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A-2p11.. <br />ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MWODYYYn <br />lkw� 1 2/07/2020 <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 endomement(s). <br />PRODUCER <br />VIG, LLC., dba/The Vestama Group <br />CONTACT <br />NAME. $USaD Crain <br />PHONE 2055$2-0244 F" No ; 205-244-8072 <br />Ea1A1L <br />ADDRE <br />2090 Columbiana Road, Suite 2300 <br />INSURERS) AFFORDING COVERAGE <br />NAIL# <br />NWRER A: IronShore Insurance Company 'A" XV <br />25445 <br />Birmingham AL 35216 <br />INSURED <br />INSURERS: Great American Insurance Company 'A+XIV <br />16691 <br />NsuR c: The Travelers Insurance Company 'A" XV <br />19M <br />NaphCare, Inc. <br />D: <br />2090 Columbiana Road, Suite 4000 <br />=;Z <br />NSIIRER E: <br />NSURFAF: <br />Birmingham AL 35216 <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HERPJN IS SUBJECT TO ALL THE TERMS. <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />LSR <br />TYPE OF INSURANCE <br />ADOLSUSR <br />Jill&POLICY <br />NUMBER <br />POLICY EFF <br />MWDD <br />POLICY ESP <br />UNITS <br />A <br />X. <br />COMMERCUU.GENERALLIABILITY <br />X CLMM64AADE F-1 OCCUR <br />Y <br />N <br />#03886501 <br />121312019 <br />12(312020 <br />EACH OCCURRENCE <br />Is 1,000.000 <br />PREMISES anaarNke1 <br />50,000 <br />MED EXP (Any ore �) <br />s 5,000 <br />PERSONAL SADV INJURY <br />f 1,000,000 <br />GENL <br />AGGREGATE LIMIT APPLIES PER: <br />POLICY ❑JEPRO.Cr LOC <br />GENERAL AGGREGATE <br />S 6,500,000 <br />PRODUCTS -COMPIOPAGG <br />S 1,0001000 <br />$ <br />OTHER <br />I <br />AUTOMOBLE <br />LIAUNU Y <br />COMBINED SINGLE UMIT <br />tlM <br />I S 1'000'000 <br />B <br />ANY AUTO <br />N <br />CAP1116382 <br />09/30/2019 <br />09/302020 <br />BODILY INJURY(Pw lwl ) <br />f XXX)COOO( <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />I <br />BODILY INJURY(Pw acddwd) <br />f X)OOoOO(X <br />PROPERTY DAMAGE <br />a 'Cant <br />S XX)XX)OO( <br />S <br />A <br />X <br />uMBRELU LIAR <br />OCCUR <br />N <br />003928601 <br />12/312019 <br />12/312020 <br />EACH occuRRENcE <br />S 5,000,DDO <br />AGGREGATE <br />f 5,000,000 <br />EXCESS LNB <br />X <br />CLAIMSAVDE <br />]1A <br />DED RErENTIONf <br />S <br />C <br />WORKERSCONPENSATmN <br />AND EMPLOYERS' UABLRY r/xN <br />ANYPROPwETORIPARTIERIEXECUTNE <br />OFFICERNEMBERUCLUDED? ❑Y <br />VB-iP248768-19-51-K <br />UB-1P250924-19-51-R <br />091302018 <br />09/302020 <br />X PER <br />STATUTE O - <br />EL EACH ACCIDENT <br />S 1,000,000 <br />EL DISEASE • EA EMPLOYE <br />S 1,000.000 <br />(Yaadawry In NH) <br />N yes Onmw abler <br />DESCRIPTION OF OPERATIONS txN <br />E.L. DISEASE -POLICY LIMIT <br />f 1,000.000 <br />A <br />Professional Liability <br />N <br />#03886501 <br />12/31/2019 <br />12/312020 <br />Each Mad Incident <br />$1,000,000. <br />Claims Made <br />Ann. Aggregate <br />$6,500,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101. Ackfitt al Remaft Seha N. may In atM d N. span is ra 1N 1) <br />It is understood and agreed the City Ana, officers, employees, agents, volunteers and representatives are named as additional insured as respects their contract <br />with NaphCare, Inc.,; the insurance provided by NaphCare, Inc., shall be primary and noncontributory to the insurance carried by the City of Santa Ana; A <br />policies are changed or materially modified a thirty (30) day notice shall be provided to the City of Santa Ana as respects their contract with NaphCare, Inc. <br />REVI D & APPR <br />VEC <br />CERTIFICATE HOLDER CANCELLATION <br />'1MON <br />City of Santa <br />SHOULD ANY OF THE ABOVE DESCRIBED POU0AWHATICAMR-RT <br />� <br />Risk Management Division <br />9 <br />THE EXPIRATION DATE THEREOF, NOTIC <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />IN <br />20 Civic Center Plaza, 4th Floor <br />AUTHORREDREPRESENTATNE <br />Santa Ana, CA 92702 <br />© 1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD <br />