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Client#: 1086878 INTERCON35 ACORDTM CERTIFICATE OF LIABILITY INSURANCE rDATE(MM/DD/YYYY) 12/13/2018 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 have ADDITIONAL INSURED provisions or 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: USI Colorado, LLC Prof Liab PHANEo, dFAX NELEt : 800 873-8500 XC P.O. BOX 7050 Englewood, CO 80155 ADDRESS: 800 873-8500 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Travelers Property Cos. Co. of America 25674 INSURED INSURER B : XL Specialty Insurance Company 37885 Interwest Consulting Group Inc P.O. Box 18330 INSURER C INSURER D : Boulder, CO 80308 E : rINSURER INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER - 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 CONTRACTOR 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. R LTRS TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X1 COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR ❑ Y Y 6806H441235 11/14/2018 11/14/2019 EACHOCCURRENCE $1 OOOOOO °�EMISEs� a occurrence $1 000 000 MED EXP (Any one person) $1 O 000 PERSONAL & ADV INJURY $1,000 000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X ECCT LCC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $2,000,000 $ OTHER: A AUTOMOBILE LIABILITY Y Y BAOJ093233 11/14/2018 11/14/2019 COMBINED SINGLE LIMIT Ea accident 1,000,000 X ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS X AUTOS ONLY X NON -OWNED AUTOS ONLY BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ A j( UMBRELLA LIAB I X OCCUR Y Y CUP2F178249 11/14/2018 11/14/2019 EACH OCCURRENCE s4,000,000 EXCESS LIAB ffJ CLAIMS -MADE AGGREGATE s4.000.000 DED I X RETENTION $O $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? N N/A Y UB81034006 11/14/201811/14/201 X PER OTH- E.L. EACH ACCIDENT $1 OOO OOO E.L. DISEASE - EA EMPLOYEE $1 000 000 _ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT $1,000,000 B Professional Liab Y DPR9933966 11/14/2018 11/14/2019 $2,000,000 per claim Pollution Liab $5,000,000 annl aggr. Claims Made DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) Additional Insured: City of Santa Ana, its officers, employees, agents, volunteers and representatives. All policies include 30 Day Notice of Cancellation in favor of the City of Santa Ana. As required by written contract or written agreement, the following provisions apply subject to the policy terms, conditions, limitations and exclusions: The Certificate Holder and owner are included as matic (See Attached Descriptions) REVIEWED BY: 01 EUNICE HEREDIA (PG I OF City of Santa Ana 20 Civic Center Plaza (M-30) PO Box 1988 Santa Ana, CA 92702-1988 CLLA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) 1 Of 2 #S24475055/M24330283 The ACORD name and logo are registered marks of ACORD SHAZP