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ORRICHER CERTIFICATE OF LIABILITY INSURANCE PATE (MMIPOIYYYY) 5/16/2018 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(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer riahts to the certificate holder in lieu of such endorsemar 1. Commercial Lines - (628) 201-9001 USI Insurance Services National, Inc. - CA Uc#: OD08408 201 Mission St, 11th Floor San Francisco, CA 94105 INSURED BLX Group, LLC 777 South Figueroa Street, Suite 3200 Great Northern Insurance Federal Insurance COmOa 20303 20281 Los Angeles, CA 90017 1 INSURER F: COVERAGES CERTIFICATE NUMBER: 13023201 REVISION NUMBER: See below 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. ILTR TYPE OF INSURANCE UBRI POLICY NUMBER ,N PL;S735821151 POLICY Epp MMIDDryYYY LIMITS A X ............. COMMERCIAL GENERAL LIABILITY ...... CLAIMS -MADE u OCCUR D6/01/2018 06/01/2019 EACHOCCURRENCE OAMAG" TUR5RTED ....__.._..__. PREMISES Ea occurrence $ 1,000,000 __._._....,....__.. $ 1,000,000 MED EXP (Any one pereonL $10,000 X Host Li ucrincludetl q I PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000000,' X PRO- POLICY 1 JECT LOC --- PRODUCTS._COMP/OP AGO_ -- $ Incl In Gen Agg X OTHER: Ind, Contractors S B AUTOMOBILE LIABILITY 1 74996569 06/01/2016 06/01/2019 En acel.,alBINED LE LIMIT $ 1,000,000- BODILY INJURY (Per person) $ ANYAUTO _..._ OWNED ASCHEDULED ____ AUTOS ONLY UTOS BODILY INJURY (Per arndent),S X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY pFiOFERTV pAMAGE--- Per sudden)_,,,,_ $----- ---.._..__..._ $ I B X UMBRELLALIAB X OCCUR 79820023 06/01/2018 06/01/2019 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 EXCESSMAB CLAIMS -MADE 1 DED RETENTION$ S WORKERS COMPENSATION AND EMPLOYERS'LIABILIrY YIN iP R H- _ §TATUT�, E.L. EACHACCIDENT $ ANYPROPRIETORIPARTNERIEXECUTIVE ❑ OFFIOERIM EMBER EXCLUDES? NIA E.L. DISEASE - EA EMPLOYEE $ 1 (Mandatory in NH) If ear, describe 1DESCRIPTION O OrPERATIONSbelow E.L. DISEASE -POLICY LIMIT S i i 1 I i DESCRIPTION OF OPERATIONS I LOCATIONS i VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) The Certificate Holder Is named as Additional Insured as it relates to general & auto liability in accordance with the terms and conditions of the policy. CERTIFICATE HOLDER CANCELLATION City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 Civic Center Plaza M-25 ACCORDANCE WITH THE POLICY PROVISIONS, Santa Ana CA 92701 AUTHORIZED REPRESENTATIVEny 9?`-1W— The ACORD name and logo are registered marks of ACORD ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103)