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CERTIFICATE OF LIABILITY INSURANCED M(MM/Do e 1
<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 />certificate holder in lieu of such endorsemendt 1.
<br />PRODUCER CONTACT-__-- --
<br />NAME; Fernando Rivas _ _
<br />__..
<br />ISII Insurance Services - Centinel Agency, LLC PHONE gXDL(415)657-2000 fFAX (4151657.2002
<br />250 Executive Park Blvd 'MAIL farnandoC9leuaa.00m
<br />Suite 4500 .....___...__— ... ..... _._..... ......
<br />_
<br />_ INEURERISLAFPORDINO COVERAGE NA
<br />San Francisco _ CA 94134 ___ __ INSUReRAIScottsdale Insurance 412_9'
<br />-- ...._.... .-___........__. _____—__._ .. _ ..._. _ .
<br />INSURED INSURERSAmeriCIIn_Fite and Casualty Com an ,2406
<br />California Barricade Rentals Inc -aoi y"OS'%(5) ---- y— 8 y
<br />INSURER t..National Union Fire Insurance Cc of 1.1944
<br />1550 S Saint Gertrude Place ,...-----.4-- Te-
<br />CA 92705 1I115URERF:Kinaale, Insurance Coawanv —___11.38920
<br />COVERAGES CERTIFICATE NUMBER:18-19
<br />GL,WC,BA,XS,E&O,PL 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 />EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR I--.-___.. .. __..._........ --__.. ADDLSUSR'_.._.._.
<br />TR' TYPE OP INSURANCE -—P01 -ICY EFF (P361CY6`XV-1------LIMITS
<br />POLICY NUMBER DD MMI
<br />X 1 COMMERCIAL GENERAL LIABILITY
<br />......
<br />I EACH OCCURRENCE 1S
<br />1, 000, 000
<br />,.
<br />A .... CLAIMS -MADE OCCUR j
<br />-DAMAGE TO AENTEO .I_.__
<br />PREMISESjEnnccmrexo) -_S„
<br />.......... _.......
<br />...
<br />.�
<br />-.____—_ _. X OCS0037139
<br />7/1/2018 7/1/2019 MEDEXP(Any Ore_ponaon) S
<br />_100,000
<br />Excluded
<br />PERSONAL&ADVINJURY IS
<br />11000,000
<br />N'L AGGREGATE LIMIT APPLIES PER:
<br />'GENERAL AGGREGATE $
<br />2,000,000
<br />XJECI
<br />POLICY T LOC
<br />L
<br />IPRODUCTS COMP/OP ADD S
<br />.
<br />2,000,000
<br />OTHEREmployee
<br />eenerite S
<br />11000,000
<br />AUTOMOBILE LIABILITY!I
<br />_......,
<br />I DnQ I L I
<br />La ewdej S
<br />11000,000
<br />BL.X ANY AUTO
<br />—
<br />BODILY INJURY (Par Person) j S
<br />ALL OS -!AUTOS IED BAA (191 58 OS
<br />_. 1 AUTOS AUTOS X
<br />63 03 7/1/2018 7/1/2019 BODILY INJURY aeodenlIS
<br />I
<br />; � ; I NON -OWNED
<br />i X `PRO
<br />. X HIRED AUTOS
<br />ERTY DAMAGE
<br />,X...� AUTOS
<br />;
<br />UMBRELLA LIAS X OCCUR
<br />— �......-.I
<br />FACHOCCUENCE
<br />RR_
<br />5,0_00 000
<br />EXCESS LING
<br />C CLAIMS_MADE.AGGREGATE_
<br />_S_
<br />S
<br />_
<br />5,000,000
<br />OED '. FIETENTI S ''. BE 014795709
<br />_
<br />7/1/2018 7/1/2019 ;.S
<br />WORKERS COMPENSATION
<br />H
<br />STATUTE_= um.
<br />AND EMPLOYERS' LIABILITY YIN
<br />---
<br />Z ANY PROPRIETORIPARTNERIEXECUTIVE �-!j
<br />OFFICERIMEMBER EXCLUDED? NIA
<br />E.L. EACH ACCIDENT 1.3
<br />1,000,000
<br />D 1(Mandatory In NIU —'-'I '19063608-2018
<br />7/1/2018 7/1/2019'E.L DISEASE EMPLOYEES
<br />�IE,L.
<br />1_,_000, tl00
<br />If yyes. describe under
<br />_-EA
<br />! I�
<br />----
<br />'DESCRITIONOFOPRA710NSlrebw
<br />DISEASE, POLICY UNIT'S
<br />1000000
<br />E 1. Professional Liability NPL1E63490.18
<br />7/1/2018 '.; 7/1/2019 1Each Clam:
<br />$1,000,000
<br />F ", Pollution Liability 10100052798-1
<br />'', 7/1/2018 '.i 7/1/2019 Each Po8u8un CarWition
<br />$1,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONSI VEHICLES (ACORD 101, Additional Remark. Schedule, my" anaehad if more 4Aaea Is Uqulrall
<br />The City of Santa Ana, its officers, employees,
<br />agents, and representative are named as additional
<br />insured per form CO 20 33 04 13 and CO 20 37 04
<br />13 on the GL policy.
<br />Additional Insured applies per form CA 88 10 01
<br />13 on the Auto policy.
<br />seg' ill
<br />Those usual to the insured's operations.'
<br />JraC✓
<br />City of Santa Ana
<br />20 Civic Center Plaza - M-23
<br />Santa Ana, CA 92702
<br />SHOULD ANY OF THE ABOVE
<br />THE EXPIRATION DATE
<br />ACCORDANCE WITH THE P it
<br />REPRESENTATIVE
<br />Ferenc/FR
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
<br />INS025I2014011
<br />BE CANCELLED BEFORE
<br />LL BE DELIVERED IN
<br />
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