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<br />CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MMIDD/YYYY)
<br />10611212019
<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 />CONTACT
<br />NAME:
<br />MARSH USA INC
<br />�Wc.
<br />1717 Arch Street
<br />r{Al Na, Ext): N.S:
<br />Philadelphia, PA 19103
<br />E�nAIL
<br />AQ4f?E$�'
<br />Attn: Philadelphia.certs@marsh.com I Fax: (212) 948-0360
<br />INSURER 3 AFFORDING COVERAGE
<br />NAIC #
<br />INSURER A: Lexin ton Insurance Company
<br />19437
<br />CN1 1 8025105-ALL-GAWU-1 8-19
<br />INSURED Allied Universal Topco, LLC
<br />INSURER B : Greenwich Insurance Company an
<br />22322
<br />INSURER C : XL Insurance America
<br />24554
<br />(See Attached for Additional Named Insureds)
<br />INSURER D : Lloyd's Syndicates - SeeAcord 101
<br />161 Washington Street, Suite 600
<br />Conshohocken, PA 19428
<br />INSURER E : XL Specialty Insurance Company
<br />37885
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER: CLE-006447772-01 REVISION NUMBER: 1
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY FXP LIMITS
<br />LT POLICYNUMBER MID YY
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />082695264
<br />11/01/2018
<br />11/0112019
<br />EACH OCCURRENCE
<br />$ 10,000,000
<br />. CLAIMS -MADE OCCUR
<br />Erb
<br />PREMISES .Eaa
<br />$ 10,000.000
<br />X
<br />MED EXP (Any oneperson)
<br />$
<br />CONTRACTUAL LIABILITY
<br />X
<br />SIR $1,750,000
<br />PERSONAL & ADV INJURY
<br />$ 10,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />$ 10,000,000
<br />X POLICY jE LOC
<br />PRODUCTS-COMP/OPAGG
<br />$ 10,000,000
<br />$
<br />OTHER:
<br />B
<br />AUTOMOBILE LIABILITY
<br />RAD9437818-02
<br />11/0112018
<br />11/01/2019
<br />COMBINEDSINGLELIMIT
<br />,_�Eaaccld l
<br />$ 2,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />X ANY AUTO
<br />X OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />X HIRED X NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />BODILY INJURY (Per accident)
<br />$
<br />-PROPERTY DAMAgE
<br />$
<br />X
<br />UMBRELLA LIAB X
<br />OCCUR
<br />BOWCN1800836
<br />11/01/2018
<br />11/01/2019
<br />EACH OCCURRENCE
<br />$ 10,000,000
<br />AGGREGATE
<br />$ 10,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />➢ED I I PETENTIOUS$
<br />C
<br />E
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y t N
<br />OF IC RPMEMB REXCLUDED? ECUTIVE F
<br />(Mandatory In NH)
<br />NIA
<br />RWD3001203-02 (AOS)
<br />RWR3001204.02 AK &WI
<br />( )
<br />11/01/2018
<br />1110112019
<br />11/01/2019
<br />X SEAT TE R
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E,L, DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />E.L. DISEASE - POLICY LIMIT
<br />1,000,000
<br />$
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
<br />The City of Santa Ana, its officers, employees, agents, volunteers and representatives are included as additional insured where required by written contract with respect to General Liability and Auto Liability. Liability
<br />coverage shall be primary and non-oonlributory wh required by written contract. Waiver of subrogation is applicable where required by written contract.
<br />REV I WE'D BY:
<br />[ Ir
<br />CERTIFICATE HOLDER CANCELLATION
<br />The City of Santa Ana AUTHORIZED
<br />REPRESENTATIVE
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92701
<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 />of Marsh USA Inc.
<br />©1988-2016 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />
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