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Client#: 390893 UPAI6CEN <br />ACOROn CERTIFICATE OF LIABILITY INSURANCE ° "re'"IrID°"" <br />7/12/20„ <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLJCIE8 <br />BELOW. THIS CERT7FlCATE OF INSURANCE DOES NOT CONS77TUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER_ <br />P RTA tl» holder Is an ADDITIONAL INSU D, the polfry(les) must br rndorpd. K SUBROGATION IS WAIVED, aubJsct to <br />the trims and eondltions of the Polley, eerteln policies may regalia en endorsement A statement on this artlfleats does not confer rights to the <br />oeltHleatr holder In Ilea of such endorsenrrnt(sI. <br />PRODUGlR <br />USI Southern California CL <br />Llc # 035'1'162 N-2O 1 � -o% i -� � <br />2'1600 Oxnard Strsa; 8th Floor <br />Woodland Hills, CA 9'1367 <br />UPA #'16- Central Orange County <br />5665 Greenbrier Driw <br />Yorba Linda, CA 92887 <br />crlvevAr_ee ree,rlel�ary u„ueve. e��ae•„�u � . <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 CONDTON 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 />TrPE OF NrDRANC! <br />SHOULD ANY OF TFIE ABOVE DESCRIBED POL10Ea BE CANCELLED BEFORE <br />POLICY NUYBlR <br />Y <br />UYRr <br />A <br />GlNeRwLLIwmUTY <br />MXC60467063'16 <br />7/0'1/20'1'1 <br />07/O'1/20T <br />EACHOCCLIIiRFNCE <br />s2 000 000 <br />PR <br />S5O OOO <br />X COMMEI�IAL GENERAL LIABLLITY <br />CIAIMS -MADE � occuR <br />MEO E)cP m.. y.rson) <br />510 000 <br />PERSONAL a wov INJlazr <br />s2 000 000 <br />X PD Ded:500 <br />GENERAL AGGREGATE <br />S4 OOO OOO <br />(TENT AGGREGATE LMR APPLIE8 PER <br />PRODUCTS - COYP/OP AGf' <br />i2 OOO OOO <br />POLICY PRO- LOC <br />S <br />AUTOY0011L! <br />LUUIILITY <br />COMBINED SINGLE UMrr <br />(Ee eedtleny <br />s <br />BOOILY INJURY (Per pereenJ <br />S <br />ANY AUTO <br />ALL OWNED AUTOS <br />BODLLY INJURY (Per etl'JtlMll <br />S <br />SCHEDULED A1/TOS <br />HOtcn AUTOS <br />(P�eOeCrltltlll��GE <br />i <br />NON -OWNED AVros <br />T� <br />APPRIC3 V °'.Jt� A� <br />T� FO <br />M <br />s <br />s <br />UYaRELLA LIAR <br />OCCUR <br />�� � <br />EACH OCCURRENCE <br />S <br />AGGREGATE <br />S <br />EXCEae LUVr <br />CLAI•••• •••••� <br />._ - -. -- <br />DED�cnBL.E <br />�' Laura SCIt <br />Ytuedy <br />s <br />R 1 N <br />Assistant Ci 'y <br />ttorney <br />WORKERS COYPETiBAT1OM <br />STATU- H• <br />AMD EYPLOYERr' LIAaBJiY Y / N <br />ANY PROPRIETORIPARTNER/EXEGI/T <br />OFFICEWMEMBER EI(CLUOEDT NE� <br />WA <br />EL EACH ACCIDENT <br />= <br />E.L. DISEASE - EA EMPLO <br />(MentlelOfr le NN) <br />ryW, YwIW antler <br />DESCR N Etl <br />EL DISEASE - POLCY LIMfT <br />s <br />A <br />Pollution Cleanup <br />MXG80467063'16 <br />7/0'1/20'1'1 <br />07/0'1/20'1 <br />15,000 <br />DCrORIPnON OP OPERATKINB / LOGATONr / VENICLlr (Alfeel, ACORD 101, ArldtlwW Re,vb rrJled0le. tl Ine,e ePeCe h regWretl) <br />Currant Member: Jason Hunt. <br />The City of Santa Ana, Its ofiieers, employees, agents and rsprosentatiws <br />(See Attached DsscHptlons) <br />L:CK l IF14A 1 C KVLJJCK <br />GANGCLJJi l I V N <br />SHOULD ANY OF TFIE ABOVE DESCRIBED POL10Ea BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />City Of Santa Ma <br />ACCORDANCE WRH THE POLICY PROVISIONS. <br />do Public Works Agency/The Depot <br />20 CIVIC CerMSr Plaza, M -2i <br />wurl/oRaED REPRE9lNrATNE <br />Santa Ana, CA 9270 <br />1 <br />ACORD 25 (20DB/O9) � Of 2 Ths ACORD name and logo ars regisfsnrd marks of ACORD <br />#56222405/M6096864 M4CJA <br />