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A�KU CERTIFICATE OF LIABILITY INSURANCE DATE(M3/2019 Yn S1132019 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: H the certificate holder Is an ADDITIONAL INSURED, the poliey(tes) 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 endorsoment(s). PRODUCER NAME; Lynette (Lynn) Eye PLA Select Insurance Solutions AIc (805)975.3531 I 100 Industrial Rd., "+3 ADDRESS: IYnn-eYe(&—pieSaI"LCOm INSURERIS) AFFORDING COVERAGE NAIC S San Carlos CA 94070 INSURER A: Anlco ln$unuace Company 002014 INSURED INSURER B: Employers Insurance Group 10346 Data Ticket. Inc. INSURER C : DBA: Revenue Experts INSURER D 2603 Main SImOi Ste. 300 INSURER E: Irvine CA 92614 INSURER F: CER 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. LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER I0DD/1'1'YY) LIMITS X COMMERCIAL GENERAL UASILITY CLAIMS -MADE OCCUR EACH OCCURRENCE S 2,000,000 PREMISES Me=nancel S 300,000 MED EXP (" m parson) S 5,000 PERSONAL a ADV INJURY S Excluded A Y Y ACP BP03047427618 11/012018 IU0112019 GEN% AGGREGATE LIMIT APPLIES PER X POLICY ❑JEECCT �LOC GENERAL AGGREGATE S 4,000,000 PRODUCTS-COMP/OP AGG $ 4.000,000 OTHER: S AUTOMOBILE LIABILITY IEa aaaMM)E LIMIT $ I,W0,000 BODILY INJURY (Par pers*m S OWNEDSCHEDULED AUTOS ONLY AUTOS HIRED ONLY NON -OWNED AUTOS X AUTOS ONLY ACP BPO 3047427618 11/012018 I I /01,Z019 PANYAUTO BODILY INJURY (Per aaidenn S Par ac m $ S A X UMBRELLA LIAB EXCESS UA8 OCCUR CLAIMS -MADE ACP CAA 3047427618 11101.2018 11/01,2019 EACH OCCURRENCE S 2,000,000 AGGREGATE 5 200,000 DED I I RETENTIONS S B AFORIKIEFus COMPENSATION ND EMPLOYERS'UABIUTY YIN NY PROPRIETORMARTNER/EXECUTNE FRCERIMEMBEREXCLUDEDT dalary In NH) lyyeess M urtler ESCRIPTIRIPTION OF OPERATONS eMav NIA Y EIG2869443 071122019 07: 12-2020 XSTATUTE ER E.L. EACH ACCIDENT S 1,000,000 E.L. DISEASE - EA EMPLOYEE$ I,000,000 EL DISEASE -POLICY LIMIT $ 1.000,000 DESCRIPTION Of OPERATIONS / LOCATIONS I VEHICLES IACORO 101, Additional Remarks Schedule, may M aRaerrE N mpM apau M rM4ukW) City of Santa Ana, officers, agents. employees, and volunteers are named as additional insured on the General Liability policy pursuant to Britten contract, agreement, or memorandum of understanding. The General Liability policy includes a Waiver of Subrogation. Primary A. Von -Contributory wording and 30 day notice of cancellation as required by written contract (see attached). Workers Compensation includes a his r of Subro anon (sea anackedl. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana 2 6 2019 THE EXPIRAT10N DATE THEREOF. NOTICE ACCORDANCE N E WITH THE POLICY PROVISIONS.L BE DELIVERED IN WILL Risk Management Divisi MA A M. LAMBERT "° D REPRESENTATIVE 20 Civic Center Plan, 4th lCOT �` \ Santa Ana CA 92702 1988-2018 ACORD CORftMnON. All rights reserved. ARVKIJ 25 (30161113) The ACORD name and logo are registered marks of ACORD