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COO(MMIDD <br />Ao CERTIFICATE OF LIABILITY INSURANCE <br />DATE YYYYI <br />3/12/2020 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND 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(ies) 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 certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />CONTACT NAME: Halidee Callejas <br />MOC Insurance Services <br />License No. 0589960 <br />PHONN E (415)957-0600 FAX luslas-asn <br />A/C Ne: <br />E-MAIL <br />ADDRESS: hcalle]a3@mOCin3. COm <br />101 Montgomery St., Suite 800 <br />San Francisco CA 94104 <br />INSURERS AFFORDING COVERAGE <br />NAIC# <br />INSURER A: Massachusetts Bay Ins. Co. <br />22306 <br />INSURED <br />Keyser Marston Associates, Inc. <br />1299 4th Street Suite 408 <br />INSURERS: AllmeriCa Financial Benefit Co. <br />41840 <br />INSURERGHanover Insurance Company <br />22292 <br />INSURER D: <br />INSURER E: <br />San Rafael CA 94901 <br />rnveoAr_ee <br />INSURER F: <br />CERTIFICATE NUMBER:2019-2020 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 PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH <br />THIS <br />CERTIFICATE MAYBE 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 <br />TYPE OF INSURANCE <br />gODL <br />SWISSLTR <br />POLICY NUMBER <br />POLICY EFF <br />MMIDDM'YY <br />POLICYEXP <br />MM/DDfYYVYI <br />LIMITS <br />X <br />COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ 1,000,000 <br />DAMAGE(, WED <br />A <br />CLAIMS -MADE OCCUR <br />PREMISESSE,Ea occurrence) <br />$ 500,000 <br />X <br />ZDFA49,04905 <br />12/1/2019 <br />12/1/2020 <br />NEC EXP Anyone person) <br />$ 10,000 <br />PERSONAL SAOV INJURY <br />$ 1,000,000 <br />GENLAGGREGATE <br />LIMITAPPLIES PER: <br />[X] PECO- <br />GENERALAGGREGATE <br />$ 2,000,000 <br />PRODUCTS-COMP/OPAGG <br />$ Included <br />POLICY LOC <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />Ea aaitlent <br />$ 11000,000 <br />B <br />ANYAUTOWNED <br />X <br />BODILY INJURY (Per Person) <br />S <br />ASCHEDULED <br />BODILY INJURY (Per acddea0 <br />$ <br />AUTOS AUTOS <br />X <br />AN7A490049 <br />12/1/2019 <br />12/l/2020 <br />NON-OWNEDPROPERTY <br />AUTOS <br />HIRED ALII'OS Nx <br />X <br />DAMAGE <br />Per$ <br />accloser) <br />ComP5500 Crossed <br />X <br />U.Ika.mE mobnN oamhlnaEsingle <br />S 11000,000 <br />X <br />UMBRELLA DAB <br />X <br />OCCUR <br />EACH OCCURRENCE <br />$ 4,000,000 <br />AGGREGATE <br />$ 4,000,000 <br />C <br />EXCESS LIAR <br />CLAIMS -MADE <br />DEO I X I RETENTION $ 0.00 <br />$ <br />X <br />URFA4911710$ <br />12/l/2019 <br />12/1/2020 <br />WORMERS COMPENSATION <br />PER OTH- <br />ANDEMPLOVERS'LIABILItt YIN <br />STAT E ER <br />E.L. EACH ACCIDENT <br />$ <br />ANY PROPRIETORIPARTNER/E)ECUTIVE <br />OFFICERIMEMBER EXCWDED7 ❑ <br />NIA <br />(Mandatoryfyes,d in NH) <br />If yes, describe under <br />E L. DISEASE - EA EMPLOYEE <br />$ <br />E.L. DISEASE -POLICY LIMIT <br />$ <br />DESCRIPTION OF OPERATIONS below <br />C <br />Professional Liability <br />LHM42616502 <br />12/1/2019 <br />12/1/2(120 <br />Each WmrrulAd $1,000,000 <br />Retention $25,000 <br />Retne Date: 11/11/1976 <br />Aggregate Umit $2,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be aaacbed if more space is required) <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, employees, 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 Day Notice of Cancellation/10 Day for nonpayment of premium. <br />REVIEWED & APPROVED <br />City of Santa Ana <br />Risk Management (RMD) <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 THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />Callejas/ECA <br />Aw. C IWwI <br />xa� I ne rAwrgu name and logo are registered marks of ACORD <br />INS025 (201401) <br />