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GENEPUM-01 SBEN
<br />ACORO" CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY)8/2712019
<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 endorsements .
<br />PRODUCER License # 0757776 �c rACT Sherri Ben -Nun
<br />HUB International Insurance Services Inc. aCONN Et: (818) 257-7438 uc No:
<br />16030 Ventura Blvd., Suite 500 E-Mnl
<br />Encino, CA 91436 sheril.bannun@hubintornaUonal.com
<br />INSURED
<br />General Pump Company, Inc.
<br />159 N. Acacia Street
<br />San Dimas, CA 91773
<br />AATravelers Property Casualty Company of America
<br />a : The Travelers Indemnity Company of Connecticut
<br />D:
<br />f'QVFRAQFS CERTIFICATE NUME3FR: REVISION NUMBER:
<br />10717
<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 TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />UBR
<br />POLICY NUMBER
<br />1'OLkCY
<br />POLICY EXP
<br />61112020
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE [X] OCCUR
<br />X
<br />630-7K939062-T1L-19
<br />—
<br />810-ON810047-19-CAG
<br />611/2019
<br />6/112019
<br />OCCURRENCE
<br />1,000,000
<br />ppETORE"E°
<br />g 100,000
<br />MED EXP An one arson
<br />5 6,000
<br />PERSONALBADV INJURY
<br />110001000
<br />L AGGREGATE LIMIT APPLIES PER:
<br />X POLICY I� jP&- n LOG
<br />G R L A GREGATE
<br />S 2,000,000
<br />PRODUCTS -COMPIOPAGO
<br />2,000,000
<br />a
<br />p
<br />AUTOMOBILE LIABILITY
<br />X ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUUpTNNOSy�/�.� pp
<br />_.. AUTOS ONLY .... AUTOS OI�Y
<br />6/1/2020
<br />COMBINLDti}NGLEUMrr
<br />1,000,000
<br />BODILY URY Per n
<br />90DILy�W7yJIJFj er accldenl
<br />„(i� sAciidanl AGE
<br />B
<br />X
<br />UMBRELLA LIAB
<br />EXCESS LIAB
<br />M
<br />OCCUR
<br />CLAIMS -MADE
<br />CUP•lN325156.19-14
<br />611/2019
<br />61112020
<br />EACH OCCURRENCE
<br />4,000,000
<br />AGGREGATE
<br />$ 4,000,000
<br />DED I I RETENTION$
<br />S
<br />A,
<br />WORKERS COMPENSATION
<br />ANDEMPLOYTORIP RTNEY
<br />ANY PROPRIETORIPARTNERlF�CECUTIVE YIN
<br />ppFFICERIMEM�r EXCLUDED? ❑Y
<br />(Man story n }
<br />If yes, descdbe under
<br />DESC PTI N 0 10 S bWow
<br />N I A
<br />UB-7K940269-TIL-19
<br />6/112019
<br />6/112020
<br />X PEFt OTH-
<br />E:L EACH ACCIDENT
<br />1,000,000
<br />$
<br />_E.L.DISEASE -EAE PLY
<br />�_ 1,DOD,DOD
<br />F I. DIOEY, LIMIT
<br />1,D00r1)00
<br />C
<br />Pollution Liability
<br />_r
<br />ERAHL9619
<br />2/512019
<br />2/512020
<br />Each Incident
<br />1,000,000
<br />DESCRIFTIAN OF OPERATIONS I LOCA"ONS 1 VEHICLES (ACORD let, AddRional RnmatNc Schedule, may be allnchod 1( more apace fs ragWkad)
<br />When required by Written oentract, the City of Santa Ana. Its officers, employees, agents, and representatives are Included as Additional Insured as respects
<br />operations of the Named Insured as their Interest may appear per the attached #CG D2 46.04 19. Coverage is primary and non-contributory per Form CGD246
<br />0419 and #CGT100 02 09, page 16, paragraph 4, 30 Days Cancellation except 10 Days for Non -Payment
<br />REVIEWED & APPROV
<br />By R!sk MANAgFMENT D1VI51
<br />City of Santa Ana
<br />Risk Management Division, 4th Floor
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92702
<br />SHOULD ANY OF THE ABOVE DESCRIBED PiNd
<br />THE EXPIRATION DATE THEREOF, NOTIC
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />r V
<br />ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved.
<br />:-D
<br />DIN
<br />The ACORD name and logo are registered marks of ACORD
<br />
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