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CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MMIDCNYYY) <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 policyfies) 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 endareementlRl_ <br />PRODUCER <br />BIBERK <br />P.O. Box 113247 <br />Stamford, CT 06911 <br />Ana ie °i9 <br />INSURED <br />Jeanette Pletcher <br />2020 Fronde Street A� e e v e d o <br />San Diego, CA 92107- 33 <br />Insurance C <br />Insurance <br />COVERAGES CERTIFICAT�'eUMBER: REVISION NUMBER - <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY 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 />LT <br />TIDE OFINSURANCE <br />ADDLSUBR <br />POLICY NUMBER <br />POLICY EFF <br />(MMDffYY)n <br />POLICY UP <br />fMMMDNYYYI <br />LIMITS <br />X <br />COMMERCIALGENERAL LABILITY <br />OCCUR <br />EACH OCCURRENCE <br />$ 1,000,000 <br />-DAMACLAIMS-MADE <br />PREMISES TO <br />PREMISES Ea aaunenw <br />E SO 0O0 <br />MED UP CAW one Person) <br />$ 5000 <br />A <br />X <br />N9BP752992 <br />08/16/202308/16/2024 <br />PERSONAL&ADV INJURY <br />$ Included <br />AGGREGATE UMIT APPLIES PER: <br />POLICY Elj� 17] LOG <br />GENERALAGGREGATE <br />$ 2,000,000 <br />GENL <br />PRODUCTS-COMP/OPAGG <br />$ 2,000,000 <br />$ <br />X <br />OTHER <br />AUTOMOBILELABILITY <br />COMBINED SINGLELIMIT <br />Ea aooMen <br />$ <br />BODILY INJURY(Perparnes) <br />$ <br />ANY AUTO <br />OWNED AUTOS ONLY AUTSCHEDOSULED <br />BODILY INJURY (Per accident) <br />$ <br />HIRED NON -OWNED <br />AUTCSONLV AUTOS ONLY(Par <br />PROPERTYDAMAGE <br />sodden <br />$ <br />$ <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />EXCESS LAB <br />CLAIMS -MADE <br />DED I I RETENTIONS <br />$ <br />WORKERSCOMPENSATION <br />AND EMPLOYERS! LIABILITY YIN <br />ANYPROPRIIETORIPARTNER/EXECUTIVE ❑ <br />OFFICERNEMBEREXC WDED4 <br />N/A <br />I PER OTH- <br />STATUTE ER <br />EL EACH ACCIDENT <br />$ <br />E.L. DISEASE -EA EMPLOYEE <br />$ <br />(Mandatory in NH) <br />R yes, describe under <br />E.L. DISEASE - POLICY LIMIT <br />$ <br />DESCRIPTION OF OPERATIONS below <br />B <br />Professional Liability (Errors & <br />Omissions): Claims -Made <br />N9PL677246 <br />08/16/2023 <br />OB/16/2024 <br />Per Occurrence/ <br />Aggregate <br />$1.000000,000/ <br />$1,,000 <br />DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached d more space is required) <br />City Of Santa Ana , It's Officers, Agents, Representatives And Employee Risk Management Division is listed as additional insured as it pertains to general <br />liability (see endorsement attached) <br />City of Santa Ana (CA) <br />Risk Management Division <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 <br />ACORD 25 (2016/03) <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 PRI <br />Risk MwgeneadDtuhlon <br />AUTHORIZED REPRESENTATIVE f� "6+„._� REVIEWED Sr APPROV®RY: <br />L•yTtl./Y�I I A.� Ad�.�c� <br />Risk Management SpertAut <br />©1988-2015 AC( <br />The ACORD name and logo are registered marks of ACORD <br />