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JFSHEAC-01 LHETHERINGTON <br />s1►CC7R® CERTIFICATE OF LIABILITY INSURANCE DAT6t3t2019 i <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 endorsemen{(s). <br />PRODUCER License # OM70471 tla Hetherington <br />Orion Risk Management Insurance Services, An Ali Group Insurance g49)608-4920 lAfcNei:(949) 263-8860 <br />1 gency, LLC EMAIL Ihotherin ton orionrisk.com <br />1800 Quail Street, Suite 110���Alt'_N <br />9 @ <br />Newport Beach, CA 92660 . 11...I ,, <br />INSURED <br />Dyer Business Park LLC <br />c/o Shea Properties <br />130 Vantis Dr Ste 200 <br />Aliso Viejo, CA 92656 <br />rrb%f= t:F¢ rFRTIFIQATF MIIMRFP- REVISION NUMRER: 1 <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE INSURED NAMED ABOVE FORTHE POLICYPERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT <br />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 />INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EPF PML�pV EXP <br />LIMITS <br />A X <br />COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE <br />3,000'POO <br />CLAIMSMADE %( OCCUR rs2661066115028 an/aola <br />8/1/2019 <br />DAMAGE TO RENTED <br />pREMISESlEanrcurre OOy„` <br />1000000 ' <br />' <br />MED EXP (Anv one aersan)r, <br />0 <br />PERSONAL&ADV INJURY $ <br />3,000,000 <br />GENT <br />AGGREGATE LIMIT APPLIES PER: <br />GENERALAGGREGATE $ <br />6'000'000 <br />POLICY 1 j T (R1 LOG <br />PRODUCTS - COMP OP AG $ <br />6,D90'999 <br />Ol"HER: <br />A <br />COMBINED SINGLE LIMIT' <br />2,000,000 <br />AUTOMOBILE LIABILITY <br />flm accident) $ <br />X ANYAUTO AS2661066115018 8/1/2018 <br />8/1/2019 <br />BODILY INJURY Pergefs n $ <br />OWNED SCHEDULED <br />AUTOS ONLYqXAUUTTGSSWry� <br />_BODILY INJURY (Peraoeldes $ <br />X A�R AUTOS <br />F e�a.orrYitDAFAAGE $ <br />S ONLY ONLDY <br />B UMBRELLA LIAR X OCCUR <br />EACH OCCURRENCE <br />3,009'DOO <br />X EXCESS LIAB CLAIMS -MADE B0595XR5668019 8/1/2018 <br />811/2019 <br />AGGREGATE <br />3,000,000 <br />DED X RETENTION$ 25,000 <br />A WORKERS COMPENSATION_ <br />AND EMPLOYERS'LIABILITY <br />X PER OTM- <br />_ STATUTE _ER__ <br />ANY PROPRIETORIPARTNERtEXFCUTCJE YIN A266DO66115038 811t2018 <br />81112019 <br />BL EACH ACG70ENf_,,, $ <br />1'000'000 <br />OO��..FICERlMEMBER EXCLUDED? ® NIA <br />(fiAandatory En NH} <br />E.L. DISEASE - EA EMPLOYE $ <br />1,000,000 <br />f yes, describe untler <br />DESCRIPTION OF OPERATI <br />E.L. DISEASE POLICY LIMIT $ <br />1000000 <br />,,_ <br />I <br />DESCRIPTION OF OPERATORS t LOCATIONS t VEHICLES (ACORD 101, AddNionai Remarks Schedule, may be attechad it more space is required} <br />Re: East Alton Avenue Lot License Agreement; RFP No.: 19A07 <br />As Respects General Liability: the City, its officers, employees, agents, volunteers and representatives are Included <br />as additional insureds. <br />This insurance <br />is primary and any insurance of the additional insureds Is non-contributory. 30 days ntice of cancellation except 10 days for non-payment,,Vn\h <br />n` �W <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE t&aCELLED BEFORE <br />Cityof Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Risk Management Division <br />20 Civic Center Plaza — <br />Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE <br />ACORD 25 (2016103) © 1988-2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />