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AC" d CERTIFICATE OF LIABILITY INSURANCE DATE A E 3/M 9YY) 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(iss) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WANED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endomement(s). PRODUCER CONTACT NAME: WILLIS OF ILLINOIS, INC. PHONE 888)780.5381 FAX P; (866 828-2424 EA UNESS: CertiBcate@Hanover.com INSURER(S) AFFORDING COVERAGE NAIC R 233 S. WACKER DR, STE 2000 CHICAGO IL 60606 INSURERA: Citizens ins Co of America 31534 INSURED INSURER B: Hanover Insurance Cc 22292 INSURERC: MED EXP (Any one Person) $ 10,000 INSURER D: GONG ENTERPRISES INC 7755 CENTER AVENUE STE 1100 INSURER E: HUNTINGTON BEACH CA 92647 INSURER F: COVERAGES CERTIFICATE NUMBER: RPVLCInIU MIUMPOR. 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 ADOL UBft POUCYNUMBER POLICY EFF MWDD POLICY EXP N LIMITS �I COMMERCIALGENERALUABIUTY CLMS-MADE IV]OCCURE AI FACHOCCURRENCE $ 2,000,000 RENT 1,000,000 PREMISES Ea occurrence $ MED EXP (Any one Person) $ 10,000 PERSONAL 8 ADV INJURY $ 2,000,000 A Y N OBC A361099 04 03/25/2018 03/25/2019 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY Z JEa 1-1 LOC GENERALAGGREGATE $ 4,000,000 PRODUCTS-COMP/OPAGG $ 4,000,000 $ OTHER: AUTOMOBILEUABRJTY COMBINE SINGLE LIMB $ 2,000,000 a accident ANYAUTO BODILY INJURY (Per Person) $ A AUUTTOSDONLv AUTOSULED HIRED✓ NON -OWNED AUTOS ONLY AUTOS ONLY Y N OBC A36109904 03/25/2018 03/25/2019 BODILY INJURY (Per accident) $ PROPERWDAMAGE $ Per accident UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DEC) I I RETENTION$ Is WORKERS COMPENSATIONPER ANDEMPLOYERS'LIABILITY YIN ANYPROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBEREXCLUDED? NIA O - STATUTE ER E.L. EACHACCIDENT $ E.L. DISEASE -EA EMPLOYEE $ (Mandatory In NH) describe under DESCRIPTION un OPERATIONS below WE.L. DISEASE - POLICY LIMB $ B Architects 8 Engineers Prof Llab N N LHC 988479106 03/25/2018 03/25/2019 Claims -Made: $1M Ea Claim/$2M Agg DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Ramarx9 Schetlule, may be attached H more space Is requlred) The City of Santa Ana, its officers, employees, agents, volunteers, and representatives Certificate Holder is an Additional Insured on the General Liability pursuant to the terms and conditions by form 391-1586. Additional Insured is Primary and Noncontributory to the extent provided by form 391-1003 (pg 79 of 81). Separation of Insureds provided to the extent allowed by form 391-1003 (pg 73 of 81). Cancellation Notice will be provided to the Certificate Holder pursuant to endorsements: 401-1235 and 910-0296. Such notice is solely for the purpose of informing the Certificate Holder of the effective date of cancellation and does not grant, alter, or extend any rights or obligations under these policies. CITY OF SANTA ANA PUBLIC WORKS AGENCY WATER RESOURCES DIV 220 S DAISY AVENUE - BLDG A SANTA ANA CA 92703 ATTN: BRIAN I GE PE V7 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORVUH) REPRESENTATIVE 1988-2015 ACORD CORPORATION. All riohts reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD PI