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ilk d CERTIFICATE OF LIABILITY INSURANCE <br />°" 2JI 019 ' <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 POLWES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERIS), AUTHORBED <br />REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER <br />IMPORTANT: It the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. It SUBROGATION IS WAIVED, subject to the <br />farms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsoment(s). <br />PRODUCER <br />C04TACT <br />NAMERedngO BanUeIOS__ _ _ _ <br />Dickerson Insurance Services, License Y.OM291 f2 <br />tt�ra.Tiao:.(323)450-2374—. <br />1918 Riverside Drive <br />E-NAIL <br />ADILRess. ROdn2cl@dhkersoWoup.fAtn_ — <br />Los Angeles CA 90039 <br />9 <br />r <br />MSUNER(5)AFFOROMGWVEMM _ NAIL/ <br />(323)662-7200 <br />_ <br />RERA: Philadelphia Indemnity Insurance Company 21044 <br />_ <br />INSURED <br />INSURER e: NEW York Marine and General InsuranceCompany16808 <br />Charitable Ventures of Orange County <br />1505 E. 17th Street Suite 101 <br />WSURERC: <br />— <br />Santa Ana, CA 92705 <br />INSURER n: <br />INSURERE: <br />_ <br />INSUROIF: <br />COVERAGES - CERTIFICATE NUMBER: REVISION 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 VMiICH 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 />R <br />TYPEMINSURANCE <br />POLICY NUMBER <br />Eff EIIP LWITS <br />GENERALl1ABNTY <br />%�: C7aNERCuI GEAi �nABllfiT <br />MADE_ DCCUR <br />� <br />1, <br />1' <br />EACH OCCURRENCE_ _ <br />��AGETD'REATm .. <br />- _PPEM4iESlEeamnarel <br />VIED ExP(AM Plnml <br />�I <br />5 1.00000_ <br />51.00.000 - <br />s5.000 <br />A <br />_�CTpALS <br />' X Improper Sexual Conduct <br />PHPK1990984 <br />07/151201907/152020 PERsoN aAov waxen <br />si.000.000 <br />s 2,000.000 <br />GEHERALAGGREGATE <br />GUMAWREGATELIMRAPPIJESPER <br />i 2.000.000 <br />PRODUCTS -COMPIOPAGG <br />5 <br />X FOt)CY <br />Pm LOG <br />pU10Y00"LlABNTY <br />�y <br />(E41I Y <br />BODILY INJURY (Pcpersan) <br />oLY I1 <br />5 <br />ANY AUTO <br />BONLYINJURYIPe MkIi it <br />s <br />A <br />X ALL OARED M SCHEDULED <br />X IERED Avice ALPTM <br />WOS <br />PHPK1990984 <br />07/152019 <br />07/152020 <br />R`?UiEGeY� <br />S <br />S <br />X <br />UYBNE11J1LNB <br />X <br />OCCUR <br />�. <br />EACH OLLUiRENCE <br />$4000000 <br />AGGREGATE <br />a4,000,000 <br />A <br />Excess LIAe <br />CWMBMME <br />1 <br />I PHUSS78897 <br />07/152019 <br />07tlW020 <br />ceb I I NETENTIoes in ON <br />is <br />S <br />WORKERS COMPENSATION <br />AND EMPLOYERS IIABRJTY <br />ANY vaoPRIETORm ERIEUEnmVIE Y� <br />OFFILEMEMBEft IDCLUDEO! N <br />(Men4aroryln NH) <br />Nlp <br />r <br />I <br />WC2019OW19924 <br />97/152919 <br />07/152020 <br />X V.CYiJMM TATII gR <br />EL EACN ACCIDENT <br />s <br />EL. DISEASE-EAEL@I.OlE <br />S i 000.000 <br />EL. DISEASE -PIXICY UNIT <br />16 1,000.000 <br />Ilyee. Gower uMer <br />r <br />f <br />I''� <br />I <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(AU.h ACORO let, AGGIMenal R..a"&hWule, It moreapace 1.,e 1U ) <br />RE: SAAS Safely Outreach Contract <br />City of Santa Ana. its officers. employees. agents and representatives are named as Additional Insureds. on a primary and non-contributory basis, as respects to <br />the above mentioned General Liability and Automobile Liability coverages as required by written contract, subject to policy terms and conditions. Workers' <br />Compensation is evidence of insurance only. <br />CPRTIP1cATP Hnt nFR CANCELLATION <br />City of Santa Ana <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />Risk Management Division, 41h Floor <br />20 Civic Center Plaza <br />REVIE <br />Santa Ana, CA 92702 y Risk <br />D & APPR <br />NAGEMENT D <br />ACCORDANCE VAT" THE POLICY PROVISIONS. <br />Q <br />A TEED REPRESENTATIVE <br />ISION <br />/ <br />Rodrigo Banuelos <br />L� 15 ©1988-20i0Y1COf�D CORPORATION. All rights reserved. <br />ACORD 25 (2070/OS) h a and logo are registered marks of ACORD <br />SAMA A M. LAMBERT <br />