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OP ID: YC
<br />A�,�„�^�" "~ CERTIFICATE, OF LIABILITY INSURANCE
<br />DATE 12812(MMJD01 VY)
<br />11f2812017
<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 INSURER(S), 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 />certificate holder In lieu of such endorsements .
<br />PRODUCER
<br />Narver Insurance
<br />841-W.-Las Tunas Drive - -
<br />PO Box 1609
<br />San Gabriel, CA 91778-1509
<br />WESLEY HAMPTON HOUSE
<br />CONTACT June Samarin
<br />NAME
<br />_cR/A_c° No.Exm43.2237 - - n/c No : 686.299.1010
<br />E�MAO.
<br />AooREss; Isamarin@narver.com
<br />cuosiovnErsm ,LIEGE-1
<br />INSURERS AFFORDING COVERAGE
<br />NAIC N
<br />INSURED LlebertCassidy Whitmore
<br />6033 W. Century Blvd.
<br />Los Angeles, CA 90045
<br />INSURER AISentinel Insurance Company
<br />11000
<br />NsuRERe;Federal Insurance
<br />20281
<br />INSURER 01Aspen Specialty Insurance
<br />10717
<br />INSURER D; Pelous Insurance Company
<br />INSURER E I
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER' RFVIARIN NHMRrIP,
<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 CONDITION 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 BY PAID CLAIMS,
<br />ITR
<br />LIE.JiRPOLICY
<br />TYPE OF INSURANCE
<br />NUMBER
<br />POLICY EFF
<br />MMIDDIYYYY
<br />POLC
<br />M IDDY
<br />LIMITS
<br />GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 2,000,000
<br />A
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE N OCCUR
<br />X
<br />72SBAAK0318
<br />12/1412017
<br />12/14/2018
<br />PREMISES asoccurencs
<br />$ 1,000,000
<br />MED EXP(Any one person)
<br />$ 10,000
<br />PERSONAL &ADV INJURY
<br />$ 2,000,000
<br />GENERAL AGGREGATE
<br />$ 4,000,000
<br />BENL AGGREGATE
<br />LIMIT APPLIES PER:
<br />PRODUCTS - COMPIOP AGO
<br />$ 4,000,000
<br />T POLICY
<br />PRO LOC
<br />$
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />(Eaaccldent)
<br />$ 2,000,000
<br />ANY AUTO
<br />BODILY INJURY (Per person)
<br />$
<br />ALL OWNED AUTOS
<br />BODILY INJURY (Per eccldenl)
<br />$
<br />A
<br />X
<br />SCHEDULED AUTOS
<br />HIRED AUTOS
<br />72SBAAK0318
<br />12/14/2017
<br />12/14/2018
<br />PROPERTY DAMAGE
<br />(PER ACCIDENT)
<br />$
<br />A
<br />X
<br />NON-OWNEDAUTOS
<br />72SBAAK0318
<br />12I14/2017
<br />12/14/2018
<br />$
<br />$
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 2,000,000
<br />AGGREGATE
<br />$ 2,000,000
<br />A
<br />EXCESS LIAR
<br />CLAIMS�MADE
<br />72SBAAK0318
<br />1211412017
<br />12114/2018
<br />DEDUCTIBLE
<br />$
<br />X
<br />RETENTION $ 10,000
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANYPROMEMBER/PARTNER/E%ECUTIVE
<br />(102datory In ER EXCLUDEOP
<br />(Manddtoryin NH)
<br />If Dp8 describe under
<br />DESCRIPTION OF OPERATIONS below
<br />NIA
<br />7175-05-96
<br />04/01/2017
<br />I
<br />04/01/2018
<br />X WC STATU OTH-
<br />E
<br />E.L EACH ACCIDENT
<br />$ 1,000,000
<br />E,L, DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />I E.L., DISEASE -POLICY LIMIT
<br />1 $ 1,000,000
<br />C
<br />Professional Llab,
<br />LRASAF817
<br />12/10/2017
<br />12/10/2018
<br />Per Claim 5,000,000
<br />D
<br />Professional Llab.
<br />XPL409238
<br />Aggregate 6,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schodula, If more space to required)
<br />Certificate Holder is named as an Additional Insured in regards to attached
<br />General Liability Form B9 00 08 04 05, per written contract or agreement.
<br />CITYSAA
<br />City of Santa Ana
<br />20 Civic Center Plaza
<br />P.O. Box 1988
<br />Santa Ana, CA 92702
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS,
<br />AUTHORIZED REPRESENTATIVE
<br />01988.2009 ACORD CORPORATION. All riahtc rPgPm,,,I
<br />ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD
<br />
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