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16. � CERTIFICATE OF LIABILITY INSURANCE DATE,NMIDDIYYYY, <br />2/5/2020 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS <br />UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED TE <br />BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURE <br />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 <br />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 <br />on <br />this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). <br />PRODUCER <br />Arthur J. Gallagher & Co. <br />NAMEACT MBUreen M9M0 McDonald <br />Insurance Brokers of CA., Inc. <br />PHONE <br />818.539.8625 FAc No:818.539.8725 <br />505 N Brand Blvd, Suite 600 <br />Glendale CA 91203 <br />noolie s: maureen MCdonald@ajg.com <br />INSURERS AFFORDINGCOVERAGE <br />NAICp <br />INSURER A: Berkley National Insurance Company38911 <br />L 0726293 <br />INSURED INTEHOU43 <br />Interval House <br />INSURERS: New York Marine And General Insurance Company <br />16608 <br />INSURER C <br />P.O. Box 3356 <br />Seal Beach, CA 90740 <br />INSURER <br />INSURER E : <br />NSURER F: <br />C(1VFR4GFS rvormrn nmr � <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED <br />KCvIbILIN NUMBER: <br />NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED <br />WITH RESPECT TO WHICH THIS <br />EXCLUSIONS AND CONDrrIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />HEREIN IS SUBJECT TO ALL THE TERMS, <br />INSR -AUYL UBR <br />LTR TYPE OF INSURANCE INSD MO POLICYNUMBER PMIDDI FF POLICYEXP <br />/ODIYYYY MMIODI'rYY <br />LIMITS <br />A X COMMERCIAL GENERAL LIABILITY Y HHS8525626-13 10/112019 10/1/2020 <br />CLAIMS-MADEff] OCCUR <br />EACHOCCOE$1,000,000 <br />AE_ <br />PREMISES Ed occurrence)8500=0 <br />MED EXP Any one arson) $10000 <br />PERSONAL&ADV INJURY $1.000.000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />X POLICY ❑ PRO- El LOC <br />GENERA -AGGREGATE $3.000,000 <br />PRODUCTS-COMP/OP AGG $3,000,000 <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />LIMIT <br />"— <br />ANY <br />Ee awl deeDt51NGLE <br />$ <br />BODILY INJURY (Per person) <br />$ <br />WNED <br />OWNED SCHEDULED <br />BODILY INJURY (Per acciden0 <br />$ <br />AUTOS ONLY AUTOS <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />PROPERTYDAMAGE <br />Per accident <br />$ <br />A <br />UMSRELLALIAB <br />X <br />OCCUR <br />HHN8585444-10 <br />10/l/2019 <br />10/1/2020 <br />X <br />EXCESS DAR <br />EACH OCCURRENCE <br />82,000,000 <br />AGGREGATE <br />$2,000,000 <br />CLAIMS -MADE <br />X <br />Sa Misconduct <br />$Included <br />OEO RETEITHON$ <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />Y <br />WC202000005078 <br />21V2020 <br />2/1/2021 <br />PI <br />X OTH <br />ANYPROPRIETOR/PARTNEWEXECUTIVE YIN <br />STATUTE ER <br />OFFICER/MEMBEREXCLUDED? <br />NIA <br />E.L. EACH ACCIDENT <br />$1.000,000 <br />(Mandatory In NH) <br />yes, describe antler <br />E.L. EA EMPLOYEE <br />$1 000,000 <br />oESCRIPTION OF OPERATIONS bel. <br />E.L. DISEASE -POLICY LIMIT <br />$1.000,000 <br />A <br />Commercial Propetly <br />HHS8525626-13 <br />10/1/2019 <br />10/1/2020 <br />BLKT Building Limit <br />$5.231,005 <br />SLKT BPP Limit <br />$872.540 <br />Deductible <br />$1,000 <br />DESCRIPTION OF OPERATIONS [LOCATIONS I VEHICLES (ACORD 101, AdtliOanal Remarks Schedule, may be attached N more space b r „M1 <br />Policy: Crime Coverage <br />Policy Term: 10/0112019 to 1DIVISION <br />0/0112020 B <br />Y <br />RISk MANAGEMENT <br />Policy #: UCi 1717955.19-038 <br />Carrier: Underwriters at Lloyd's, London <br />p <br />Employee theft: Limit:$3,000,000 / Deductible: $25,000 <br />al IJ� <br />ERISA: Limit:$3,000,000 <br />Theft of money and securities: Limit:$3,000,000 / Deductible: $25,000 <br />Money and Securities: Limit:$3,000,000 / Deductible: $25,000 <br />See Attached... <br />CFRTIFICATF Uni nCR <br />City of Santa Ana <br />Attn: Risk Management Division <br />20 Civic Center Plaza, 4th Floor <br />Santa Ana, CA 92701 <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 />©1988-2015 ACORD CORPORATION. All riahts reserved. <br />-- •-•--/ 1 11w Ml VKu name ana logo are reglstered marks of ACORD <br />