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4y DATE (MM ID OIYYYY)
<br />CERTIFICATE OF LIABILITY INSURANCE Il/I/2017
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS N-6 -RI _GHTS UPONTHE CERTIFICATE HOLDER. TIilS
<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(8), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate Holder Is an ADDITIONAL INSURED, the policy(les) mustbe endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />AssuredPartners Northeast, LLC
<br />123 Main Street
<br />14th Floor
<br />White Plaine NY 10601
<br />___ RED ._- _ _
<br />INSU
<br />Keenan & Associates
<br />C/O AssuredPartners, Inc.
<br />200 Colonial Center Parkway
<br />T.aka Mery FL 32746
<br />Jeanne Vezina
<br />(914)761-9000_. _(9141761
<br />444
<br />3749
<br />a®
<br />JVeZinskeg.com
<br />_
<br />IN$URER(S-fAFFORpING COVERAGE.. _,
<br />NA
<br />Charteroak Fire ,-,.___
<br />2_561
<br />Travelers Indeaa?1ty Co.
<br />,2565
<br />Travelers Prop Casualty 'Co. of Am.,
<br />2567
<br />,Federal Insurance Co, _. _
<br />2028
<br />10VERAGES CERTIFICATE NUMBER CL179_2895998 HL-VISIUN NUMuetc:
<br />THIS IS TO CERTIFY THAT 'rHE 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 />I�tt TYPE OF INSURANCE ADD
<br />X COMMERCIAL GENERAL LIABILITY
<br />A 7 , CLAIMS -MADE ` X. OCCUR
<br />III x
<br />GEN L AGGREGATE LAMP APPLIES PGI2'.
<br />X POLICY F� J1 -Cr L 1 IOC
<br />4 AUTOMOBILE LIABILITY
<br />B x ANY AUTO
<br />ALL AUTOS OWNED
<br />3
<br />`HIREDAUTOS I_
<br />X I UMSRMA A LIAR I X OCCUR
<br />C F.xCE58 LIAfl CLAIMS
<br />C
<br />D 1 Raployas Theft
<br />6301C226996
<br />HA330p0750
<br />..n,- CUP9J434350
<br />IA
<br />VB304e1072-17
<br />-_.J-.__-_.._..
<br />10225-9951
<br />10/1/20171 10/1/281.9
<br />PERSONALdADV INJURY I
<br />10/1/2019 10/1/2019 BODILY INJURY(P0raccdsnt) $
<br />PROPEIH[Y RAMAUE $
<br />a
<br />10/1/2017 10/1/2018
<br />EL FACIIACCID
<br />10/1/2017 10/1/2018 E,1_01 SEAS E -E
<br />EL DISEASE - P'
<br />10/1/2017 10/1/2010 1 $10,000,0001-imlt
<br />11000,000
<br />11000,000
<br />10,000
<br />1,000,000
<br />7.,000,000
<br />2,000,000
<br />1,000,000
<br />25,000
<br />$100,000 Ded.
<br />'_-0— ___
<br />_....
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AGGRO IDt, Additional Ramarks Schedule, may bo mtNehetl If more specs Is reyulredl
<br />The City of Santa .Ana, its officers, employees, agents, and representatives included as additional
<br />insured with respects to General Liability per endorsement kCG D2 47 08 05 (Copy Attached). Coverage is
<br />primary non-contributory. 30 Day Notice of Cancellation Applies.
<br />City of Santa Ana
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92701
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH TNF POLICY PROVISIONS,
<br />AUTHORIZED REPRESENTATIVE
<br />©1988-2014 AC(
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
<br />11,18025(C11401)
<br />PROD17CT5 COMPIOP AJ)i
<br />BODILY INJURY(Por e,1
<br />10/1/2019 10/1/2019 BODILY INJURY(P0raccdsnt) $
<br />PROPEIH[Y RAMAUE $
<br />a
<br />10/1/2017 10/1/2018
<br />EL FACIIACCID
<br />10/1/2017 10/1/2018 E,1_01 SEAS E -E
<br />EL DISEASE - P'
<br />10/1/2017 10/1/2010 1 $10,000,0001-imlt
<br />11000,000
<br />11000,000
<br />10,000
<br />1,000,000
<br />7.,000,000
<br />2,000,000
<br />1,000,000
<br />25,000
<br />$100,000 Ded.
<br />'_-0— ___
<br />_....
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AGGRO IDt, Additional Ramarks Schedule, may bo mtNehetl If more specs Is reyulredl
<br />The City of Santa .Ana, its officers, employees, agents, and representatives included as additional
<br />insured with respects to General Liability per endorsement kCG D2 47 08 05 (Copy Attached). Coverage is
<br />primary non-contributory. 30 Day Notice of Cancellation Applies.
<br />City of Santa Ana
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92701
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH TNF POLICY PROVISIONS,
<br />AUTHORIZED REPRESENTATIVE
<br />©1988-2014 AC(
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
<br />11,18025(C11401)
<br />
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