|
NORTSTA-01
<br />4114 v CERTIFICATE OF LIABILITY INSURANCE
<br />D 10123/20/7 Y)
<br />10/2312017
<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 policy(les) must have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION 1S WAIVED, sub)ect to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer ri hte to the certificate holder in lieu of such endorsements .
<br />PRODUCER
<br />Nashville(WE)/AssuredPartners NL
<br />840 Crescent Centre Drive, Suite 300
<br />Franklin, TN 37067'odii�ss:
<br />9TWCT
<br />PHONE FAX
<br />AIC, No E.t: (615) 301-2500 IA/0,140146115) 301.2597
<br />_
<br />INSURERIS) AFFORDING COVERAGE
<br />MAIC p
<br />EACH OCCURRENCE
<br />_ _
<br />INSURERA:,,%lncinnatl. Insurance Company
<br />10677
<br />$ 1,000,000
<br />INSURED
<br />INSUR B:Cincinnati Indemni# Company
<br />23260
<br />INSURERC:AXIS Insurance Company-
<br />37273
<br />North Star Destination Strategies, Inc
<br />NSURER 0:
<br />PRODUCTS-COMPIOPAGG
<br />209 Danyacrest Drive
<br />Nashville, TN 37214
<br />E:
<br />"`INSURER
<br />INSURER F:
<br />AUTOMOBILE
<br />X
<br />LIABILITY
<br />ANY AUTO
<br />SCHEDULED
<br />OWNS ONLYN
<br />p� AUUTNOSSWB�ODILYINJU�RAY-P,Aracc_Idard
<br />ONLY AUTOS ONLB
<br />COVFRAGFS CFRTIFICATF NUMRFRf RFVIl4lrTN Nt IMRPR•
<br />THIS 18 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 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 />INSR
<br />Lm
<br />TYPE OF INSURANCE
<br />A00
<br />BURR
<br />POLICY NUMBER
<br />PCIUCYEFF
<br />11/12/2017
<br />POLICYEXP
<br />11/12/2018
<br />_ __
<br />LIMITS
<br />A
<br />X I COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE OCCUR
<br />ECP 0289555
<br />EACH OCCURRENCE
<br />1,OD0,000
<br />DAMAGETOREoNTED
<br />$ 1,000,000
<br />MED E%P An ane Arson
<br />B 10,000
<br />PERSONAL &ADV INJURY
<br />S
<br />GEN'L AGGREGATE LIMI1 APPLIES PER:
<br />POLICY j LOC
<br />OTHER:
<br />GENERAL AGGREGATE
<br />2,000,000
<br />PRODUCTS-COMPIOPAGG
<br />$ 2,000,000
<br />A
<br />AUTOMOBILE
<br />X
<br />LIABILITY
<br />ANY AUTO
<br />SCHEDULED
<br />OWNS ONLYN
<br />p� AUUTNOSSWB�ODILYINJU�RAY-P,Aracc_Idard
<br />ONLY AUTOS ONLB
<br />ECP 0289555
<br />1111212017
<br />11/12/2018
<br />COMBINED SINGLE LIMIT
<br />1,000,000
<br />BODILY INJURY Per eraon
<br />$
<br />Pea cltlent�GE
<br />$
<br />A
<br />UMBRELLA LIAR
<br />EXCESS LIAR
<br />X
<br />OCCUR
<br />CLAIMI
<br />ECP 0289555
<br />11/1212017
<br />11/12/2018
<br />EACH OCCURRENCE
<br />1,000,000
<br />AGGREGATE
<br />DEO I RETENTION$
<br />$ 1,000,000
<br />B
<br />WORMERS COMPENSATION
<br />ANDEMPLOYERS'LIABILITY YIN—
<br />ANY PROPRIETOR/PARTNERIEXECUTIVE
<br />OFFICERry inN RREXCLUDED?
<br />(mandatory mNH)
<br />0 es,descdbe er und
<br />DESCRIPTION FOPERATI NS below
<br />NIA
<br />EWC 0290922
<br />11/1212016
<br />11/12/2017
<br />PER OTH-
<br />TAitLT
<br />E.1.,; EACH ACQIDENT
<br />1r100,000
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1'000'000
<br />.L. DISEASE -POLICY LIMIT
<br />1,000,000
<br />C
<br />C
<br />Professional
<br />MCN000036991701
<br />MCN000036991701
<br />07/2412017
<br />07/2412017
<br />07/24/2018
<br />07/2412018
<br />Each Wrongful Act
<br />Total Limit
<br />1,000,000
<br />2,000,000
<br />DESCRIPTION OF OPERATIONS/ LOCATIONS I VEHICLES (ACORD 101 Additional Remarks Schedule, maybe attached if more space is required)
<br />"Developing a community -wide brand for Santa Ana, CA" ) �
<br />4
<br />City of Santa Ana
<br />20 Civic Center Plaza M-31
<br />Santa Ann, 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 />ACORD 25 (2016/03) ©1988.2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />I05
<br />i
<br />
|