|
CERTIFICATE OF LIABILITY INSURANCE
<br />oarE(MMmprrvvl
<br />1omBrzols
<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 ATE
<br />THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURE
<br />RBY (S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must heve 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
<br />on
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsemenus).
<br />PRODUCER
<br />Marsh Risk & Insurance Services
<br />NAME: Cr
<br />17901 Von Karmen Avenue, Suite 7100
<br />PNONE -- -
<br />Ems` iwd N '
<br />(949) 399-5800; License #0437153
<br />E-MA"
<br />ADDRRESS:
<br />Irvine, CA 92614
<br />INSURERIS AFFORDa1GCOVERAGE
<br />NAIC#
<br />CN70245272&STNDGAUWP-13
<br />22357
<br />INSURED
<br />INsuRRp:Hallord Acdden!&Indemnil Co.
<br />Overland, Pacific & Culler, LLC
<br />INSURER B : Hartford Casually Insurance Company
<br />29424
<br />3750 Schaukle Avenue
<br />Suite 150
<br />INSURER c: Sea Additional —9
<br />l Nis
<br />— -
<br />-
<br />INSURER D: OBE Insurance Corporation
<br />392V
<br />LongBeach,CA 90808
<br />INSURER E:
<br />INSURER F:
<br />COVERACFR r•co,•rnnarc.
<br />THIS
<br />INDICATED.
<br />CERTIFICATE
<br />EXCLUSIONS
<br />NSR
<br />LTR
<br />A
<br />1S TO CERTIFY THAT THE POLICIES
<br />NOTWITHSTANDING ANY REQUIREMENT,
<br />MAY BE ISSUED OR MAY
<br />AND CONDITIONS OF SUCH
<br />TYPEOFINSURANCE
<br />X COMMERCIALGENERALUABILJTY
<br />CLAIMS -MADE M OCCUR
<br />OF INSURANCE
<br />PERTAIN,
<br />POLICIES.
<br />I
<br />X
<br />B
<br />LISTED BELOW HAVE BEEN ISSUED TO
<br />TERM OR CONDITION OF ANY CONTRACT
<br />THE INSURANCE AFFORDED BY THE POLICIES
<br />LIMITS SHOWN MAY HAVE BEEN REDUCED BY
<br />PODCYNUMBER MMIOCOYIYYYY
<br />IODUNHF0064 0911012019
<br />THE INSURED
<br />OR OTHER
<br />DESCRIBED
<br />PAID CLAIMS.
<br />aNW YE%P
<br />OB/1012020
<br />KCVIAIUN NUMBER:
<br />NAMED ABOVE FOR THE
<br />DOCUMENT WITH RESPECT
<br />HEREIN IS SUBJECT TO
<br />LINERS
<br />EACH OCCURRENCE
<br />POLICY PERIOD
<br />TO WHICH THIS
<br />ALL THE TERMS,
<br />$ 1,000,000
<br />PREMISES Ee ecanrr--
<br />_
<br />$ i30A00
<br />MEDEXP(Anyone epos)
<br />$ 10,000
<br />_ PERSONAL &ADV INJURY
<br />$ 1,000,000
<br />A
<br />1000NHF0064 OBI70f2019
<br />OB1i112020
<br />GEML
<br />AUTOMOBILEDABILm
<br />AGGREGATE DMITAPPDES PER:
<br />M PRO.
<br />POLICY I ACT 0 LOC
<br />OTHER:
<br />ANY AUTO
<br />GENERALAGGREGATE
<br />$ 2,000,000
<br />PRODUCTS -COMP/OP AGO
<br />Is 2,000,OW
<br />Ee �d.ut31 LE OMIT
<br />$
<br />$ 1,000,DOD
<br />BODILY INJURY(Perpareon)
<br />$
<br />X
<br />X
<br />OWNEX
<br />AUTOS SCHEDULED
<br />AUTOS ONLY AUTOS
<br />HIRED X AUTOSNO�OONLY
<br />AUTOS ONLY OLL$1000
<br />CAMP $1000 X COLL $1000
<br />BODILY INJURY (Per ecdaen0
<br />_
<br />$
<br />Par accideaft BE
<br />$ —
<br />$
<br />$ 2,OM,000
<br />X
<br />UMBRELLA LIA X accuR
<br />EXCESS LIAR CLAIMS -MADE
<br />tORHUJA8919 00/10019
<br />ON1012020
<br />BE O X ftETENTIQN$10000
<br />AGGROCCURRENCE
<br />AGGREGATE
<br />-
<br />E 2,000,000
<br />X STATUTE ERA
<br />$
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITYANYPRYIN
<br />OF CEORMIEMB REXCLUDEW�CUTIVE
<br />(Mandatary In NH)
<br />NIA
<br />10WEAS991
<br />OB/10 prep
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L DISEASE -EA EMPLOYE
<br />-
<br />$ 1,000,000
<br />D
<br />Iryes,dazvlbeunder
<br />DESCRIPTK)N OF OPERATIONS hebw
<br />Professional Liability
<br />100003244 081102019
<br />08/102020
<br />E.L DISEASE -POLICY UNITE
<br />Each Clan l Aggregate
<br />1,OW,000
<br />2,000,000
<br />Dadn"Ne
<br />50000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS IWHICLES IACORD 101, Addillmal Remark, Sclmdule, maybe attached nmore sPece is required)
<br />City of Santa Ana, its officers, employees, agents, volunteers and representatives are included as additional insured where required by written correct with respect to General Liability. This insurance is primary and
<br />mnconlnhut0y over any existing insurance and limited In liability edging out of the operations of the named insured subject to policy terms and conditions win respect to General Liability. Ermrs & Omissions
<br />Insurance Company will not provide 30 Day Notice of Cancellation to anyone, except the First Named Insured. Notice of Cancellation applies as per he allached endorsements
<br />�EVIEM & APPROVED
<br />_CERTIFICATE HOLDER MENT I Infictea...... __._..
<br />CityofSanta Ana laL
<br />A 20f9
<br />Risk Management, 4th Floor Y SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />20 Civic Center Plaza THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />Santa Ana, CA 92702 ACCORDANCE WITH THE POLICY PROVISIONS.
<br />S MANT A M. EAMBE UTHOR 2ED PRESENTA RENE
<br />of Marsh Risk 8lnsurance Services
<br />Manashi Mukhedee
<br />ernan ou Pone GIn9L
<br />""" „aa,w a„u rugs ere regrsrerea manes of ACORD
<br />
|