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PROOF OF INSURANCE (2023 - 2023) CLOSED
Client#: 786848 IDENTINC3 DATE (MM/DD/YYYY) ACORD. CERTIFICATE OF LIABILITY INSURANCE 1 3/02/2023 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. p y(...... .W....... ......... IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the olic les) 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER ONTA Zack ZukoWski NAME.:. Marsh & McLennan Agency LLC PHONE 800 321-4696 C 858-452-7530 .L.APC,�Ng&� t�---_.... .0 C N. P. .._... Marsh &McLennan Ins. Agency LLC .nnA/I rushoccerts@Mars,hMMAm,com 1 Polaris Way#300 INSURER A: Atlantic ...... ._...... Aliso Viejo, CA 92656 INSURERS) AFFORDING COVERAGE Specialty Insurance Company 27154 NAIC # ........................................................................................................_ .......... A INSURED INSURER B ;Indian Harbor Insurance Company 36940 Identiv, Inc....................................................._.�......................... 1900-B Carnegie Avenue ��i.NSURER. INSURER C ..�..�.........................................�......�.�.�......�.�.�..........�.�.�.�.�....�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�..................................................�.�.n.n... Santa Ana, CA 92705 - _ ....................... .. INSURER E 3 INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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, LTRR TYPE OF INSURANCER�,,,, BR .. ................ POLICY NUMBER . POLICY EFF (MMIDDIYYYY POLICY EXP (MM/DD/YYYY ----.... _ _ _ _ LIMITS A X COMMERCIAL GENERAL LIABILITY X X 7110137950009 3/01 /2022 6/29/2023 EACH OCCURRENCE $1 OOO 000 CLAIMS -MADE � OCCUR DAMAGE TORENTED ' PRPMISES_ Ea occurrence $1r000,O00 MED EXP (Any one person) $10 000 PERSONAL S_--......�.. ADVINJURY ..... $ ..' .................. GATE IT APPLIES PER: GENERAL AGGREGATE $ , PRO R .... ...r PR XN POLICY EJ LOC PRODUCTS -COMP/OP $2 OOO OOO _ O HER' A AUTOMOBILE LIABILITY.................................................................................................. X ,........... """"""""".........________________________.._________............... X 7110137950009 3/01/2022 6/29/2023 COMBINED SINGLE LIMY �.�aiu�ylna� —.._ ..... 1 000 000 $ r ANY AUTO BODILY INJURY (Per person) $ OWNED _. SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) , $ HIRED NON -OWNED PROPERTY DABd6AGE $ X AUTOS ONLY X AUTOS ONLY ......... „....... ........................ A .X UMBRELLA LIAB X '', OCCUR X 7110137950009 3/01 /2022 6/29/2023 EACH OCCURRENCE $? U,000,,OOQ,,,,,, .._ EXCESS LIAB CLAIMS -MADE . AGGREGATE $10,�000yOQO DED RETENTION $ _ ._ _ .......e.......m......._ ..... .. .......................... .......... .._ ^^ .. WORKERS COMPENSATION PER OrH- AND EMPLOYERS' LIABILITY Y / N ANY PROPRIIETORIPARTNEMEXECUTIVE OFFICEMM%EMfiBER EXCLUDED",? N / A E.L. EACH ACCIDENT $ - ....................... (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ ._........... If yes, describe under DESCRIPTION OF OPERATIONS below �.�...- �. ........................... ... ............................ E.L. DISEASE - POLICY LIMIT $ ...................................................... .__. B Cyber / E&O MTP903914802 /29/2022 06/30/202 $5,000,000 Limit $100,000 Retention 1/18/2012 Retroactive D DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Evidence of coverage. Evidence of Coverage SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE g THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE I, ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S12493665/M12493483 WOKZA