IIMPORTANT, If the Certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and condtttons 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 endorsament(s), PRODUCER Davalos Insurance Agency LLC 45 S Atlantic Blvd NAME CT Ringwalt & Liesche Co. dba Pacific Gateway Insuran PHONE I.C. Na. Eat' 6612575977 AIC. FAx A+C. No E-MAIL Los Angeles, CA 90022 ADDRESS: INSURER(S) AFFORDING COVERAGE NAIL 0 INSURER A NATIONAL LIABILITY & FIRE INS. CO. 20052 INSURED OHANA SHUTTLES LLC $645 SHULL ST INSURER B: NATIONAL FIRE & MARINE INSURANCE CO 20079 INSURERC: INSURER D BELL GARDENS, CA 90201 1INSUREIRE I INSURER F: COVERAGES CAi ICA 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. INSR LTR TYPE OF INSURANCE AODL INSR SUER WVD POLICY NUMBER POLICY EFF MMIDDIYy POLICY EXP MMIDDTYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE ❑OCCUR DAMAGE TO RENTED S PREMISES Eeoco.i—non) MED EXP (Any one person) S PERSONAL S ADV INJURY S GENT AGGREGATE LIMIT APPLIES PER POLICY ❑ O �LOC IIIIII.....JJJJJJ GENERAL AGGREGATE S PRODUCTS -COMPIOP AGG $ S OTHER. AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S 1,000,000 A ANYAUTO OWNED scHEDULED AUTOS ONLY AUTOS 73APS114627 1012612023 12:01 AM 10/26/2024 12:01 AM Ea made, l BODILY INJURY {Per pecan) $ NIA BODILY INJURY (Per amden0 S NIA PROPERTY DAMAGE Per accident $ NIA HIRED AUTOS NON -OWNED ONLY AUTOS ONLY 1. t1MBRFI I A LIAO OCCUR EACH OCCURRENCE ; CLAIMS -MADE AGGREGATE f EXCESS UAe DED RETENTIONS S WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY EL EACHACCIDENT ANY PROPRIETOWPARTNEWEXECUTNE NIA OFFICER/MEMBER EXCLUDED? Y f N E. L. DISEASE - EA EMPLOYEE $ (Mendeicry 1n NH) II yes, descrIbe under E L DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS below B EXCESS AUTO LIABILITY 72XA5009503 10/26/2023 10/26/2024 OMITS OF LIABILITY $ 4,000,000 S DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, mey be attach*dI man apace la required) Comp or Stated Phys. Dam, lr-Tow Cargo Year, Make, Model, VIN Collision 2003 PREVOST BUS 2PCH334lX31014642 NIA N/A NIA NIA WA :ERTIFICATE HOLDER CANCELLATION SYPS LLC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 2550 FIFTH AVE SUITE 600 ACCORDANCE WITH THE POLICY PROVISIONS. SAN DIEGO, CA 92103 AUTHORIZED REPRESENTATIVE ,sae? ACORD 25 (2016103) M-5652 (10/2017) The ACORD name and logo are registered marks of ACORD 01888-2015 ACORD CORPORATION. All rights reserved.