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ACOROa CERTIFICATE OF LIABILITY INSURANCE
<br />ATE (MMIDDNYYY)
<br />r4/20/2018
<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(ies) must have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />Dealey, Renton & AssociatesPHONE
<br />199 S Los Robles Ave Ste 540
<br />CONTACT
<br />NAME: Marie Swaney
<br />FAX
<br />A/C No Elf : 626-844-3070 we No
<br />Pasadena, CA 91101
<br />ADDRLEss: mswaney@dealeyrenton.com
<br />Lic #0020739
<br />INSURERS AFFORDING COVERAGE NAIC #
<br />INSURER A: Travelers Indemnity Co. of Connecticut 25682
<br />4/18/2018
<br />INSURED PROJEPART
<br />Project Partners
<br />23195 La Cadena Drive, Suite 101
<br />INSURER B: Travelers Property Casualty Cc of Ameri 25674
<br />INSURER C: U.S. Specialty Insurance Company 29599
<br />INSURER D:
<br />Laguna Hills, CA 92653
<br />949 852-9300
<br />INSURER E:
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: 1239199550 RF_VISION NIIMRFR-
<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
<br />TR
<br />TYPE OF INSURANCE
<br />ADDL
<br />SUER
<br />POLICY NUMBER
<br />EFF
<br />MM DIDYNYYY
<br />EXP
<br />MM DD/YYYY
<br />LIMITS
<br />B
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS-MADEI-XI OCCUR
<br />Y
<br />Y
<br />680OJ543236
<br />4/18/2018
<br />4/18/2019
<br />EACH OCCURRENCE $ 2,000,000
<br />DAMAGE O RENTD
<br />PREMISES Ea occurrence $1,000,000
<br />Xj Contractual Liab
<br />MED EXP (Any one person) $ 10,000
<br />X XCU Included
<br />PERSONAL & ADV INJURY $ 2,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE $ 4,000,000
<br />POLICY FX] JEC7 [--] LOC
<br />PRODUCTS - COMP/OP AGG $ 4,000,000
<br />$
<br />OTHER:
<br />A
<br />AUTOMOBILE LIABILITY
<br />Y
<br />Y
<br />BA93611_484
<br />4/18/2018
<br />4/18/2019
<br />COMBINED SINGLE LIMIT
<br />Ea accident $1.000.000
<br />BODILY INJURY (Per person) $
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />iAUTOS ONLY AUTOS
<br />BODILY INJURY (Per accident) $
<br />X HIREDX NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />PROPERTY DAMAGE $
<br />Per accident
<br />X NoOwnedAutos
<br />$
<br />B
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />Y
<br />Y
<br />CUP8833Y649
<br />4/18/2018
<br />4/18/2019
<br />EACH OCCURRENCE $ 1,000,000
<br />AGGREGATE $ 1,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED I X RETENTION $,
<br />$
<br />a
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y I N
<br />U133J809976
<br />4/18/2018
<br />4/18/2019
<br />X STATUTE ETH
<br />E.L. EACH ACCIDENT $ 1,000,000
<br />ANYPROPRIETOR/PARTNER/EXECUTIVE ❑
<br />OFFICER/MEMBER EXCLUDED?
<br />N / A
<br />E.L. DISEASE - EA EMPLOYEE $1,000,000
<br />(Mandatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT $1,000,000
<br />C
<br />Professional Liability
<br />USS1828638
<br />4/18/2018
<br />4/18/2019
<br />$2,000,000 Per Claim
<br />$2,000,000 Annual Aggregate
<br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
<br />Insured owns no company vehicles; therefore, hired/non-owned auto is the maximum coverage that applies. Umbrella policy is a follow -form to underlying
<br />Policies: General Liability/Auto Liability/Employers Liability. AM Best's Rating for all policies listed are: A/XII or greater.
<br />Re: All operations of named insured -- The City of Santa Ana, its officers, employees, agents, volunteers and representatives are named as additional insured
<br />as respects general and auto liability for claims arising from the operations of the named insured as required per written contract or agreement. General Liability
<br />is Primary/Non-Contributory per policy form wording. Insurance coverage includes waiver of subrogation per the attac ed endorsement(s).
<br />REVIEWED BY: EUNICE HEREDIA (PGJ OF )
<br />�, r_m I Irww I r
<br />City of Santa Ana
<br />120 Civic Center Plaza - M36
<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 />1�
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