Cities Index.
1.D.4 INSURANCE

Placentia City Council
January 23, 2024

Document
1.D.4 INSURANCE
Meeting
January 23, 2024
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Placentia City Council
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2
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AccoR o® CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY) /18/2024
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
TCP Insurance
820 Pacific Coast Hwy
Hermosa Beach, CA 90254
www.TCPinsurance.com

INSURED
Red88 Media
600 Parkrose Avenue
Monrovia CA 91016

COVERAGES

ICONTACT
NAME:

IPHONE
(A/C. No. Extl:

IE-MAIL
ADDRESS:

Certs Dept.
800.726.3701
CertsTCPinsurance.com

INSURER(S) AFFORDING COVERAGE
FAX
(A/C, No):

License # 6008301 INSURERA: Great American Insurance Company INSURER B : Great American Alliance Insurance Co
I INSURER C :

I INSURER D :

I INSURER E :

I INSURER F :

CERTIFICATE NUMBER: 78272739 REVISION NUMBER:
310-318-9840
NAIC #
16691
26832

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.

INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS

LTR INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY)
A ( COMMERCIAL GENERAL LIABILITY ✓ ✓ SPP1279895 6/16/2023 6/16/2024

CLAIMS -MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER:
✓ POLICY PRO-
JECT
OTHER:

A AUTOMOBILE LIABILITY

ANY AUTO
OWNED

AUTOS ONLY
HIRED
✓ AUTOS ONLY

UMBRELLA LIAB

EXCESS LIAB
■

SCHEDULED
AUTOS

NON -OWNED

AUTOS ONLY
OCCUR

CLAIMS -MADE
DED RETENT ON $

B WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY

ANYPROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBEREXCLUDED?
(Mandatory in NH)
If yes, describe under
vcrociPTION OF OPERATNS below
A Miscellaneous Rented quipment
Y/N
Y
NIA
✓ SPP1279895
6/16/2023 6/16/2024
j WC1279897 6/16/2023 6/16/2024
SPP1279895 6/16/2023 6/16/2024

EACH OCCURRENCE

DAMAGE TO RENTED
PREMISES (Ea occurrence)
MED EXP (Any one person)

PERSONAL & ADV INJURY

GENERAL AGGREGATE

PRODUCTS - COMP/OP AGG

COMBINED SINGLE LIMIT
(Ea accident)
BODILY INJURY (Per person)
BODILY INJURY (Per accident)

PROPERTY DAMAGE
(Per accident)
$ 2,000,000
$ 300,000
$ 10,000
$ 2,000,000
$ 4,000,000
$ 4,000,000
$ 1,000,000
EACH OCCURRENCE $
AGGREGATE $
✓ STATUTE ERH
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE
E.L. DISEASE - POLICY LIMIT
No Coverage
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) * See Attached "

CERTIFICATE HOLDER CANCELLATION
City of Placentia
401 E. Chapman
Placentia CA 92870
ACORD 25 (2016/03)
$ 1,000,000
$ 1.000.000
$ 1,000,000

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
TCP - Amanda Felix
© 1988-2015 ACORD CORPORATION. All rights reserved.

The ACORD name and logo are registered marks of ACORD
78272739 RED88M1 Master Certificate - Special Wording TCP - Chet Frias 1/18/2024 4:14:15 PM (PST) Pagc 1 of 2

ACOROTh
AGENCY CUSTOMER ID: RED88M1
LOC #:

ADDITIONAL REMARKS SCHEDULE
Page of
AGENCY
TCP Insurance

POLICY NUMBER

CARRIER

ADDITIONAL REMARKS

NAIC CODE

NAMED INSURED
Red88 Media
600 Parkrose Avenue
Monrovia CA 91016
EFFECTIVE DATE:

THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability (03/16) HOLDER: City of Placentia
ADDRESS: 401 E. Chapman Placentia CA 92870
(a) Additional insureds: "The City of Placentia and its elected and appointed boards, officers, officials, agents, employees, and volunteers are additional insureds with respect to: liability arising out of activities performed by or on behalf of the Consultant pursuant to its contract with the City; products and completed operations of the Consultant; premises owned, occupied or used by the Consultant; automobiles hired, or borrowed by the Consultant." (b) Notice: "Consultant shall provide immediate written notice if (1) any of the required insurance policies is terminated; (2) the limits of any of the required polices are reduced; (3) or the deductible or self-insured retention is increased. In the event of any cancellation or reduction in coverage or limits of any insurance, Consultant shall forthwith obtain and submit proof of substitute insurance. Should Consultant fail to immediately procure other insurance, as specified, to substitute for any canceled policy, the City may procure such insurance at Consultant's sole cost and expense."
(c) Other insurance: "The Consultant's insurance coverage shall be primary insurance as respects the City of Placentia, its officers, officials, agents, employees, and volunteers Any other insurance maintained by the City of Placentia shall be excess and not contributing with the insurance provided by this policy."
(d) Any failure to comply with the reporting provisions of the policies shall not affect coverage provided to the City of Placentia, its officers, officials, agents, employees, and volunteers.
(e) The Consultant's insurance shall apply separately to each insured against whom claim is made or suit is brought, except with respect to the limits of the insurer's liability.

ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved.

The ACORD name and logo are registered marks of ACORD ADDENDUM 78272739 1 RED88M1 1 Master Certificate - Special Wording 1 TCP - Chet Frias 1 1/18/2024 9:19:15 PM (PST) 1 Page 2 of 2

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