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<br />CGIFc� CERTIFICATE OF LIABILITY INSURANCE 07I0212019
<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 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 />MARSH USA INC.
<br />1050 CONNECTICUT AVENUE, SUITE 700
<br />WASHINGTON, DC 2DO36-5385
<br />CON ACT
<br />NAME:
<br />PHONE I KC. Nol:
<br />EX.
<br />60"AIL12
<br />ADDRESS:
<br />INSURER(S)AFFORDINO COVERAGE
<br />NAIC#
<br />INSURER A: Great Northern Insurance Com an
<br />20303
<br />CN101976702-MULTI-EO+FI-19-20
<br />INSURED
<br />ICMA RETIREMENT CORP.
<br />ATTN: D'JUANA THOMAS
<br />INSURERB: NIA
<br />NIA
<br />INSURER C: Padfic Indemnity Insurance Company
<br />20346
<br />INSURER D : Federal Insurance Company
<br />20281
<br />777 NORTH CAPITOL ST., NE
<br />WASHINGTON, DC 20002 -
<br />INsuRERE:Travalars Casualty And Surety Company Of America
<br />31194
<br />INSURER F
<br />COVERAGES CERTIFICATE NUMBER: CLE-006041464-38 REVISION NUMBER: 5
<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 />INS.
<br />LTR
<br />TYPE OF INSURANCE
<br />ADOL
<br />SUER
<br />POLICYNUMSEft
<br />MMIDIDIYYYY
<br />POLICYXP
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE � OCCUR
<br />CONTRACTUAL COV. INCL,
<br />3604-49-95
<br />08/01/2018
<br />0810112019
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />DAMAG oo IIENTL
<br />PREMISES Ea occurrence
<br />$ 1,000,000
<br />X
<br />MED EXP (Any one parson)
<br />$ 10,000
<br />PERSONAL &ADV INJURY
<br />$ 1,000,000
<br />GEN'LAGGREGATE LIMITAPPLIES PER:
<br />POLICY F j p7 LOC
<br />OTHER:
<br />GENERALAGGREGATE
<br />$ 2,000,000
<br />PRODUCTS - COMPIOP AGE
<br />$ 2,000,000
<br />$
<br />AUTOMOBILE LIABILITY
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />HIRED NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$
<br />BODILY INJURY (Per person)
<br />$
<br />BODILY INJURY (Per accident)
<br />$
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />UMBRELLA LIAR
<br />EXCESS LIAB
<br />OCCUR
<br />CLAIMS -MADE
<br />1
<br />1
<br />EACH OCCURRENCE
<br />$
<br />AGGREGATE
<br />$
<br />DEO I I RETENTION$
<br />$
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS'LIABILITY YIN1,000,000
<br />ANYPROPRIETORIPARTNERIEXECUTIVE —NIA
<br />0FFICENMEMB ER EXCLUDED4
<br />(Mandatory In NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />7176-36-85
<br />08101I2019
<br />X STATUTE ERH
<br />E.L. EACH ACCIDENT
<br />$
<br />E.L. DISEASE-EAEMPLOYEE1$
<br />1,000,000
<br />-
<br />E.L. DISEASE -POLICY LIMIT
<br />$ 1,000,000
<br />D
<br />E
<br />BANKERS PROF, LIAB.
<br />SIR: $1,000,000
<br />8211-6261
<br />106758967
<br />06/30/2019
<br />06/3012019
<br />06/30/2020
<br />06/30/2020
<br />$7,500,000 plo $12,500,000
<br />$5,000,000 PIC $12,500,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS IVEHICLES (ACORD 1111, Additional Remarks Schedule, maybe attached If more space is requlred)
<br />CITY OF SANTA ANA
<br />ATTN: EXECUTIVE DIRECTOR OF PERSONNEL SVS
<br />20 CIVIC CENTER PLAZA M-34
<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 />of Marsh USA Inc.
<br />Manashl Mukherjee
<br />CORPORATION. All riahte reserved.
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
<br />
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