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CLEAR-1 <br />acoRo CERTIFICATE OF LIABILITY INSURANCE <br />�./ <br />DATE 019 <br />07/19/2019 <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 thD terms and conditions of the policy, certain pollcles may require an endorsement. A statement on <br />this certificate does not confer rl hts to the oor09Get& holder in lieu of such endorsemon s . <br />PRODUCER 8 1-337.46B1 <br />Clarion Pacific Insurance <br />2035 N.. Pacific Ave. <br />Santa Cruz, CA 95060 <br />Ryon Deane <br />GT Coryn ardiner <br />_ _ _ <br />P E —1 AX <br />A7iRNP, eat: 831-337.4H69 ._ _ I�aD Ron831-812.1810 <br />oryn peC•fIsrL.corn <br />IN RE SIAFfORUIND COVERAGE <br />INNURCRA, Philadelphia Indemnity <br />Ctl. <br />18058 <br />suaeo <br />iearsource Financial <br />tos, CAu960wte: B363 <br />Apo$nsy$ufl},UITT ¢ ❑p <br />INSURER a. Travelers Property Casualty Co <br />25674 <br />Su RC: Nationwide Mutual Insurance Co <br />23787 <br />NSUR RD: <br />111 URER F: <br />enr,evATc an lueee. RFVI.SInN NUMBER - <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 RAVE BEEN REDUCED BY PAID CLAIMS. <br />INSfl <br />TYPE OF INSURANCE <br />OOL <br />oBR <br />POL&Y NUMaER <br />PO YaFF <br />POLIC EXP <br />OMITS <br />D <br />X <br />R <br />COMMERCIAL GENERAL LIMRRY <br />cLWMSMADE [K DccLR <br />X <br />ACP 3009102473 <br />i210912018 <br />12109/2019 <br />IT OCCURRENCE <br />2000,000 <br />,�g'v'uue oR�.t s <br />Eo cP , sn u n <br />3 0,og0 <br />s 0�0 0 <br />R f BAOy INJ RY <br />eD�'OD <br />NL AGMIX E LIMIT APPLIES PER: <br />X POLICY JEL•T LOC <br />a E- <br />4,000,000 <br />TS-COMP/OP.'-' <br />, DO,OD9 <br />C <br />On <br />AUTOMOBILE LVSILITY <br />CAMEOSINCIEOMIT <br />acdeen0__--._s_. <br />ANYAUTO <br />X <br />ACP 3009102473 <br />12109/20181210912019 <br />NI]Du.YINJURYtPa1%Ea;f. <br />PAp L1I IN.lURYfPo/ay�dgtl <br />raE AMAGE <br />OWNED <br />TU OSONLY AUOpTOSVVUJJNL E®UU <br />X AUTOS ONLY X AUT00MILY <br />OK PeY his <br />M <br />...___.. <br />_ <br />UMBRELLA LIA9 <br />OCCUR <br />EACH 0GyIngNCil, <br />AgM JATR_ <br />EXCESS LIAR <br />CWMSMADE <br />OED nIgawtoMs <br />13 <br />A <br />WORKERS COMPENSATION r'�L <br />ANY PROPRETORIPARTNEUEXECDTNE r i <br />ppFFN:FrfUMr.halmrq EXGLUDEOP LJ <br />IMai Julery to Nll) <br />n Ynx doxdba aMm <br />OES llPFI OF TONS aul <br />Profosalonal Llab <br />NIA <br />U8.8M759710.79.42 <br />PHS01302248 <br />91/01/2019 <br />1 0912018 <br />0110112929 <br />1 0912019Fourence <br />X PE OTII <br />H. <br />1r600,o00 <br />-EL <br />E�L.01 -EAEMPILOfE <br />I DDO 000 <br />EL.OLSEASE• 'Y T <br />gregate <br />1,000,000 <br />2,000,000 <br />2,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD te1, Addlllonal Remarks Schedule. may be attached I/ more $pace is mqulred) <br />RE: OR Ide Indirect Cost Allocation Plan and Internal Service Funds Cost REVIEWED &APPROVED <br />Ailocal on Methodology. Citlyy of Santa Ana, its officers, employees, agents, <br />and reppresentOUVas are Additienal Insureds with respect to General By RISk MANAGEMENT DIVISION <br />Llablllty and Auto Liability per the attached endorsements or as required by <br />written contract, Insurance is Primary and Non -Contributory. 30 day notice` <br />G 26 2019 <br />AA QXJ0, <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 />City of Santa Ana <br />Risk Management Division, <br />4th Floor AURIOR17EP REFRf9ENTATIVE <br />20 Civic Center Plaza �IAiv.�b•--�"'^ <br />,A. loSOl9n1A arnan CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />