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CERTIFICATE OF LIABILITY INSURANCE DATE(MM/OOYyyy <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE /CERTIFICATE HOLDER./04" <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 INSU ORDER R(S), AUTHORIZED <br />HIS <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificat <br />h <br />a older is an <br />If SUBROGATION IS WAIVED, subject to the DtermsOa dLconditio s the <br />this certificate does not confer rights to the certificate holder in lieu of $ PRODUCER Lockton Companies <br />1185 Avenue of the Americas, Suite 2010 <br />New York NY 10036 <br />646-572-7300 <br />INSURED <br />1538750 RadWOrks Track Services LLC <br />12740 Lakeland Road Suit B <br />Santa Fe Springs CA 906A c e ve d o <br />certain policies may req <br />: or be endorsed. <br />sement(s). uire an endorsement onA statement <br />----.. •_�.".�nior=rc 20455916 <br />IS IS TO CERTIFY THAT THE POLICIES UI INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />REVISION NUMBER: <br />INDICATED. NOTWITHSTANDING ANY PERTAIN, <br />THE <br />TERM A CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE AND <br />O 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 />R AODL SUBR <br />R TYPE OF INSURANCE <br />A X COMMERCIAL GENERAL LIABILITY <br />rvucY NUMBER <br />MM C:ea <br />POLICY EXP <br />IM/DD <br />Y <br />CMMSMADEfil OCCUR <br />Y TB5-621-095327-034 <br />4/1/2024 <br />4/1/2025 <br />LIMIT[ <br />EACH OCCURRENCE <br />X Incl. Cont. Liab <br />A A R N <br />PREMISES Ea Occurrence <br />X 50' RR EA. Del <br />MED EXP (Any one person) <br />GENL AGGREGATE LIMIT APPLIES PER: <br />PERSONAL S ADV INJURY <br />POLICY [K) PRO- <br />JECT ❑X LOC <br />GENERALAGGREGATE <br />OTHER: <br />A AUTOMOBILE LIABILITY <br />PRODUCTS-COMP/OP qGG 7 <br />Y <br />Y AS5-621 -095327-044 <br />9 <br />X ANYAUTO <br />4/1/2024 <br />4/1/2025 <br />COMBINED SINGLE LIMIT <br />OWNED <br />AUTOS ONLY AUTOSULEO <br />Ea saddle,[ $ <br />BODILY INJURY (Par person) $ <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />BODILY INJURY (Per acciden) $ <br />PROPERPeracccitlenDAMAGE <br />UMBRELLA LIAB <br />X <br />$ <br />OCCUR Y <br />X EXCESS LIAB CLAIMS -MADE <br />Y G71120983007 <br />MKLMIEUL102325 <br />4/I2024 <br />4/1/2025 <br />$ <br />EACH OCCURRENCE <br />DIED RETENTION$ <br />4/1/2024 <br />4/1/2025 <br />$ <br />AGGREGATE <br />WORKERS COMPENSATION <br />$ <br />ANY PROPRIETOR LIABILITY <br />ANYCERIMEETORIPARTNDED? CUTIVE YIN <br />Y WA2-62D-095327-014 <br />WC2-621-095327-02 <br />4/I2024 <br />¢/I/2025 <br />PER _ $ <br />X STATUTE 011i <br />(Mandatory In ER EXCLUDED? N/A <br />(Mandatory In NHI <br />4(WD <br />4/(/2024 <br />4/1/2025 <br />—. _ _ ER <br />DESCRIPTION CERTIFICATE <br />OPERATIONS /LOCATIONS /VEHICLES (ACORD 101, gtldltlonal Remarks Sehetlule, ma be aaachetl H more s ace is <br />rHIS CEe 106, 100 SEPERSEDES ALL PREVIOUSLY ISSUEp CERTr[CATES ""HIS HOLDER, APPLICABLE ID TFfl! CARRIERS a space is THE POLICY TERM(SI REFERENCED. <br />ie: Suite 106, ID00 East Santo Ana Boulevard (SAATC). The Ci of Santa P requiretl) <br />ives <br />:contributory cont basis with respect y/ General Liability where requved by written contract. Waiver,fs,brrg.tion m in favor ofAdditional Insured s <br />vritten contact. Cross Liability/Severab0ity of Interest is included adder the General Liabilitypol cy wheregran In fld by written contact hadeco; and [Excess follows respect <br />t Genes Per al Lisicy tereimaa <br />le6vitions, exclusions. Excess follows form as per policy terms, conditions, definitions, exclusions. (1 v^IA respect [o General LiabOity v <br />20455916 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />The City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />Attention: Executive Director of Public Works ACCORDANCE WITH THE POLICY FIR <br />AgCy 20 Civic Center Plaza (M-21) <br />REOErirSanta Ana CA 92701 AUTHORIZED REPA <br />R1ekMAnagement� <br />\ It <br />REVIEWED 6 APPROVE. Ill: <br />Risk Management Sp,oAVt <br />ACORD 25 (2016/03) The ACORD name and logo are registered m rrks of ACORD 1988-2015 ACORD <br />