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DAVITAU-01
<br />LBURRILI
<br />DAT/1012024 )
<br />,4coR0" CERTIFICATE OF LIABILITY INSURANCE
<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 rights to the certificate holder in lieu of such endorsements .
<br />PRODUCER
<br />CONTACT Lisa Burrill
<br />Acrisure Southwest Partners Insurance Services, LLC
<br />4000 Westerly Place
<br />Suite 110
<br />jAlc No, EXl : 909 766-1788 FAX
<br />( ) (A/C, No):
<br />e-MAIEss:liburrill@acrisure.com
<br />Newport Beach, CA 92660
<br />INSURERS AFFORDING COVERAGE
<br />NAIC e
<br />INSURER A: Sentinel Insurance Company, Ltd
<br />11000
<br />INSURED David Taussig & Associates Inc.
<br />dba DTA
<br />INSURER B: California Automobile Insurance Corri
<br />38342
<br />INSURER C: Starstone National Insurance Company
<br />25496
<br />INSURERD: Hartford Casualty InsurEE7�
<br />29424
<br />18201 Von Karmen Ave
<br />Suiteort
<br />Newport Beach, CA 92612
<br />INSURER E:Philadelphia lndemnit Ian
<br />18058
<br />INSURER r: Hartford Fire Insurance
<br />19682
<br />COVERAGES CERTIFICATE NUMBER: RFVI410N NIIMRFR•.
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOWHAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FORTHE POLICYPERIOD
<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 />LTRLIMITS
<br />TYPE OF INSURANCE
<br />ADDLSUBR INSD
<br />MD
<br />POLICY NUMBER
<br />POLICY EFF
<br />POLICY EXP
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE [X]OCCUR
<br />X
<br />72SBAAP5439
<br />212412024
<br />2/24/2025
<br />EACH OCCURRENCE
<br />$ 2,000,000
<br />DAMAGE TORENTED
<br />nce
<br />1,000,00PREMISES 0
<br />MED EXP (My one erson
<br />10,000
<br />PERSONAL &ADV INJURY
<br />2,000,000
<br />AGGREGATE LIMIT APPLIES PER:
<br />POLICY[ X]jEeT LOC
<br />GENERAL AGGREGATE
<br />4,000,000
<br />GEN'L
<br />PRODUCTS - COMPIOPAGG
<br />4+000,000
<br />OTHER:
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />We accident
<br />$ 1,000 000
<br />BODILY INJURY Perperson)
<br />$
<br />X
<br />ANY AUTO
<br />BA040000030599
<br />1211912023
<br />12/1912024
<br />AUTOSONLYAUTNNOSULED
<br />BODILY INJURY Per accident
<br />$
<br />AUTOS ONLY AUT090NLy
<br />PeOP.ERe I AMAGE
<br />$
<br />C
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 5,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />85717R241ALI
<br />2124/2024
<br />2/2412025
<br />AGGREGATE
<br />$ 5,000,000
<br />DED RETENTION$
<br />III
<br />D
<br />WORKERSCOMPENSATION
<br />ENSA IOI N YIN
<br />ANY PROPRIETORIPARTNEREXECUTIVE ❑
<br />pFFICERIMEMBER EXCLUDED?
<br />'Mandatory In NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />NIA
<br />72WECEU2873
<br />91112023
<br />91112024
<br />X PER
<br />-UlERH
<br />E. L. EACH ACCIDENT
<br />$ 1,000,000
<br />E. L. DISEASE - EA EMPLOYE
<br />$ 1,000,000
<br />E.L. DISEASE - POLICY LIMIT
<br />1,000,000
<br />E
<br />Prof. Liab.IClaims
<br />PHSD1835820
<br />1111/2023
<br />111112024
<br />Limit
<br />2,000,000
<br />F
<br />Crime
<br />72 BDD HP8140
<br />6114/2023
<br />611412024
<br />1,000,000
<br />DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
<br />cityclerk@santa-ana.org; FVlllareal@santa-ana.org
<br />Cyber Liability coverage with State National Insurance Company, Inc. -Policy 4EHJ-ADMO1715148 Eff: 7122123-712W24. Limit $2,000,000
<br />Excess follows form over General Liability, Automobile Liability, and Employers Liability and all applicable endorsements apply.
<br />THE CITY OF SANTA ANA, IT'S OFFICERS, EMPLOYEES, AGENTS, AND REPRESENTATIVE ARE NAMED AS ADDITIONAL INSURED IN REGARDS TO
<br />GENERAL LIABILITY.
<br />-All ATTACHED.
<br />CITY OF SANTA ANA
<br />20 CIVIC CENTER PLAZA
<br />SANTA ANA, CA 92701
<br />ACORD 25 (2016103)
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREO
<br />ACCORDANCE WITH THE POLICY PR(
<br />AUTHORIZED REPRESENTATIVE
<br />ZZE�...-
<br />RlekMvvgemextDMalan
<br />REVIEWED&APPROVED BY:
<br />AIJUA1044
<br />Risk Management Specialist
<br />@ 1988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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