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ACOR& CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 11111 01 /08/2019 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(ies) 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Sue Lusk NAME: Cornerstone Specialty Insurance Services, Inc. (714) 731-7700 FAX(714) 731-7750 a�NN Ext : No): 14252 Culver Drive, A299 E-MAIL sue@cornerstonespecialty.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # Irvine CA 92604 INSURERA: Travelers Property Casualty Co 25674 INSURED INSURER B : Travelers Indemnity Co of Conn 25682 C BELOW, INC. INSURER C : Continental Casualty Company 20443 14280 Euclid Avenue INSURER D : INSURER E : Chino CA 91710 INSURER F: COVERAGES CERTIFICATE NUMBER: 18/19 COVERAGES REVISION NUMBER: 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. INSR LTR TYPE OF INSURANCE AUULbUbK INSD WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MMIDDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE 7 OCCUR PREMISES Ea occurrence $ 100,000 X MED EXP (Any one person) $ 5,000 ADDTL INSRD/PRIMARY X BLNKT WVR OF SUBRO PERSONAL BADV INJURY $ 2,000,000 A Y Y 680-51-1559891 12/18/2018 12/18/2019 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY JEo LOC PRODUCTS-COMP/OPAGG $ 4,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X ANY AUTO BODILY INJURY (Per person) $ B OWNED SCHEDULED AUTOS ONLY AUTOS Y Y BA-7D687122 12/18/2018 12/18/2019 BODILY INJURY (Per accident) $ HIRED NON -OWNED PROPERTY DAMAGE Per accident $ AUTOS ONLY AUTOS ONLY X UMBRELLA LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ 10,000,000 AGGREGATE $ A EXCESS LIAB Y Y CUP-4181T634 12/18/2018 12/18/2019 X DED I I RETENTION $ 0 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN X STATUTE ERH E.L. EACH ACCIDENT $ 1,000,000 A ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? Ey N/A Y XJUB-8J675252 12/18/2018 12/18/2019 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1,000,000 $ Each Claim $2,000,000 Professional Liability C Claims Made MCH288306745 12/18/2018 12/18/2019 Annual Aggregate $2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) City of Santa Ana, its officers, employees, agents, volunteers and representatives are Additional Insured for General Liability but only if required by written contract with the Named Insured prior to an occurrence and as per attached endorsement. Coverage is subject to all policy terms and conditions. `30 days notice of cancellation, except for 10 days notice for non-payment of premium. For Professional Liability, the aggregate limit is the total insurance for all covered claims reported within the policy period. REVIEWED BY: EUNICE HEREDIA (PG I OF ) I.CM I IrIL Al t MULutK SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza M-36 AUTHORIZED REPRESENTATIVE Santa Ana CA 92701 @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD