EMPLOYEE GROUP INSURANCE RENEWALS (REACH) -2010

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CERTIFICATE OF LIABILITY INSURANCE /4 E(MWDD/YYYY) 3 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT- If the certificate holder Is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. H SUBROGATION IS WAIVED, Subject to the terns and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER ACT NAME: Van Wagner Agency pE FAX PO Sox 9017 NC No Ein : - 35-1 58 8 A/C No : 8 8 8 - Woodbury NY 11797 ADDRESS: RO C ER ID :REACH-3 INSURER(S) AFFORDING COVERAGE NAIC 0 INSURED INSURER A: Ace American Ins. Co. 22667 Reach Employee Assistance, Inc 650 North Rose Drive #350 INSURER B: Placentia CA 92870 INSURERC: INSURER D : INSURER E: NS URER F : THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTTRR TYPE OF INSURANCE POLICY NUMBER mw Dl ? POLICY EXP LIMITS A GENERALLIABILITf ARM 149446 2/17/2011 2/17/2012 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABI.ITY DAMAGE TO NIHMTEaaxt §100,000 CLAIMS-MADE F. OCCUR MEDEXP(An one eon) $2,000 PERSONAL& ADV INJURY $1,000,000 GENERALAGGREGATE $3,000,000 GENL AGGREGATE UNIT APPLES PER PRODUCTS - COW/1OP AGG $1,000,000 PjRQ- POLICY LOC $ AUT OMOBILE LIABILITY COMBINED SINGLE LIMB ANY AUTO (Eaacckko) _ § ALL OWNED AUTOS BODILY INJURY (Per person) $ BODILY INJURY (Per amitlgnl) $ SCHEDULEDAUTOS D HIR PROPERTY DAMAGE $ AUTOS E (Pet ambem) NON-OWNED AUTOS $ S UIYMRELLALIAB H OCCUR EACHOCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE RETENTKNJ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N _ TORY LIMITS ER ANY PROPRIETORIPARTNrPJEXECUrtVE OFFICERIMEMBEREXCLUDED? F-] N/A E.L. EACH ACCIDENT $ (Mandatory M NH) If Yes dMaibe urdw E.L. DISEASE - EA EMPLOYEE $ DESCRIPTION OF OPERATIONS bobw - E.L- DISEASE - POUCY LI T$ A Professional Liability r ri AEA1 149446 2/17/2011 2/17/2012 Each Occurrence $1,000,000 - I Aggregate $3,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (Attach ACORD 101, Addilioml Remarks Schedule, if more apace is required) The City of Santa Ana, Its Officers, Agents and Employees are included as additional insureds as respects to the contract between Reach Employee Assistance, Inc. and The City of Santa Ana for services provided by the Insured. ectxrIcIrIATe Nf%l nee City of Santa Ana Attention Kathleen Crook, Human Resources 20 Civic Center Plaza, M-39 Santa Ana CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORRED REPRESENTATIVE F () 18-2009 ACORD CORPORATION. All rights Aa ?cw>r,varl I he AwKV name and b are registered marks of ACORD A .-, .?llC?.dy