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�® CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MMIDDNYYY)
<br />06128/2019
<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 />If SUBROGATION IS WAIVED, subject to the terms and conditions of the
<br />this certificate does not confer rights to the certificate holder in (feu of suc
<br />Marsh Risk & Insurance Services
<br />17901 Von Karmen Avenue, Suite 1100
<br />(949) 399-5800; License 00437153
<br />Irvine, CA 92614
<br />Attn: NewpodBeach.CedRequest@marshcom/F: 212-948.4323
<br />CN 115158923-01-01-19.20
<br />INSURED
<br />PlaceWorks, Inc
<br />Doe. The Planning Center
<br />Design Community & Enviomment
<br />3 MacArthur Place, Suite 1100
<br />Santa Ana, CA 92707
<br />must nave muu1I IUnIHL nYoummu provisions or Be endorsed.
<br />certain policies may require an endorsement. A statement on
<br />COVERAGES CERTIFICATE NUMBER IOR-0ro212n46.21 DPlncanM MnnnamD• o
<br />44520
<br />25674 - - --
<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 />EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR
<br />LTR
<br />TYPEOFINSURANCE
<br />ADDL
<br />SUBR
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM/00
<br />POLICY EXP-'--
<br />MOLM21 YYY I
<br />LIMITS
<br />A
<br />X COMMERCIAL GENERAL LIABILITY
<br />!� CLAIMS -MADE 1E OCCUR
<br />X
<br />X
<br />EPK127413
<br />0710112019
<br />07N1/2020
<br />EACHOCCURRENCE
<br />Is 5,000,000
<br />DAMAGE TO RENTED
<br />PREMISES Ea accunence
<br />S 50,000
<br />X 81 & PD Ded, $5.000
<br />�d--___...
<br />_ _
<br />MED EXP (Any one person)
<br />_
<br />S 5,000
<br />PERSONAL& AOVINJURY
<br />S 5,ODO,000
<br />PER'
<br />GENL AGGREGATELIMB'.
<br />_ APPLIES
<br />r X_POLICY J PR T LOC
<br />GENERALAOGREGATE
<br />5 5,000,000
<br />PRODUCTS-COMP/OP AGO
<br />5 5,000,000
<br />OTHER
<br />i
<br />Contactors Pollution
<br />S 5,000,000
<br />B AUTOMOBILE LIABILITY
<br />_1. ANY AUTO
<br />X
<br />X
<br />!
<br />X
<br />BA1N9640fiA19CAG
<br />0710112019
<br />07/01/2020
<br />COMBINED SINGLE LIMIT S 1,000,000
<br />Ea accident
<br />BODILY INJURY (Per person) ,5
<br />i OWNSAUTOONLY SCHEDULED
<br />OWNED SCHEDULED
<br />AUTOS
<br />-- �
<br />BODILY INJURY (Peraccident) S
<br />. HIRED - NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />PROPERTY DAMAGE g
<br />Peraccidomi
<br />CanplColl Deductibles 5 1.000
<br />UMBRELLA UAS
<br />X�EXCESS LIAB
<br />X OCCUR
<br />CLAIMS -MADE
<br />EX6J3287561943
<br />0710112019 0710112020
<br />EACH OCCURRENCE
<br />5 4,000,000
<br />5 _ 4,000,000
<br />S
<br />AGGREGATE
<br />LIED RETENTIONS
<br />B
<br />WORKERS COMPENSATION
<br />ANDEMPLOYERS'LIABILITY YIN
<br />ANYPROPRIETORIPARTNEWEXECUTIVE
<br />OPFICERIMEMBEREXCLUDEOi N�
<br />(Mandatory In NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />NIA
<br />UB7K7286761943G
<br />1 1 07/01/2020
<br />1
<br />X PER D7H-
<br />STATUTE ER__
<br />E.L. EACH ACCIDENT
<br />is 1,000,000
<br />E.L. DISEASE -EA EMPLOYEd
<br />5 1,000,000
<br />E.L. DISEASE -POLICY LIMIT
<br />I 5 1,000,000
<br />A
<br />Errors & Omissions -Claims Made
<br />EPK127413
<br />0710112019
<br />07101/2020
<br />Each ClaiMAggregate
<br />5,000,000
<br />Rehm Dates: See 2nd Page
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD101,Addlllonal RemarksSchedule,maybeaUaehodifmoraapece lerequlred)
<br />Re: Operations performed by the named insured for the certificate holder
<br />City of Santa Ana, its officers, agents, employees, and volunteers are induced as additional insured where required by written contract with respect to General and Auto Liability. This insurence is primary and non-
<br />contributory war any existing insurance and limited to liability arising out of the operations of the named insured and where required by written contact with respect to General Liability. Waiver of subrogation is
<br />applicable where required by wriaen contract with respect to General and Auto Liability.
<br />CERTIFICATE HOLDER ULVIEWEU & APPROVED CANCELLATION
<br />Cityof Santa Ana
<br />Risk Management Division
<br />20 Civic Center Plaza, 41h Floor
<br />Y IS MANAGEMENTDIVISION
<br />0 2019
<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 />Santa Ana, CA 92701
<br />•r
<br />&
<br />FRANCINER.VIL REAL
<br />AUTHORIZED REPRESENTATIVE
<br />of Marsh Risk &InsumnceService.
<br />Rosslynda Martinez B"sa s6 o L,a4�%J�ffi01��
<br />@ 1988.2016 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />
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