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V-2_(,iR <br />mmi< <br />CERTIFICATE OF LIABILITY INSURANCE pmi <br />DI) � N Y) <br />01.6 <br />T�11 7� II <br />THIS CERTIFICATEIS 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 this <br />certificate does not confer rights to the certificate holder in lieu of such endorsement(s), <br />PRODUCER <br />CONirAG7 <br />NAME <br />PAYCHEX INSURANCE AGENCY INC <br />PHONE(AfC Na, EA). 777717N., (888) 443-6112 <br />21U05 P: F:(888) 443-6112 <br />E-MAIL <br />-ADDRESS <br />PO BOX 33015 <br />INSURERS}AFFORDING COVERAGE NAiC# <br />SAN ANTONIO TX 78265 <br />IN9URER A Har- -_C)rCj InS C.,�D Lh,u Midwest 314 C8 <br />INSURED <br />INSURERS <br />PARTNERS IN CON'i I ROL INC DBA ENTERPRISE <br />INSURER C <br />AUTOMATION <br />INSURER D <br />210 GODDARD <br />INSURER E <br />IRVINE CA 92618 <br />INSLJRER 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 <br />TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />IYSR <br />I <br />1 TYPE0FL%S1 RAN0. <br />IDDL <br />LVKH <br />S(Bn <br />jUiD <br />POLIO N I IIIV."R <br />PoUt FEFI. <br />ursunn/1 )I')) <br />POLIC YENP <br />t tTI) <br />L011TV <br />COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE <br />CLAIMS -MADE ❑OCCUR <br />DAMAGE TO RENTED <br />PREMISES (Ea occurrence) <br />MED EXP (Any one person) <br />PERSONAL & ADV INJURY <br />GEN'L AGGREGATE LIMIT APPLIES PER <br />GENERAL AGGREGATE <br />POLICYPRO- D LOG <br />17 JECT <br />PRODUCTS - COMPIOP AC3G <br />OTHER <br />AUTOMOBILE LIABILITY <br />COMBINED SINGLE LIMIT <br />(Ea accidenl) <br />BODILY INJURY (Per person) <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />BODILY INJURY (Per acciI <br />HIRED NON -OWNED <br />PROPERTY DAMAGE <br />AUTOS ONLY AUTOS ONLY <br />(Per acdde,t) <br />UMBRELLA LIAR <br />OCCUR <br />EACH OCCURRENCE <br />I <br />EXCESS LIAB <br />CLAIMS -MACE <br />AGGREGATE <br />I []EU IIIEIE.1111N <br />I <br />UORKERSCOMP .3.iTION <br />N'1) FIN01WITA51 11,1111137'1' <br />X 1PER <br />STATUTE I JER <br />EJ_ EACH ACCIDENT 1, 000, coo <br />ANY,PROPRIETORiPARTNERiEXECUTIVE YIN <br />A <br />Orr GER/MEMBER EXCLUDED? F] <br />(Mandatory in NH) <br />NIA <br />6 WE( GBI-737 <br />/13/21, <br />EL DISEASE- EA EMPLOYEE 1, 000, 000 <br />If yes,, describe under <br />DESCRIPTION OF OPERATIONS below <br />EL DISEASE - POLICY LIMIT -,1,000,000 <br />DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ACORD iOl, AddMonal Remarks Schedule, may be attached if more space is required) <br />Those usual to the Insured's Operations. Notice of Cancellation will be <br />provided in accordance with Form WC990394, attached to this policy. <br />441 <br />CERTIFICATE HOLDER CANCELLATION <br />City of Santa Ana <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br />Finance & Management Services Agency <br />BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE <br />DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 CIVIC CENTER P L Z # M-16 <br />AUTHORIZED REPRESENTATIVE <br />PO BOX 1988 <br />SANTA ANA, CA 92702 <br />(D 1988-2015 ACORD CORPORATION. All rights reserved, <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />E <br />