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CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MMIDD/YYYY)
<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 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 />PRODUCER
<br />CA
<br />INSURED OCCU•MIED, LTD INSURER a: CNA 36289
<br />2121 W BULLARD AVE
<br />FRESNO, CA 93711 INSURER 0:
<br />INSURER O:
<br />INSURER 6:
<br />INSURER F:
<br />nnVPRAGES CERTIFICATE NUMBER- 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 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 TYPE OF INSURANCE
<br />LTR
<br />WVp
<br />OLIC 1'1"lV MMI1cYEXY
<br />VEPF MMIDDN XP LIMITS
<br />POLICY NUMBER POLICY
<br />A X
<br />COMMERCIAL GENERAL LIABILITY
<br />AUTHORIZED REPRESENTATIVE
<br />EACH OCCURRENCE $ 2,000,000
<br />Tony Stornetta
<br />CLAIMS -MADE LKOCCUR
<br />OHF9262847 08/13/2018 08/13/2019 pREMIBES Ee occurrenpe $ 300,000
<br />MED EXP (Any one porson $ 6,000
<br />PEASONAL3ADV INJURY S
<br />- GENERAL AGGREGATE $ 4,000,00
<br />_
<br />GENL AGGREGATE LIMITAPPLIES PER:
<br />RO-POLICY❑JEC LOC
<br />PRODUCTS-COMP/OPAGG $ 4,000,00
<br />OTHER.
<br />EMPL BENE $ 1,000,000
<br />AUTOMOBILE LIABILITY
<br />COMBINEDSINGLE LIMIT— $ 1,000,000
<br />A ANY AUTO
<br />D258905 05/15/2018 05/15/2019 BODILY INJURY (Per person) $
<br />ALL OWNED SCHEDULED
<br />X
<br />BODILY INJURY (Per accident) $
<br />AUTOS AUTOS
<br />NON -OWNED
<br />PROPERTY DAMAGE $
<br />HIRED AUTOS AUT S
<br />Perzcmden
<br />X Hired Car X.. Non&Ned
<br />S
<br />)( UMBRELLA LIAB
<br />OCCUR
<br />EACH OCCURRENCE S 4,000,000
<br />A EXCESS LIAB
<br />CLAIMS -MADE
<br />OHF9262847 08/13/2018 08/1312019 AGGREGATE $ 4,000,000
<br />$
<br />OED RETENTION$
<br />WORKERS COMPENSATION
<br />X STATUTE IH
<br />AND EMPLOYERS'LIABILITY YIN
<br />` — _
<br />_ c
<br />A RrEr0 PARTNERIEXECUHVE
<br />D258679 06/0612016 0610612019 EACH
<br />OFFICERrMEMBER EXCLUDED? Y NtA
<br />Mandato ❑
<br />( ,y )
<br />A HACCIID EMPLOYEE $ 1,000,00
<br />'
<br />EL. ,000,00
<br />If yes. describeunder
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT $ 1,000,000
<br />A EMPL PRACTICES UA
<br />OHF9262847 08/93/2018 08/1312019 AGGREGATE 250,000
<br />B PROFESSIONAL LIAB
<br />425437058 08/22/2018 08/22/2019 AGGREGATE 6,000,000
<br />DESCRIPTION OF OPERATIONS i LOCATIONS t VEHICLES (ACORD 1e1, AdtlRiona7 Remark, Schedule, mop ba aaached If mare spave is required)
<br />Notice of cancellation is 30 days except in the event of cancellation for
<br />non-payment or non -reporting which a 10 days. The City of Santa Ana its,
<br />officers, agents, volunteers, and employees are added as additional insured
<br />as respects to operations and activities of, or on behalf of the named
<br />insured performed under contract with the The City of Santa Ana, ...
<br />CERTIFICATE 1-401 DFR CANCELLATION
<br />SANTAAN
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />CITY OF SANTA ANA
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 CIVIC CENTER PLAZA
<br />SANTA ANA, CA 92701
<br />AUTHORIZED REPRESENTATIVE
<br />Tony Stornetta
<br />ACORD 25 (2014101)
<br />© 1988-2014 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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