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)19 <br />DATE(MMIDD)YYYY) <br />AFRO® CERTIFICATE OF LIABILITY INSURANCE 712 712 01 5 <br />THIS CERTIFICATE IS ISSU ION ONL 13ON 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 endomement(s). OIT <br />PRODUCER NAMEp __ Risk StrateOlBS Compan .- <br />Risk Strategies Company paoNe FAX <br />7040 Main [reet. Suite 450 sag- za2 -s2ao II Not; _ <br />CA DOI License No. OF06675 <br />INSURED <br />Phase II Systems <br />dba: PARS <br />4350 Von Karmen Ave. Ste 100 <br />Newport Beach CA 92660 <br />.,rClna/ .II IRAQ=R. <br />NAIC % <br />COVERAGES utzmi riamic nlunluc =r- col, lv» <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED <br />- - -- <br />ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />BY PAID CLAIMS__ <br />INS9T <br />LTR <br />TYPE OF INSURANCE <br />ADOL <br />SUER <br />POLICY NUMBER <br />POLICY EFF <br />MMIDDIVYYY <br />5/812015 <br />POLICY E <br />MMIOD/YY9Y <br />518/2016 <br />LIMITS <br />EACH OCCURRENCE $ $2,00_0,000 <br />A I <br />COMMERCIAL GENERALLIABILITY ✓ 172SBAAC2429 <br />CLAIMS -MADE OCCUR <br />�J - -- <br />DAMAG�RENTED ­T - <br />PREMISES IS. occunence) 5 $1:000,000 <br />MED EXP (Any one Person)) $ $10,000 <br />PERSONAL &AOV INJURY $ $2,000,000 <br />GENERAL AGGREGATE <br />$4,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER <br />POLICY. ✓ PRO LOC <br />JECT <br />PRODUCTS- COMPIOP AGG <br />F:5 $4,000,000 <br />A <br />I OTHER. <br />AUTOMOBILE LIABILITY <br />,BODILY <br />ANY AUTO <br />_ AUTOS OWNED SCHEDULED <br />AUTOS <br />NON -OWNED <br />✓.� HIREDAUTOS ✓ AUTOS ! <br />72SBAAC2429 <br />5/8/2015 <br />/ <br />5/812016 <br />COMBINED SINGLE LIMIT <br />Ea_eccident _._ _ <br />$ _ $2000000 <br />INJURY (Per person) <br />BODILY INJURY (Peraccidenp <br />- <br />PROPERTY DAMAGE <br />Per accidantL_ <br />$ <br />S <br />- - <br />S <br />UMBRELLA LIAR <br />OCCUR <br />O <br />EACH OCCURRENCE <br />$ <br />EXCESS LIAR <br />CIAIMS-_MADE <br />✓ <br />AGGREGATE <br />$ <br />pER OTH- <br />STATUTE ER <br />_ <br />$ <br />/� <br />_ <br />DED RETENTION $ <br />REPS CO A <br />_ <br />E.L. EACH ACCIDENT <br />�$ <br />AND RS' LI ILIT <br />AND EMPLOYERS' LIABILITY YIN: <br />ANY PROPRIETORIPARTNER)E%ECUTIVE <br />XV <br />E. L. DISEASE -EA EMPLOYEE <br />8 <br />OFFICER/MEMBER E %GLUDED4 <br />(Mandatory In NH) <br />NIAI <br />- <br />B <br />fyesdescribaunder <br />DESCRIPTION CF OPERATIONS below <br />Professional Liability <br />LDUSA1504508 <br />7130/2015 <br />7/30/2016 <br />E.L. DISEASE - POLICY LIMIT 8 <br />Per Claim: $2,000,000 <br />Aggregate: $2,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be Hach ad If coons space Is required) <br />Projects as on file with the insured including but not limited to those usual to the insured's operationsIPARS Supplementary Retirement Plan. <br />The City of Santa Ana, its officials, employees and volunteers are named as additional insureds on the general liability policy -see attached <br />endorsement. <br />CERTIFICATE HOLUtR <br />— <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />City of Santa Ana <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />Attn: Executive Director of Personnel Services <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 Civic Center Plaza <br />AUTHORRED REPRESENTATIVE <br />Santa Ana CA 92701 <br />i <br />Michael Christian <br />a rnon rnoonCe TlnN All rinhfc reenrved. <br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD <br />2512'/1 C9 15 -16 CA GL- HNOA -PL Sherry Yowg 1 'x/21/2015 9:91:00 AM 1PDV I Pace 1 of 12 <br />