|
ACOREf CERTIFICATE OF LIABILITY INSURANCE DATE (MM OU)YWI
<br />`/ 11/13/2019
<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(ies) must have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />Dealey, Renton & Associates NMIACT
<br />Marie Swaney FAX
<br />790 E. Colorado Blvd, #460 U1(C.No Earr. 62fr844-3070 (uc R,:
<br />Pasadena CA 91101 1
<br />AnnRF , mswanevCdldealevrenton.com
<br />License#'. 0020739 INSURER A: National Fire Insurance Cc of Hartfor
<br />INSURED URaACRG41 INSuRER B: Valley Fore Insurance Company
<br />Urban Crossroads, I0C.
<br />260 E Baker St, #200 KsIuaeItc: Continental Insurance Company
<br />Costa Mesa, CA 92626 IKsuRERD: Travelers Casualty and Surety Cc of
<br />949-606-1994 ..........._ _ r....c..e..,.,I r.,.....,w, r....._......
<br />COVFRAr.FR CFRTIFIr`ATF Ml wCoo-Rc,nnoom eancanu wwoco.
<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 />BLTR IER
<br />TYPE OF INSURANCE I.qn SUER
<br />PDUCYNUMBER
<br />POLICY E"
<br />20[0(P
<br />UNAITS
<br />B
<br />X
<br />COMMERCAL GENERAL LUUKLITY
<br />CLAIMS -MADE 1 OCCUR
<br />Y
<br />- Y
<br />8021297176
<br />11H/2019
<br />11/1/2020
<br />EACH OCCURRENCE
<br />$2,000,000
<br />$1,000,000
<br />DAMAGE TO RENTED
<br />PREMISES Ea om manna
<br />MED EXP (Any q parson)
<br />TX CalpecalM liaS
<br />_
<br />$10,000
<br />X
<br />XCUlndutled
<br />PERSONAL B ADV INJURY
<br />$2,000.000
<br />GENL AGGREGATE LIMIT APPLIES PER:
<br />POLICY JJECTT FLOC
<br />GENERALAGGREGATE
<br />$4.000,000
<br />PRODUCTS -COMPIOPAGG
<br />$4,D0O,OGO
<br />$
<br />OTHER:
<br />C
<br />AUTOMOBILE
<br />ULAINITY
<br />ANY AUTO
<br />Y
<br />Y
<br />6020089431
<br />11/1/2019
<br />11/1(2020
<br />Mea Iwam)INGLE UMn
<br />$1,000,000
<br />$
<br />X
<br />BODILY INJURY Per pereon)
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />$
<br />BODILY INJURY Par acadon0
<br />X
<br />WM-O
<br />HIRED AUTOS NLY
<br />AUTOS ONLY X AUTOS ONLY
<br />PP OPT DAMAGE
<br />ftl
<br />$
<br />E
<br />X
<br />UMBRELLA LIAB X
<br />OCCUR
<br />Y
<br />Y
<br />6020089476
<br />1111/2019 11/112020
<br />EACH OCCURRENCE
<br />$2.000,000
<br />EXCESS LAB
<br />CzCc -MADE
<br />AGGREGATE
<br />It2,000,000
<br />DELI I X 1 RETENTIONS n
<br />$
<br />A
<br />*011 ERSCOMPENSATIOR
<br />ANDEMPLOYERS•LABILITY YIN
<br />ANYPROPRIETORIPARTNERIEXECUTNE
<br />0"ICERrMEMBEREXCLUDEDT
<br />NIA
<br />Y
<br />6025002328
<br />11/1/2019 11/12020
<br />X STATUTE ER
<br />E.L. EACH ACCIDENT
<br />$1,000,000
<br />E.L. OISEA$E-EA EMPLOYEE
<br />$1,000,000
<br />(Mandatory In NH)
<br />H yes, desvlbe under
<br />DESCRIPTION OF OPERATIONS W.
<br />E.L. DISEASE -POLICY LIMIT
<br />$1,000,000
<br />D
<br />Professional UaWty
<br />105517955 11/1/2019
<br />11/1/2020
<br />Par Clelm
<br />$1,000.000
<br />Annual Aggregate
<br />$2,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Addidamai Ramaras Schedule, may bs aeachad R more spa" M raqulred)
<br />AM Best Rating on all Policies above: A/XII or greater. Umbrella policy is follow form to its underlying Policies: General Liability/Auto Liability/Employers
<br />LiabitRy,
<br />RE: All operations of the named insured —
<br />City of Santa Ana, its officers, employees, agents, and representatives are named as additional insured as respects general and auto liability as required per
<br />written contract or agreement. General Liability is Primary/Non-Contributory per policy form wording. Insurance coverage inGudes waiver of subrogation per the
<br />attached endorsement(s).
<br />REV
<br />By
<br />WED & APPRO
<br />k MANACfEMENT DIVI
<br />EPOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />IOANE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />City of Santa Ana
<br />Attn: Risk Manegement Div!
<br />20 Civic Center Plaza, 4th F
<br />Santa Ana CA 92701
<br />n
<br />Of
<br />9
<br />AN l i ZO[0
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPREBENTATNE
<br />SA
<br />ANTHA M, LAMBS
<br />01988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />
|