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<br />A�co,�rn CERTIFICATE OF LIABILITY INSURANCE
<br />1111 912 19/2 Y0 18
<br />001/19/2018
<br />0 8
<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 poliay(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 sndorsemant s .
<br />PRODUCER
<br />RMALcT Daniel R. Gunter
<br />Thompson Flonagan Executive Liability Group
<br />626 W. Jackson BWd. 5th Floor
<br />Chicago, IL 60661
<br />PHONE —Pax
<br />(AID.No eat: (312 239.2890 i (Alc Nal:(312) 283.1551
<br />ljr"Ato, dgunter �thompsonfianagan,com
<br />Na ,6f $)AFFOROINr1C�tERAQE #
<br />6043362567
<br />NsU ,The COntinentaf Insurance OomP4ry 5289 _
<br />01124/2019
<br />INsuREo
<br />Government Revenue Solutions Holdings LLC
<br />WWII MuniServices, LLC
<br />Attn: Me. Patricia Dunn
<br />7625 Palm Avo„ Suite 108
<br />Fresno, CA 93711
<br />INsu py.American Casualty Company of Reading, Pennsylvania 9--A42i
<br />Nsu ; RSUI Indemnity
<br />__ —22314
<br />AMIllig:Axis Insurance Company 3
<br />INsuREh E:
<br />—
<br />NSURERP:
<br />COVERAGES CERTIFICATE NIIMRER• RPVICIf)M NI IMCIRR-
<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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRSEO HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INTSRR
<br />TYPE OF INSURANCE
<br />ADOL
<br />SUER
<br />T POLICY NUMBER
<br />POLICY EFF
<br />P LICY EXP
<br />_
<br />LIMITS
<br />A
<br />X COMMERCIAL GENERAL LIABILITY
<br />: CLAIMS-MADEX OCCUR
<br />X
<br />6043362567
<br />0124720/8
<br />01124/2019
<br />EACH OCCURRENCE 1,000,000
<br />Oq GEioRENTED 1,000,000
<br />fBMF.MAuSF,ii ��
<br />�.
<br />EDEXP(Anvone vK 15,000
<br />_
<br />P RSONAL& AOVINJI/Rx_1,000,000
<br />'L AGGR TE LIMIT APPLIF-S PER:
<br />X POLICY jECT LOC
<br />GENERAL AGGREGATE v 2,000,000
<br />R TS -C P P GG S 2,000,000
<br />S
<br />OT
<br />B
<br />AUTOMOaILS
<br />LIABILITY
<br />COMBINED SINGLE LIMIT 1,000,000
<br />0 ILV INJURY rper Parssy, 3
<br />_
<br />ANY AUTO
<br />0wryE tl F SCHEOULEO
<br />AUTOSONLY gOTOS
<br />6043362570
<br />01/24/2018
<br />01/24/2019
<br />Rp 1 Y JURY Pvr Iden11
<br />X
<br />p
<br />ONLY '� AUTOS ONLY
<br />AUS N
<br />P Ca ERTY' E $
<br />S
<br />A
<br />X
<br />I UMBRELLA LIAB
<br />EXCESS WPB
<br />X
<br />OCCUR
<br />CLAIMBMAOE
<br />8043362584
<br />0112412018
<br />01/24/2019
<br />Ch1CCURRENCE 10,000,000
<br />A GTE 3 10,000,000
<br />OED I X I RETENTION S 10,000
<br />j
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS'LIABILITY YIry6043362536
<br />ANY PROPRIETORIPARTNERIEXECUTIVE ❑
<br />OFFICERIM MHHhhR E%CLUOED?(Mantlaury�n rvH)
<br />111016 tleletlba untler
<br />DESCRIP P P RATION b ora
<br />NIA
<br />01/24/2016
<br />012420191,000000
<br />LEqgAa�EAMP_IQYE
<br />1,000,000
<br />IE DISEASE ICY LIMiT 3 1,000,000
<br />C
<br />Professional Listed
<br />CY761747
<br />01/2412018
<br />01724!2019
<br />Limit 5,000,000
<br />D
<br />Directors S Officers
<br />MCN620510/0112018
<br />01/2412018
<br />01/24/2019
<br />Limit 3,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD101,Addalanei Remarks Schedule may be attached 11 ma maeace is requlrodl
<br />Per the cancellation wording listed on this form, the policy provisions Include at (east 30 days' notice of cancellation except for non-payment of premium.
<br />The City of Santa Ana, its agents, officers, servants and employees are named as additional insureds under the General Liability policy withrg, pect t0 the
<br />operations and work performed by the named insured as required by contract. 6-1 c�--�?,�l c7APRULD,
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />City of Santa Ana
<br />Attn: Finance Director
<br />20 Civic Center Plaza
<br />ACORD 25 (2016/03) O 19882015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />F
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