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HCISYST-01 PATF
<br />oR0 CERTIFICATE OF LIABILITY INSURANCE DAT;I'M ^l.
<br />DIYYYY)
<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 5 .
<br />PRODUCER License If OM70471 H&AEACT Andrea Todd
<br />Orion Risk Management Insurance Services, An Alera Group Insurance PHONE _ 949 6 FAX
<br />Agency,LLC (AJC. No. Eee.I )_ OB-4924 (AC. No): Senn n. :I o..__, c..:._ aan EJAAIL n��-,Irlll...:---;_I, _ _
<br />INSURED
<br />MCI Systems, Inc.
<br />1354 South Parkside Place
<br />Ontario, CA 91761
<br />CflVFRangn r1GGT1CN`ATC: Mlikii
<br />_ NSURERtS)AFFORCINGCOVERAGE _ NAICe_
<br />INSURER A. Everest Indemnity Insurance Company _ 10851
<br />INSURER B Federal_ Insurance Company 20281
<br />.ENSURER c The Ohio Casualty Insurance Company _ ;24074_
<br />INSURER D
<br />INSURER E
<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
<br />PAID CLAIMS.
<br />INSF'---- -TYPE OF INSURANCE ADDLSUBRt INSD MOPOLICY NUNBER- POLICY ii
<br />LTR
<br />-- -- - LIMITS -
<br />POLICYEXP I
<br />A X I COMMERCIAL GENERAL LIABLL
<br />I EACH OCCURRENCE F
<br />1.000,006
<br />CLAIMS MADE X OCCUR X SIGLO14270191 312/2019
<br />=12020 I DAMAGEAET RENTED �)_
<br />100.000
<br />meimj t-
<br />5,000
<br />PERSONAL a_ADV INJURY
<br />1-000,000
<br />GENL AGGREGATE LIMIT APPLIES PER.
<br />GENERAL AGGREGATE
<br />2,000,000
<br />POLICY XX T LOC
<br />PRODULTS-C_ P DD_
<br />��— �----
<br />2,000,000
<br />X E15,000 Ded
<br />OTHER.
<br />B AUTOMOBILE LIABILITY
<br />�AM9BI EO RINGLE LIMB
<br />S
<br />1,0001000
<br />X ANYAUTO _ 54309497 3/212019
<br />3/212020
<br />ODDLY INJURY Pmper T)
<br />$
<br />AUUTOS ONLY _ 1 WNED AUUpTTON.pSSWWDN�NDII��
<br />INJURY (Por acckenl
<br />_
<br />X AUTOS ONLV X AUTOSONLV
<br />pODDLY
<br />F Per mttit AMNDE
<br />$
<br />-
<br />,,
<br />A UMBRELLA LIAR X OCCUR
<br />EACH OCCURRENCE
<br />j_
<br />10,000,000
<br />X EXCESS LIAR . I CLAIMS -MADE i51CC005185191 3/2/2019
<br />--__-
<br />31212020 r
<br />AGGREGATE__.
<br />10,000,000
<br />DED X RETENTIONS 10,000
<br />B AND EMPLOYERS UABILIITr
<br />�LATUTE mgµ
<br />t
<br />ANY PROPRIETOWPARTNER,EXECUTIVE YIN F14309496 312/2019
<br />oFFILEFUM1IeM R E%CLUOED° Y NIA
<br />312/2020
<br />I E.L. EACH ACCIDENT____
<br />f
<br />_
<br />1,000,000
<br />_
<br />ilENl -
<br />1,000,000
<br />i'ManaabbyIn
<br />S Yes,SCdbacr,b. upper
<br />E L DISEWE_EA EMPLOY
<br />_�
<br />_
<br />1,000,000
<br />DERIPTION OF OPERATIONS below
<br />E. L. DISEASE - POLICY LIMIT
<br />A 'Professional Liab SIGLO14270191 312/2019
<br />312/2020 Included in GL Limit
<br />C (Equipment Floater SM059609854 3/2812019
<br />312812020 IJobsite Limit !
<br />500,000
<br />DESCRIPTION OF OPERATIONS) LOCATIONS I VEHICLES AC ORD 101. Addlllonal Remarks Schedule, may be attached I1 more spat* is required)
<br />City of Santa Ana, officers, employees, agents, volunteers and representatives are Included as Additional
<br />Insured per the terms of the attached General
<br />Liability endorsements.
<br />Primary wording applies per the terms of the attached General Liability endorsement.
<br />30 Days' Notice of Cancellation; 10 Days' Notice for Non -Payment (non -reporting if applicable) apply per policy provisions.
<br />City of Santa Ana REV( ED & APPF
<br />Risk Management Division !aN
<br />ANAGEMENTI
<br />20 Civic Center Plaza, 4th Flo
<br />Santa Ana, CA 92701
<br />09 2020
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />MEXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />OROANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />ACORD 25 (2016103) v3AI�t GTHA M ©1919-2011 ACORD CORPORATION. All rights reserved.
<br />The AC name and f6OC �Ye9istered marks of ACORD
<br />
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