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A�'C7 be CERTIFICATE OF LIABILITY INSURANCE <br />�..r-'' 8/1/201$ <br />oATEIMMIool7' <br />7/17!2017 <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(ios) 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 endorsements). <br />PRODUCER Lockton Companies <br />444 W. 47th Street, Suite 900 <br />Kansas City MO 64112-1906 <br />(816)960-9000 <br />UUNIAUI <br />NAME: <br />PHONE FAX <br />IC No Est: (A1C. Nol: <br />-MAIL <br />ADDRESS! <br />EACHOCCURRENCE <br />_ <br />PREMISES Ea o cu r@nce1._.. <br />INSURER($ AFFORDING COVERAGE <br />NAIC# <br />INSURER A: Zurich American Insurance Company <br />16535 <br />INSURED WACHTER, INC. <br />6969 16001 WEST 99TH STREET <br />INSURER B: Great American Insurance Cc of New York <br />_ <br />22136 <br />INSURER C : <br />LENEXA KS 66219 <br />N-2018-144 <br />INSURER 0: <br />INSURER <br />$ 1,000,000 <br />INSURER F: <br />COVFRARFF s r.FRTIFlr.ATF NIIMRFR• Id711119 RRVICIrTN hu Bounce. Vvv111 <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 />INSR _TYADDLTSUERI —_� <br />LTR TYPE OF INSURANCE p POLICY NUMBER MMIDUi YYY MMIIOOIYYYY LIMITS <br />p <br />X <br />COMMERCIAL GENERAL LIABILITY <br />_ CLAIMS-MADE�MAGRI <br />X OCCUR <br />N <br />N <br />GLOSS_579805 <br />$!l/.a 017 <br />'8/7/2018 <br />EACHOCCURRENCE <br />.$ 1000000 <br />PREMISES Ea o cu r@nce1._.. <br />O <br />E 300 000 <br />MED EXP (Any one arson <br />$ 5,000 <br />PERSONAL B ADV INJURY <br />$ 1,000,000 <br />_ <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />$ 2000000 <br />POLICY 17 PMC LOC <br />PRODUCTS- COMPIOP AGO <br />_ <br />$ 2 000 QQQ <br />OTHER: <br />$ <br />A <br />AUTOMOBILE <br />LIABILITY <br />N <br />N <br />BAP552579905 <br />8/1/2017 -' <br />" $/1/2018 <br />COMBINED SINGLE LIMIT <br />1Ea acddenn _ <br />$ 1 QOQ 000 <br />AlANY <br />A <br />AUTO <br />BODILY INJURY (Par seasord <br />_ <br />$ XXXXXXX <br />-AUTOS ONLY YAUTaSULED <br />BODILY INJURY (Pal accident) <br />$XXXXXX'X <br />X <br />HIRED NONOWNED <br />AUTOS ONLY X Al T6(' ONLY <br />PROPERTY DAMAGE <br />(Per accidenll <br />$ XXXXXXX <br />X PHYS DAM <br />Camp/Coll Deds. <br />$ 1,000 <br />E <br />UMBRELLA LIAR <br />X <br />OCCUR <br />N <br />N <br />UMB9999693 <br />8/1/2017 <br />8/1/2018 <br />EACH OCCURRENCE <br />$9000,000_ <br />AGGREGATE <br />$ 2 000 000 <br />X <br />EXCESS LIAR <br />CLAIMS MADE <br />DEC F <br />I RETENTION <br />_ <br />$ XXXXXXX <br />A <br />WORKERS COMPENSATION Y N <br />AND EMPLOYERS' LIABILITY <br />ANY PROPNETORIPARTNERIEXECUTIVE <br />OFFICERIMEMBER EXCLUDED? <br />NIA <br />N <br />WC552580005 <br />$/1/2017 <br />.$/1/3018 <br />_X Prnr4T °iH <br />_EL,_ EACH ACCIDENT <br />$ J,000000 <br />- <br />EL. DISEASE, EAEMPLOYER <br />—' <br />$ 1,000000_._..._.__ <br />-- <br />(Mand,mylnNm <br />If yas, doom be under <br />DESCRIPTION OF OPERATIONS below <br />! <br />E.L. DISEASE - POLICY LIb11T <br />$ 1 000 QQ0 <br />I <br />DESCRIPTION OF OPERATIONS f LOCATIONS VEHICLES (ADDED 101, Additional Remarks Schedule, may be attached If more space Is required) <br />FOR CANCELLATION FOR ANY REASON OT {ER THAN NONPAYMENT OF PREMIUM, THE INSURER(S) WILL SEND 30 DAYS NOTICE,. OF <br />CANCELLATION TO THE CERTIFICATE HOLDER. CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS, VOLUNTEERS AND <br />REPRESENTATIVES IS/ARE-ADDIF10NAL-INSURED(S) ONA PRUMARY-AND NEIN-CONTMBUPORY COVERAGE BASIS AS RESPECTS LIABILITY --- <br />COVERAGE FOR THIS PROJECT. INSURANCE SHOWN APPLIES ONLY TO EXTENT OF WRITTEN CONTRACT. <br />. REVIEWED BY. j._ EUMCE HEREOIA (P� I OF � <br />14711718 --- <br />CITY OF SANTA ANA <br />20 CIVIC CENTER PLAZA (M-30) <br />SANTA ANA CA 92702 <br />ACORD 25 (2016/03) <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NONCE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />©19882015 <br />The ACORD name and logo are registered marks of ACORD <br />reserved. <br />