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ACORO® CERTIFICATE OF LIABILITY INSURANCE lh.� F DATE(MM/DD/YYYY) 1 02/12/2020 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: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) 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 endorsement(s). PRODUCER CONTACT Fred Dean NAME: Premier One Insurance Services PHONED Ert. U. (949) 727-2025 ac No: (949) 727-9219 100 Pacifica Ste 480 noursesS: fred.dean@PremierOne.com INSURER(S) AFFORDING COVERAGE NAIC# Irvine CA 92618 INSURERA: BeaZley Insurance Company 37540 INSURED INSURER B (Water, Inc. INSURERC: 12 Goodyear #130 INSURER D : INSURER E: INlne CA 92618 1 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2021208884 REVIRInN NIIMRFR- 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 CONTRACTOR 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. INSR LTR TYPE OF INSURANCE INSR MD POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMIDD/YYYY UNITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F—IOCCUR EACH OCCURRENCE $ E PREMISES Ea occurrence $ MED FXP (An one person) $ PERSONAL&ADVINJURY $ GEN'LAGGREGATE LIMITAPPLIES PER: POLICY PROJECT- 1-1LOGPRODUCTS GENERALAGGREGATE $ - COMP/OPAGG $ $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per Person) $ ANYAUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident ) $ HIRED NON-0WN AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED I I RETENTION $ $ WORKERS COMPENSATION PER EMPLOYERS' LIABILITY YIN LOTH— STATUTE ER E.L EACH ACCIDENT $ ANY PROPRIETORIPARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ NIA E.L. DISEASE - FA EMPLOYEE $ (Mandatory in NH) If yes, describe under E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS below PROFESSIONAL LIABILITY LIMIT PER OCC $1,000,000 A V1307D190801 10/04/2019 1W04/2020 DEDUCTIBLE $15,000 RETR 08-04-2011 DESCRIPTION OF OPERATIONS] LOCATIONS / VEHICLES (ACORD 101, AddlOonal Remarks Schedule, maybe attached if R EWE grY R1j5k MA PGE Vol DIVISION F City of Santa Ana Risk Management Division 20 Civic Center Plaza 41h Floor Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE CA 92701 I �� veeze, n1oaR_�nlsarnlxnrnraPnaennM eu.:..hs�.e�....,..w ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD