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A ®® CERTIFICATE OF LIABILITY INSURANCE
<br />DAT6/18/2018vv)
<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 />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(les) 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 endorsement(s).
<br />PRODUCER
<br />CONTACT
<br />Marie SwaneyFAx
<br />Dealey, Renton & Associates
<br />PHONE
<br />790 E. Colorado Blvd, #460
<br />Ext: 626-844-3070 Arc No),
<br />AD cress: mswane Beale renton.com
<br />Pasadena, CA 91101
<br />Lic #0020739 N-2018-116
<br />INSURER(S) AFFORDING COVERAGE NAIC #
<br />INSURER A: American Automobile Ins. Co. 21849
<br />INSURED URBANCROS
<br />INSURER B: Travelers Casualty & Surety Co. America 31194
<br />Urban Crossroads,ae,
<br />#no.
<br />260 E Baker St, #200
<br />INSURER C: National Fire Insurance Cc of Hartford 20478
<br />INSURERD: Valley Fore Insurance Company 20508
<br />Costa Mesa, CA 92626
<br />949-606-1994
<br />INSURER E: Continental Insurance Company 35289
<br />INSURER F
<br />COVERAGES CERTIFICATE NUMBER: 715246458 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 HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />ILTR
<br />TYPE OF INSURANCE
<br />IVSD
<br />WVD SUER
<br />POLICY NUMBER
<br />MMIODYYEYYI'
<br />POLICY EXP
<br />YY
<br />LIMITS
<br />D
<br />X COMMERCIAL GENERAL LIABILITY
<br />Y
<br />Y
<br />6021297176
<br />11/1/2017
<br />11/1/2018
<br />EACH OCCURRENCE $2,008000
<br />X
<br />CLAIMS -MADE OCCUR
<br />DAMAGE TO RENTED
<br />PREMISES Ea occurrence $1.000,000
<br />MED EXP (Any one person) $10,000
<br />X Contraqual Liab
<br />X XCU Included
<br />PERSONAL& ADV INJURY $2,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE $4,000,000
<br />POLICY IFPES FILOC
<br />PRODUCTS - COMP/OP AGG $4,000,000
<br />$
<br />OTHER:
<br />C
<br />AUTOMOBILE
<br />LIABILITY
<br />Y
<br />Y
<br />6020089431
<br />11/1/2017
<br />11/1/2018
<br />COMBINED SINGLE LIMIT $1,000,000
<br />Ea accident
<br />X
<br />BODILY INJURY (Per person) $
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOSONLY AUTOS
<br />BODILY INJURY (Per accident) $
<br />X
<br />PROPERTY DAMAGE $
<br />Per accident
<br />HIRED X NON -OWNED
<br />AUTOSONLY AUTOS ONLY
<br />E
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />Y
<br />Y
<br />6020089476
<br />11/1/2017
<br />11/1/2018
<br />EACH OCCURRENCE $2,000,000
<br />AGGREGATE $2,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />BED I X RETENTION $ 0
<br />$
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />Y
<br />VVZP81042875
<br />1111/2017
<br />111112018
<br />X I STATUTE EGRH-
<br />ANYPROPRIETOR/PARTNER/EXECUTIVE ❑
<br />OFFICER/MEMBER EXCLUDED?
<br />N/A
<br />E.L. EACH ACCIDENT $1,000,000
<br />E.L. DISEASE - EA EMPLOYEE $1,000,000
<br />(Mandatory In NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE -POLICY LIMIT $1,000,000
<br />B
<br />Professional Liability
<br />105517955
<br />11/112017
<br />11/1/2018
<br />$1,000,000 Per Claim
<br />$2,000,000 Annual Aggregate
<br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is requiretl)
<br />Umbrella policy is a follow form to underlying Policies: General Liability/ Auto Liability/Employers Liability.
<br />RE: RE: Metro East Mixed Use Project -- City of Santa Ana, its officers, employees, agents, and representatives are named as additional insured as respects
<br />general and auto liability for claims arising from the operations of the named insured as required per written contract or agreement. General Liability is
<br />Primary/Non-Contributory per policy form wording. Insurance coverage includes waiver of subrogation per the attached endorsement(s).
<br />0tr
<br />CERTIFICATE HOLDER CANCELLATION 36Da Notice U
<br />ACORD 25 (2016/03)
<br />©1988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City of Santa Ana, its officers, employees, agents, and
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />representatives
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Attn: Clerk of the City Council
<br />AUTHORIZED REPRESENTATIVE
<br />20 Civic Center Plaza (M-30)
<br />PO BOX
<br />Santa Anaa CA CA 92702-1988
<br />ACORD 25 (2016/03)
<br />©1988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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