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ACiCll CERTIFICATE OF LIABILITY INSURANCE D5�31�zo e ) 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 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 Chip Francis LIMITS PNONE (6p AIC No: (626)396-1045 Kelley Jiggins and Associates Insurance Brokers �26)396-1035 E-MAIL chi @k'ains.com S ADDRES: PO BOX 60310 INSURERS AFFORDING COVERAGE NAICN INSURERA:West American Insurance Company 44393 Pasadena CA 91116-6310 INSURED INSURERB:Ohio Security 27082 INSURER C:American Fire & Casualty CO 24066 INSURER D: Y MDG Associates, Inc. 10722 Arrow Route STK 822 INSURER E: Rancho Cucamonga CA 91730 1 INSURER F: COVERAGES CERTIFICATE NUMBER:2018 2019 GL Auto & UMB REVISION NUMEER- 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. ILTR TYPE OF INSURANCE AODL lop. SUER myr, POLICY NUMBER POLICY EFF MMDO POLICY EXP YYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I—XI OCCUR EACH OCCURRENCE $ 11000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 200,000 MED EXP (Any one person) $ 15,000 X Y BKW5717929B 7/1/2018 7/1/2019 PERSONAL & ADV INJURY $ 11000,000 AGGREGATE LIMIT APPLIES PER: POLICYLJEC LOC GENERAL AGGREGATE $ 2,000,000 GENT X PRODUCTS-COMP/OP AGO $ 2,000,000 Employee Benefits $ 11000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 11000,000 Ea accident BODILY INJURY person) $ B X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X Y BA857179298 7 /1/2018 7/1/2019 BODILY INJURY (Per accident) $ X NON -OWNED HIRED AUTOS X AUTOS PROPERTY DAMAGE $ Per accident Medical a menta $ 5, 000 UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 L, X EXCESS LIAB CLAIMS -MADE DEO RETENTION$ $ IESA57179298 7/1/2018 7/1/2019 WORKERS COMPENSATION ANDEMPLOVERS'LIABILITY YIN ANY PROPRIETORIPARTNEWEXECUTIVE OFFICERIMEMBER EXCLUDED? NIA IPER1OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe, attached If more space Is required) The City of Santa Ana, Its officers, employees, agents and volunteers and named additional insured, but only as respecys the insured's operations as it relates to their signed contract in regards to the CDBG Administration Consluting Services per form CG8810 0413Primay Insurance and Transfer of rights or recovery against others is included in the form. Auto AI CA8810 0113��(v� *30days notice of cancellation except 10 days for non-payment. City of Santa Ana Attn.: Terri Eggers, Community Development 20 Civic Center Plaza Santa Ana, CA 92701 ACORD 25 (2014/01) INS025 (201401) 1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Senior Mgmt. Analyst ACCORDANCE WITH THE POLICY PROVISIONS. Agency AUTHORIZED REPRESENTATIVE Jiggins/CHIP © 1988.2014 ACORD CORPORATION- All rinhtx rnenrvad The ACORD name and logo are registered marks of ACORD