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DATE (MMIDDYIYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the poll—y(les) must be endorsed. If SUBROGATION IS WAIVED, subject to nnriWlrmta hn1Am In li®„ ni m..,.r. .....L...._--..u_. the teems and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the PRODUCER NAME, T Chip Francis PHONE(626)396-1035'—_......_._._...____�� KelleyJi rI"(R/AC Nol. 21O i96-1045 ggina and Associates Insurance Brokers E-MDJIRN. , chip®kjains.com PO Box 60310 -- '�---- -- _`_ INSRER(S)AFFORDING COVERAGE NAIC#� Pasadena _ CA 91116-6310_ INsugggA;West American Insurance CompL 44393 INSURED IN_SURERB_O_hi0 Security _ 27082 INSURER CtAlaeriCBA _Fire & CasualtY_CO w_ d 24066 NDG Associates, Inc. INSURER D: _______ 10722 Arrow Route STE 822 ___...... INsuREaE: Rancho Cucamonga CA 91730 INSURER F:- COVERAGFA rG>DTICIr Arewwace In,. onan ... ....... __. ____.._._...._.._....-_.. ____ ___- -._ .._., MCVIOIIJM rvvmi3CK: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LR TYPE OF INSURANCE POLICYEFF PM1DDfYXP —"' PO NU YYY1 LIMITS X COMMERCIAL GENERAL LIABILITY A ---i ctAIMS-MADE ® EACH OCCURRENCE 'AM ET-F ENT D $ 1,000, 000 y — _j OCCUR SEg 1 200, 000 X BKW57179298 7/1/2018 7/1/2019 - MED EXP Anyone Gerson) IS 15,000 --- PERSONAL&ADV INJURY $ 11000,000 GEN' X L AGGREGATE LIMIT APPLIES PER: ❑ PRO-JECT . ❑ GENERAL AGGREGATE $� 2,00000 0, —.—,. _ POLICY LOC PRO DUCTS-COMPIOP AGO $ 2,000,000 TH R: Employee Benefits IS 1, 000, 000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ X Ea acrid nt 1 000,000 B ANY AUTO BODILY INJURY (Per person) $ ALL OS SCHEDULED AUTOS AU70S I X 1BAS57179298 7/1/2018 7/1/2019 BODILY INJURY (Per accident) $ X HIRED AUTOS X ANOTN SWNED i I PH PERTY DAMAGE $ --- Medical ents $ 51000 UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4 000, 000 - G, X EXCESS DAS �_LLAIMS-M_A_0_E_ GGREGATE_„ $ 4 OOO, D00 O D RETENTI N$ j ESA57179296 7/1/2010 7/1/2019 $ WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY PI ER OTH- STATUTE Y/N ANY PROPRIETORIEXCLUDRIEXECUTIVE (Mandatory In ER EXCLUDED? �INIA (Mandatory in NH) E ._ E.L:EACH ACCIDENT ..$ If yes, describa under E.L. DISEASE-EAEMPLOYE _ DESCRI ION OF OPERATIONS below E.L DISEASE -POLICY LIMIT 1 $ s DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (ACORU 101, Addltlonal Remarks Schedule, may be attached U more space is required) The City of Santa Ana, Its officers, employees, agents and volunteers and named additional insured, but only as respecys the insured's operations as it relates to their signed contract in regards to the CDBG Administration Consluting Services per form CGB$lo 0413Primay Insurance and Transfer of rights or recovery against others is included in the form. Auto Al CAS810 0113 *30days notice of cancellation except 10 days for non-payment, City of Santa Ana Attn.: Terri Eggers, Senior Mgmt. Analyst Community Development Agency 20 Civic Center Plaza Santa Ana, CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Jiggins/CHIP 3" ©1988.20t4 ACORD CORPORATION. All riahts reser J d:, (6V IN/Y 1) I ITS, ACORD name and logo are registered marks of ACORD INS025 (201401)