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DATE(MM/DD/YYYY)
<br /> A�" CERTIFICATE OF LIABILITY INSURANCE
<br /> 02/25/2025
<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 endorsement(s).
<br /> PRODUCER CONTACT Laura Macke
<br /> Agency 10 Insurance PHONE FAX
<br /> 6475 Sycamore Court North A/c No Ext: (763)551-1010 A/c,No: (763)559-1340
<br /> Maple Grove, MN 55369 ADDE-MRESS: LMacke@Agency10.com
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> INSURERA: General Star Indemnity Company 20087
<br /> INSURED Codex Corp DBA:Guardian RFID INSURERB: Auto Owners Insurance 18988
<br /> 6900 Wedgwood Road N#325 INSURERC: Technology Insurance Company/AmTrust 42376M
<br /> Maple Grove, MN 55311
<br /> INSURER D: CFC 52524
<br /> INSURER E:
<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 POLICYNUMBER MM/DD MM/DD
<br /> A COMMERCIAL GENERAL LIABILITY Y Y IYG413170M 10/01/2024 10/01/2025 EACH OCCURRENCE $ 2,000,000
<br /> DAMAGE TO RENTED
<br /> CLAIMS-MADE 1/ OCCUR PREMISES Ea occurrence $ 100,000
<br /> Primary and NonContributory MED EXP(Any one person) $ 5,000
<br /> PERSONAL&ADV INJURY $ 2,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,000,000
<br /> POLICY PRO-
<br /> JECT LOC PRODUCTS-COMP/OPAGG $ 2,000,000
<br /> OTHER: $
<br /> AUTOMOBILE LIABILITY 49-635484-01 10/01/2024 10/01/2025 COMBINEDSINGLELIMIT $ 1,000,000
<br /> B Y Y Ea accident
<br /> 1/ 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 /> A UMBRELLALIAB OCCUR IXG677684A 10/01/2024 10/01/2025 EACH OCCURRENCE $ 4,000,000
<br /> EXCESS LAB CLAIMS-MADE AGGREGATE $ 4,000,000
<br /> DED RETENTION$ $
<br /> C WORKERS COMPENSATION Y TWC4488209 10/01/2024 10/01/2025 V/ PER OTH-
<br /> AND EMPLOYERS'LIABILITY Y/N STATUTE ER
<br /> ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000
<br /> OFFICER/MEMBER EXCLUDED? ❑ N/A
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000
<br /> D Professional Liability Y ESNO040093631 10/01/2024 10/01/2025 Limit $2,000,000
<br /> D Cyber Liability Y ESNO040093631 10/01/2024 10/01/2025 Limit $2,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> Project: Santa Ana Jail-Booking/20 Civic Center Plaza 20 Civic Center Plaza Santa Ana,CA 92701
<br /> The City of Santa Ana, its City Council, its officers,officials,employees,agents,and volunteers are listed as Additional Insureds in respect to the General
<br /> Liability and Professional Liability coverage. Coverage is primary. A Waiver of Subrogation in favor of The City of Santa Ana, its City Council, its officers,
<br /> officials,employees,agents,and volunteers applies to the General Liability,Auto,and Workers'Compensation policies. A thirty(30)day notice of cancellation
<br /> will be given.
<br /> Tu Tran T.T.nyNguy nby
<br /> Nguyen 9495107'00z APPROVED
<br /> By Tu Tran Nguyen at 9:49 am,Mar 12,2025
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> City of Santa Ana Attention: ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Santa Ana Police Department Jail-Jaime Manriquez
<br /> 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE
<br /> Santa Ana,CA 92701
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<br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
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