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CLEAR-1 <br />acoRO CERTIFICATE OF LIABILITY INSURANCE <br />12/13/201 oA9rl <br />12/13/9 <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 endorsemen s . <br />PRODUCER 831337.4661 <br />Clarion Pacific Insurance <br />2036 N.. Pacific Ave. <br />Santa Cruz, CA 95060 Ryan Deane <br />Acr Coryn Gardiner <br />PHONE 831337-4661 FAX 831-6124810 <br />Alc, No. Ert : AIO, No): <br />Oryn paC-r 8 6COm <br />INSURE 8 AFFORDING COVERAGE <br />NAN:S <br />INSURER A: Philadelphia Indemnity <br />18068 <br />euR D <br />Teff ease Financial Consulting <br />erI <br />Apttoos CTS50003ste: B363 <br />INSURER .,Travelers Property Casualty Co <br />25674 <br />INSURER C: Nationwide Mutual Insurance Co <br />23787 <br />INSURER D: <br />INSURER E: <br />INSURER P: <br />COVERAGES CERTIFICATE NUMBER, R SION ER' <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 />seat Im <br />TYPEOFINSURANCE <br />1.%D�L <br />BR <br />pOUCY NUY89I <br />POLICY EFF <br />POLICY EXP <br />UNITS <br />C <br />X <br />I COMMBNCNL GENERAL LIABILITY <br />W CMBNADE [K OCCUR <br />X <br />ACP 3019102473 <br />12109/2019 <br />17JO912020 <br />EACH OCCURRENCE <br />s 2,000,000 <br />iORENrED <br />300'� <br />NED EXP om <br />S 5,000 <br />PERsowILaADVIIAIURY <br />a 2,000,000 <br />G LAGGREGATE UNIT SPER <br />X POLICY El � Loc <br />GENERAL AGGREGATE <br />S 4,000,000 <br />S - COAUPYOP AGO <br />S 4,0013,1) <br />IS <br />OTHER <br />C <br />AUTOMOBILE <br />LLABILRY <br />COMaNEp SINGLE UNIT <br />2�g0g 000 <br />IxANY <br />AUTO <br />n°gv�r�p ONLY Nwpr�er ED <br />AUTOS ONLY X AUfO3GtLY <br />X <br />rP 3019102473 <br />12/09/2019 <br />12/09/2020 <br />BoDILYIN.JURY(Plylysimirl <br />s <br />BpODLEYRIrMURY P« <br />s <br />PROP= <br />$ <br />UMBRELLA WB <br />OCCUi <br />EACH OCCURRENCE <br />S <br />AGGREGATE <br />EXCESS LNa <br />CWMB-MAOE <br />OED RETENTIONS <br />S <br />B <br />WoRyusyrs; unAelu'�'ir <br />AY PROPRIETF(ECUnVE <br />pPiniNM), EXCLUDED? <br />II W,darcW u, ddar <br />]PTIONOFOPERATIONSDal. <br />IA <br />UAM759710-20-42 <br />01/01/2020 <br />01/01/2021 <br />X PERTUREE TA I oTw <br />LEPGH ACCIDENT <br />1,000,00 0 <br />ELDISEASE-EAEMPLOY <br />S 1,000,000 <br />ILL 01SEASE -POLICY UNIT <br />5 11000,000 <br />A <br />Liab <br />12/09/2019 <br />12109/2020 <br />Occurence <br />2,000,000 <br />Folfesslonal <br />�PHSD`1492108 <br />Aggregate <br />2,000,000 <br />DESCRIPTION Of OPERATIONS I LOCATIONS I VEHICLES (ACORD lel, AddWonal RomaM aPftadWs. may M aSadwi N mom •pam is mquimdl <br />RE: Citywide Indirect Cost Allocation Plan and Internal Service Funds Cost <br />Allocation Methodology. City. of Santa Ana, its officers, employees, agents, <br />and representatives are Additional Insureds with respectto General <br />Liability and Auto Liability per the attached endorsements or as required by <br />written contract Insurance is Primary and Non -Contributory. 30 day notice" <br />City of Santa Ana <br />Risk Management Division, <br />4th Floor <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 <br />0 <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 />ACORD 25 (2016103) 01988-2015 ACORD CORPORATION. All rights reserved. <br />The AIna nn istered marks of ACORD <br />M. LAMBERT <br />