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AC"RDr CERTIFICATE OF LIABILITY INSURANCE D ��MMIOD 8
<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 INSURERS), 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 [CO
<br />NTACT MikeMS:
<br />Michael Rodgick(971832A) 94,
<br />MIL_. 196 Technology Or Ste B DRESS, mm,
<br />INSURED
<br />CA 92618-2433
<br />SANTA, ANA BUSINESS COUNCIL, RER0: Mid CenturnInEurap ce Company j 21687
<br />400 E. 4TW STREET �Nl
<br />RER 0: State Fund
<br />nea E: Travelers Insurance LL 31994
<br />COVERAGES CERTIFICATE NIIMIF$FR• omlICHAM MIUM10=12'•
<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 CONOITION 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 SY PAID CLAIMS.
<br />— .—POLIGP F POLICYEXP
<br />AUBL @ .—.----
<br />TR TYPE OF INSURANCE � p00CY NUMBER MMMDIYYV M LIMITS
<br />GENERAL DABILITY
<br />�GOMMERCIALGENERAL LIABILITY
<br />! I
<br />EACH OCCURRENCE $ 11000,000
<br />DAMAGETOft1VTE0---"_"�""'_.-.._
<br />--1 XOCCUR
<br />I
<br />PRl_MISE�^,(Ea otxarrtenca �, $ _1000000
<br />CLAIM&MAR@
<br />>
<br />Y N j eomm396
<br />i
<br />12/07/2019
<br />MED EXP(Any onepammn) I$ 10,000
<br />112107/2018
<br />P RSONAL& ACV INJURY _$ 1000000_
<br />AGGREGATE
<br />GENL AGGREGATE LIMIT APPLIES PER:
<br />1
<br />PRODUCTS CQM'OF AGO1$ 2000,000
<br />POLICY PRO,JECT 1 LOG
<br />AUTOMOBILE LIABILITY
<br />!
<br />� (
<br />�
<br />COMBINED aINGLE LIMIT ;
<br />j,lEa acpaea�J,__ is 1000,000
<br />ANY AUTO
<br />1
<br />900I4Y INJURY (Par r.mon) IS
<br />_
<br />ALL OWNED SCHEDULED
<br />B AUTO$ AUTOS
<br />NON -OWNED
<br />HIRED ALTOS I� AUTOS
<br />-
<br />( 606503396 i1211712118
<br />12107/2119
<br />J —
<br />BODILY INJURY(P,ornddant)i S y
<br />PROPERTY DAMAGE
<br />tlont_
<br />is
<br />UMBRELLA LIAR i !OCCUR
<br />j '
<br />I
<br />EACH OCCURRENCE $
<br />...y
<br />EXCESS UA@ I CLAIMSMAOE,
<br />AGGREGATE ,$
<br />DEO : RETENTIONS
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />WC STATU OTH
<br />V IW��T�—
<br />IANYPROPRIETORIPARTNERIEXECUTIVE YIN
<br />D OrFICCRNIEMReR EXCLUDED? ❑'
<br />j
<br />908i384 :12110/2018:9211012019
<br />(
<br />�ELEACH ACCIDENT % 1000,000
<br />- ...
<br />.NIn
<br />(Mandatoryin NH)
<br />I I
<br />1
<br />@ 4 DISEASE, EA EMPLOYER $S 1,000,000
<br />If yes, dosaibounder
<br />CEl
<br />DESGRIPTIONOFGPERATIDNSba:pw
<br />DISEASE POLICY UMITi$ 1,000,000
<br />Fidelity Bond
<br />6,000 SIR $500,000
<br />E ' D&0
<br />I 106032811 12/10/2018
<br />12/1012019
<br />1,000 SIR $1,000,000
<br />EPL
<br />1,000 SIR $1,00%000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS VEHICLES (Attech ACORD 101, Additional Remarks Schedule, it more space IS mgairen)
<br />400 E. 4TH STREET, SANTA ANA, CA 92701
<br />CITY OF SANTA ANA, ITS OFFICERS, AGENTS, EMPLOYEES AND VOLUNTEERS ARE NAMED AS ADDITIONAL INSUREDS FOR GENERAL LIABILITY b
<br />PURPOSES. COVERAGE IS PRIMARY AND NON-CONTRIBUTORY, WITH THIRTY (30) DAYS NOTICE OF CANCELLATION, EXCEPT 10 DAYS FOR
<br />NONPAYMENT OF PREMIUMS
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />CITY OF SANTA ANA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />20 CIVIC CENTER PU ACCORDANCE WITH THE POLICY PROVISIONS.
<br />SANTA ANA CA 92701 I , 7 -1
<br />I
<br />The ACORD name and logo are registered marks of ACORD
<br />
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