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<br />DATE(MMIDWYYYY)
<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 INSURFR(S), AUTHORIZED
<br />REPRESENTATIVE CR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certlifaato holder is an ADDITIONAL INSURED, the pollcy(les) must be 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 celtlflcate does not confer rights to the
<br />cardfloato holder in NOU of such endorsements).
<br />PRODUCER
<br />MOC'insurance Services
<br />License No. 05$9960
<br />NA EACT Balidee Callejas
<br />S (415) 957-0600 AIC Ntll• (616)95Y-0S77
<br />Eo REES:hCalle�ae�mOO1n3.ClOm
<br />INSURERS AFFORDING COVERAGE
<br />NAIC0
<br />44 Montgomery St., 17th Fl,
<br />INSURER A;Massachusetto Bay ins. Co.
<br />22305
<br />San Francisco CA 94104
<br />INSURED
<br />N6URERe:Allmericd Finanoial Benefit Co.
<br />41840
<br />INSURERGOanovar Insurance Cox ally
<br />22292
<br />Keyser Marston Associates, Inc.
<br />INSURER IRO ublic InderknitV Company of
<br />43753
<br />INSURERS:
<br />1299 4'th Street, Suite 408
<br />P1
<br />San Rafael CA 94903 -INSURER
<br />COVERAGES CERTIFICATE NUMBER;2017-2015 REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PSWOD
<br />INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS Of SUCI-I POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BYPAID CLAIMS.
<br />ILI�'6R
<br />LT
<br />TYPE OF INSURANCE
<br />ADDLSJBR
<br />POLICY NUMBER
<br />POLICY EFL
<br />N�DDNYYY
<br />LIMITS
<br />A
<br />X
<br />OOMMERCIAI GENERAL UAEILITY
<br />CLAIMS -MADE ❑X OCCUR
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />ACE TO RENTED
<br />PREMISES (Ea occunre c
<br />500 000
<br />S I
<br />MEP FXP(Any one person]
<br />4 10,000
<br />X
<br />ZDFA49104909
<br />12/1/2017
<br />12/1/2018
<br />PERSONAL &ADV INJURY
<br />$T^ 1,000,000
<br />No Deductible ApPlyea
<br />LIMIT APPLIES PER:
<br />POLICY�JECT C�Lac
<br />GENERAL AGGRFGATE
<br />$ 22,000,000
<br />0EN4AOOREOATE
<br />PRODUCTS• COMPIOP A30
<br />$ included
<br />S
<br />O ER:
<br />UUTOMOSILRLIA81LITY
<br />COMBINED SINGLE LIMIT
<br />IEE aced t
<br />$ 1,000,000
<br />FOLLY INJURY (Per person)
<br />.$
<br />B
<br />X
<br />X
<br />ANYAUTO
<br />SCHTEDULED
<br />ALLCWAU
<br />nM Cs
<br />NIREO AUTOS X AUT aWNEb
<br />X
<br />AWA490049D3
<br />12/1/2017
<br />12/1/2018
<br />BODILYINJURY(Pereccldent)
<br />$
<br />PeOecoltlentDAMAGE
<br />$
<br />Unlnsured moto"It =rnbinsd
<br />$ 1,000,060
<br />X
<br />Camp $GOD X Oo114500
<br />X
<br />UMBRELLA LIAR
<br />X
<br />OCCUR
<br />EAOH OCCURRENCE
<br />$ 4 DOD D00
<br />AGGREGATE
<br />$ 4 00D DO
<br />C
<br />EXCESS JAB
<br />CLAIMS -MADE
<br />DEO I X ETENTION a
<br />x
<br />VHFA49117103
<br />12/1/2017
<br />12/1/2018
<br />1)
<br />WORKERS COMPENSATION
<br />AND EMPLOYEFUV LIABILITY y�N
<br />A6IYPROPRIETOWPARTNERIEXGCUTIVF. —I
<br />CPFIG RRIMFMBER EXCLUDED? U
<br />(Mandatory In NR)
<br />Ifyea, des. -Le finder
<br />DESCRIPTION OF OPERATIONS Wm
<br />WA
<br />3954523
<br />12/1/2017
<br />01/01/2018
<br />�
<br />X PS7EATUTE �T -
<br />_
<br />EL EACH ACCIDENT
<br />-
<br />$ 1,000000
<br />'—`-
<br />E.L DISEASE. EA EMPLOYEE
<br />$ 11 U00 0U0
<br />EL. DISEASE -POLICY LIMIT
<br />N 7. D00 DUO
<br />C
<br />Professional Liability
<br />LUM42616500
<br />12/1/2017
<br />12/1/201e
<br />EnCh VJrorFINIAd $1,000,000
<br />kotenulon *25,000
<br />Ratro Date: 11/11/1976
<br />A0yre0ete-110 $2,000,000
<br />DPSCRIPTIGN CF OPEP.ATION31 LOCATIONS I VEHICLES (ADORE 1tl1, Additlenal Roma,ks Schedule, mny he attnchad If more space Is reyulred)
<br />City of Santa Ana, City of Santa .Ana Acting as Successor Agency and/or Housing Authority of the City of
<br />Santa Ana, ,its officers, omployeea, agents, volunteers and representatives are Additional insured with
<br />respects to the Insured+s operations, insurance provided is Primary and is not contributory with any
<br />other insurance carried. 30 bay Notice of Cancellation/10 Day for nonpayment of premium.
<br />City of Santa Ana
<br />Executive Director of CDA
<br />20 Civic Center Plaza M-25
<br />Santa Ana, CA 92701
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL RE DELIVERED IN
<br />ACCORDANCE WIT11 THE POLICY PROVISIONS,
<br />REPRESENTATIVE
<br />Callej as/BCA •wr,',e.e.,`.�
<br />reawad.
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
<br />IN5025 (201401)
<br />
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