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<br />GENEPUM-01 RCHOWDARY
<br />AGORD' CERTIFICATE OF LIABILITY INSURANCE
<br />`-�
<br />DATE/41201
<br />O6/14/208
<br />18
<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 License # 0757776
<br />CONTACTME: Sherri Ben -Nun
<br />NA
<br />HUB International Insurance Services Inc.
<br />Ventura Blvd., Suite 500
<br />1 Encino,
<br />Encino, CA 91436
<br />(A/c. No. Ext : (818) 257-7438
<br />Ri%ss. sherri.bennun@hubinternational.com
<br />INSURER s AFFORDING COVERAGE
<br />NAIC N
<br />INSURER A: Travelers Property Casualty Company of America
<br />25674
<br />_ __
<br />INSURED
<br />INSURER B :The Travelers Indemnity Company of Connecticut
<br />25682
<br />INSURERC:A9 en Specialty Insurance
<br />10717
<br />General Pump Company, Inc.
<br />INSURER o
<br />159 N. Acacia Street
<br />San Dimas, CA 91773
<br />INSURER E :
<br />INSURER F :
<br />COVERAGES CERTIFICATE NIIMRFR- RFVISInm NIIILIRFR.
<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 CONTRACTOR OTHER DOCUMENT WITH RESPECTTOWHICH 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
<br />TYPE OFIN$URANCE
<br />ADDLSUBR
<br />POLICY NUMBER
<br />POLICY EFF
<br />POLICY EXPLTR
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE [X] OCCUR
<br />X
<br />6307K939062TIL18
<br />06/01/2018
<br />0610112019
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />DAMAGE TO RENTED
<br />EBEMISES Eacccunence
<br />$ 300,000
<br />MED EXP (My one arson
<br />$ 5,000
<br />PERSONAL &ADV INJURY
<br />$ 1,000,000
<br />GENL
<br />X
<br />AGGREGATE LIMIT APPLIES PER:
<br />POLICY ❑ JEL'T LOG
<br />OTHER:
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />PRODUCTS - COMP/OP AGO
<br />$ 2,000,000
<br />$
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />SSW
<br />AUTOS ONLY AUTOS
<br />AUTOS ONLY AUTOS ONLY
<br />81OIK939719TCT18
<br />06/01/2018
<br />06/0112019
<br />OsME1NED card,SINGLE LIMIT
<br />$ 1,000,000
<br />X
<br />BODILY INJURY Per person)$
<br />BODILY INJURY Per accident
<br />$
<br />Perracaeent AMAGE
<br />$
<br />A
<br />X
<br />UMBRELLA LIAB
<br />EXCESS LIAB
<br />X
<br />OCCUR
<br />CLAIMS -MADE
<br />CUP91(5703911843
<br />06/01/2018
<br />06/0112019
<br />EACH OCCURRENCE
<br />$ 4,000,000
<br />AGGREGATE
<br />$ 4,000,000
<br />DED RETENTION$
<br />A
<br />AND EMPLOYE Rs' LIABILITY Y / N
<br />ANY PROPRIETOWPARTNER/EXECUTIVE
<br />PFFIManCabryl NH)EXCLUDED?
<br />Ifs, describe antler
<br />DESCRIPTION OF OPERATIONS below
<br />NIA
<br />UB7K94026918
<br />06/01/2018
<br />06/0112019
<br />X PSTATUTE LRH
<br />E.L. EACH ACCIDENT
<br />1,000,000
<br />E.L. DISEASE - EA EMPLOYE
<br />1,000,000
<br />E.L. DISEASE - POLICY LIMIT
<br />1000000
<br />,,
<br />C
<br />Pollution I Environm
<br />ERAHL9618
<br />0210512018
<br />02105/2019
<br />1,000,000
<br />10,000
<br />DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
<br />Where required by written contract, the City of Banta Ana, its officers, employees, agents, volunteers and representatives are included as Additional Insured
<br />with regard to liability and defense of suits arising from the operations and uses performed by or on behalf of the Named Insured per the attached CG D2 46
<br />OB 05.
<br />�lv/i 4 Peg / ot3
<br />City of Santa Ana
<br />20 Civic Center Plaza — Ross Annex (M- )
<br />Santa Ana, CA 92701
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />ACORD 25 (2016103) ©1988.2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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