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Client #: 1514175
<br />A- (`p -C7
<br />306ALLCITYM
<br />ACORD.. CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MMIDDIYYYY)
<br />TYPE OF INSURANCE
<br />02/05/2014
<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(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms 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 endorsement(s).
<br />PRODUCER
<br />NAME, Nysa Gallegos
<br />BB &T- Knight Insurance Services
<br />PHONE 818 662.4234 FAX 877 - 297.9262
<br />E MAR Ext: FAX No
<br />535 N. Brand Blvd. 10th Floor
<br />ADDRESS: NGallegos @bbandt.com
<br />Glendale, CA 91203
<br />E
<br />PREMISES Ea occurrence
<br />$50,000
<br />618 662 -4200
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC $
<br />INSURERA: Liberty Surplus Insurance Corp
<br />10725
<br />INSURED
<br />INSURERS: Aspen Specialty Insurance Co.
<br />10717
<br />All City Management Services Inc
<br />INSURER C: Admiral Insurance Company
<br />24856
<br />10440 Pioneer Blvd # 5
<br />INSURER D: Nationwide Mutual Insurance Corn
<br />23787
<br />Santa Fe Springs, CA 90670
<br />X
<br />ACP7815954504
<br />INSURER E
<br />12121/201
<br />INSURER F:
<br />$1,606,606
<br />BODILY INJURY (P., person)
<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 CONTRACTOR 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 PAID CLAIMS.
<br />LTRR
<br />TYPE OF INSURANCE
<br />NSRL
<br />MD
<br />POLICY NUMBER
<br />POLICY INYYY
<br />MMIDDNYYY
<br />LIMITS
<br />A
<br />GENERAL LIABILITY
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE ® OCCUR
<br />X
<br />X
<br />100000384003
<br />04/01/2013
<br />04/011201
<br />EACH OCCURRENCE
<br />$1,000,000
<br />E
<br />PREMISES Ea occurrence
<br />$50,000
<br />MED EXP(Any one person)
<br />$5,000
<br />PERSONAL &ADV INJURY
<br />$1,000,000
<br />GENERAL AGGREGATE
<br />$2,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICY X PERT LOC
<br />PRODUCTS - COMP /CP AGO
<br />$2,000,000
<br />$
<br />D
<br />AUTOMOBILE
<br />X
<br />X
<br />LIABILITY
<br />ANY AUTO
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />HIRED AUTOS X NON -OWNED
<br />AUTOS
<br />X
<br />ACP7815954504
<br />12/2112013
<br />12121/201
<br />COMBINED SINGLE LIMIT
<br />Ea accident)
<br />$1,606,606
<br />BODILY INJURY (P., person)
<br />$
<br />iBODILY INJURY (Per accitlent)
<br />$
<br />PROPERTY DAMAGE
<br />Peraccidenf_
<br />$
<br />B
<br />XUMBRELLA
<br />LIAB
<br />EXCESS LIAB
<br />X
<br />OCCUR
<br />CLAIMS -MADE
<br />CXAC75813
<br />04/01/201304/01
<br />/201
<br />EACH OCCURRENCE
<br />$8000000
<br />AGGREGATE
<br />DED X RETENTION 5O
<br />__$8,000,000
<br />$
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETORIPARTNERIEXECUTIVE YIN
<br />OFFICER /MEMBER EXCLUDED?
<br />(Mandatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />NIA
<br />Not Applicable
<br />WC S1 OTH-
<br />TORY
<br />E.L. EACH ACCIDENT
<br />$
<br />E.L. DISEASE - EA EMPLOYEE
<br />$
<br />E.L. DISEASE - POLICY LIMIT
<br />$
<br />C
<br />2nd Layer
<br />EXCESS LIABILITY
<br />EX46310512
<br />01130/2014
<br />04/01/201
<br />Each OCC: $1,000,000
<br />Aggregate: $1,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
<br />Certificate Holder Completed to Read; City of Santa Ana, it's officers, employees, agents, volunteers and
<br />respresentatives. As respects General Liability and required by written contract; Certificate Holder is
<br />named as additional insured. Insurance is Primary & Non - Contributory. Waiver of Subrogation applicable.
<br />City f Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />20 Civic Center Plaza, M29 ACCORDANCE WITH THE POLICY PROVISIONS,
<br />Santa Ana, CA 92702
<br />AS TO Y u.a F.• AUTHORIZED REPRESENTATIVE
<br />- °•°•-°- d' pp pp,�, @ 1988.2010 ACORD CORPORATION, All rights reserved.
<br />ACORD 25 (2010105) 1 of 1 a ACORO'W44 r d logo are registered marks of ACORD
<br />#S118246361M11824,43fidstant City Attorney NNGON
<br />
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