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Page 1 of 2 ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE 8v) 03/002/2012/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Willis Insurance Services of California, Inc. c/o 26 Century Blvd P.O. Box 305191 CONTACT NAME, PHONE 1-877-945-7378 FAX AIC o E 1-888-967-2378 N . A/C No: E-MAIL ADDRESS: certif1Catas@w1llis.c0m INSURERS AFFORDING COVERAGE NAIC# Nashville, TN 372305191 USA INSURERA: AIG Specialty Insurance Company 26883 INSURED n ArakeliaEnterprises Inc dba Athens Services INSURER B: Greenwich Insurance Company 22322 INSURER C: XI. Insurance America Inc 24554 14048 Valley Blvd. INSURERD: City Of Industry, CA 91746 INSURERE: INSURER F: CERTIFICATE THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF ADDLSUBR D POLICY NUMBER POLICY EFF MMIDO POLICY E EXPWIDD LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS-MADEOCCUR EACHOCCURRENCE $ 1,000,000 DAMAGE TO RENTED 300,000 PREMISES Ea occurrence $ MED EXP (Anyone Person) $ 25,000 A PERSONAL S ADV INJURY $ 1,000,000 y y EG6439324 03/01/2018 03/01/2019 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY [] PRO ❑ LOC JECT PRODUCTS-COMP/OP AGG $ 2,000,000 $ OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident BODILY INJURY (Per Person) $ X ANY AUTO OWN8 AUTOS ONLY AUTOSULEO RAD500042704 03/01/2018 03/01/2019 BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY H PROPERTYDAMAGE $ Peraccitlenl $ I UMBRELLALIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION$ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETORIPARTNER/EXECUTIVE Na OFFICERIMEMBEREXCLUDE04 NIA MW500042604 03/01/2018 03/01/2019 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE -EA EMPLOYEE $ 1,000,000 (Mandatary in NH) If yes, describe under DESCRIPTION OF OPERATIONS belmo E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more spare isre9uimd) The City of Santa Ana, its officers, employees, agents, volunteers and representatives are included as Additional Insureds as respects to General Liability, where required by written contract General Liability policy shall be Primary and Non-contributory with any other insurance in force for or which tray be SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Santa Ana Public Works Agency AUTHORIZED REPRESENTATIVE 220 S. Daisy Ave. M-85 n i l Santa Ana, CA 92702 '.fi✓� ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD s8 m: 15699948 sASCx: 623038 CrIRPfIRATI IM All rinbfo monn,ed