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LBU LL <br />DAVITAU-01 <br />CERTIFICATE OF LIABILITY INSURANCE <br />DATE 1 4110120224 <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 certi0c Ate P' i f n s <br />PRODUCER <br />Afirisure S(oouutthlRlYlest Part rs Insurance Services LLC Acevedo <br />e 7 _✓ + <br />e 0 ctllrlhly.g2 c e v e d o <br />Dale. 2OZ <br />L <br />'C o, Ext: (909)766-1788 ac, No: <br />E-MAIL .liburrill acrisure.com <br />1N E FFORDING COVERAGE <br />INSURER A, Sentinel Insurance Company, Ltd <br />I GO I <br />_ <br />INSURED David Taussig &Associates Inc. <br />dba DTA <br />INSURER B:California Automobile Insurance Company <br />[2: <br />INSURERC:Starstone National Insurance Com an <br />INsuRERo:Hartford Casual Insurance Company <br />18201 Von Karmen Ave <br />INsuRER:idel hia Indemni Insurance Com an <br />INSURERF: Hartford Fire Insurance Company <br />19682 <br />Suite 22o <br />Newport Beach, CA 92612 <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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAYBE 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 />TYPE OF INSURANCE <br />ADDLSUBR INSD <br />MD <br />POLICY NUMBER <br />POLICY EFF <br />POUCYEXP <br />LIMITS <br />A <br />X <br />COMMERCWLGENERAL LIABILITY <br />EACH OCCURRENCE <br />2,000,000 <br />CLAIMS -MADE OCCUR <br />X <br />72SBAAP5439 <br />2124/2024 <br />2/24/2025 <br />DAMAGE TO RENTED <br />1,000,000 <br />MED EXP (Any one rson04,000,000 <br />PERSONAL&ADV INJURY <br />GEN'LAGGREGATE UMITAPPLIES PER: <br />�JECTLOC <br />GENERAL AGGREGATEPOLICY <br />PRODUCTS-COMPIOP AGGOTHER: <br />B <br />AUTOMOBILE LIABILITY <br />COMBINED SINGLE LIMIT <br />(Fa accident) <br />BODILY INJURY Per person)$ <br />X ANY AUTO <br />BA040000030599 <br />12/19/2023 <br />12/19/2024 <br />BODILY INJURY Per accident <br />1 <br />OWNED SCHEDULED <br />AUTOS ONLY AlJT05wN <br />A�T OS ONLY AUTNO ONLY <br />Perrecud nt AMAGE <br />$ <br />C+ <br />X <br />UMBRELLALIAB <br />X <br />OCCUR <br />EACH OCCURRENCE <br />5,000,000 <br />EXCESS IJA9 <br />CLAIMS -MADE <br />85717R241AL1 <br />2/24/2024 <br />2/2412025 <br />AGGREGATE <br />5,000,000 <br />DED RETENTION$ <br />D <br />womrRs COMPENSATION <br />AND EMPLOYERS' LIABILITYYIN <br />ANY PROPRIETORRARTNER)EXECUTIVE❑ <br />(MFanEetoryEn NH)EXCLUDED? <br />NIA <br />72WECEU2873 <br />91112023 <br />911/2024 <br />X PER OTH- <br />E.L. EACH ACCIDENT <br />11000,000 <br />E.L. DISEASE - EA EMPLOYEE <br />1,000,000 <br />E.L. DISEASE - POLICY LIMIT <br />1,000,000 <br />$ <br />If yes, desenbe under <br />DESCRIPTION OF OPERATIONS below <br />E <br />Prof. Llab./Claims <br />PHSD7835820 <br />1111/2023 <br />111112024 <br />Limit <br />2,000,000 <br />F <br />Crime <br />72 BDD HP8140 <br />6/14/2023 <br />6/1412024 <br />1,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, AddRlonal Remarks Schedule, maybe attached N more space Is required( <br />cityclerk@santaana.org; FVillareal@santa-ana.org <br />Cyber Liability coverage with State National Insurance Company, Inc. - Policy #EHJ-ADMO1715148 EH: 7122123-7/22/24. 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 />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEI <br />THE EXPIRATION DATE THERED <br />ACCORDANCE WITH THE POLICY PRC <br />AUTHORIZED REPRESENTATIVE <br />'�Pe:51v� <br />y l:lyY�l-Iy <br />10-0 <br />uiIl lam' <br />RhkManagnrlenEDMebn <br />REVIEWED & APMAO BY: <br />A t-p AC4440 <br />Risk Management Spedalist <br />ACORD 25 (2016103) ©1988-2015 ACORD CORPORATION. rights reserve . <br />The ACORD name and logo are registered marks of ACORD <br />