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ACOR" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) <br /> Fo8/24/2024 <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 ^. CO RICT BETWEEN E ISSUIN9 INSURER(S), AA11THORIZED <br /> REPRESENTATIV OR PRODUCER,AND TF4 CERTIFICATE HOLDER. <br /> IMPORTANT: If erti of n DIDei,,te <br /> L INSURED,the poh :y;ie L S i endorsed. <br /> If SUBROGATI A ED, u ct t t conditions of the F N�cy, certain licies may re ire an en sement. A statement on <br /> this certificate es t nfe i s t e eolder in lieu of such id sement(s). <br /> PRODUCER COP 4CT <br /> NA' . <br /> BIBERK PF 'N -4 2- — ffa/c No: 0 - 5 - <br /> P.O. BOX 113247 F 4iAL Ext <br /> Stamford, CT 069 1 DDRESa customerservice biBERK com <br /> rAFFO I G OV AIC# <br /> �NSU- ._. . , a a,�D I r Co pa* • 391 <br /> INSURED SURER B: National Liability&F!-9 Insurance Company 20052 <br /> Jeanette Pletc P% L01= V1= d INSURER • 1 • _ ' ' <br /> 2020 Froude Street INSURER • 1 :16ftJ <br /> San Diego, CA 92107-2330 INSURERE: <br /> INSURER F: <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 /> INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS <br /> LTR INSD WVD POLICY NUMBER MMIDD/YYYY MMIDD/YYYY <br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> RENTED <br /> CLAIMS-MADE OCCUR PREM SES Ea occurrence) $ 50,000 <br /> A X X N9BP260927 08/16/2024 08/16/2025 MED EXP(Any one person) $ 5,000 <br /> PERSONAL&ADV INJURY $ Included <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 <br /> PRO- <br /> POLICY1:1 JJECT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 <br /> X OTHER: $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> Ea accident <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS <br /> HIRED NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY Per accident <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED RETENTION$ $ <br /> WORKERS COMPENSATION PER OTH- <br /> AND EMPLOYERS'LIABILITY YIN STATUTE I I ER <br /> ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? ❑ NIA <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> B Professional Liability (Errors & N9PLO92398 Per Occurrence/ $ 1,000,000 <br /> Omissions): Claims-Made os/�6/2o2a 0s/16/2025 Aggregate <br /> $ 1,000,000 <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) <br /> City of Santa Ana,Parks,Recreation and Community Services,its officers,agents,representatives,and employees is listed as additional insured as it pertains to general liability(see endorsement attached) <br /> A waiver of transfer of rights exists on this policy as it pertains to general liability in favor of City of Santa Ana,Parks,Recreation and Community Services,its officers,agents,representatives,and employees (see <br /> endorsement attached) <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> City of Santa Ana, Parks, Recreation and Community Services THE EXPIRATION DATE THEREO- " <br /> 20 Civic Center Plaza ACCORDANCE WITH THE POLICY PR( <br /> Santa Ana, CA 92701 RteieManagement Dmslort <br /> �?-' REVIEWED&APPROVED BY: <br /> AUTHORIZED REPRESENTATIVE <br /> f 4 Aecv4o <br /> Risk P.lanagennent Specialist <br /> ©1988-2015 ACORD <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />