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Aco� Pf- CERTIFICATE OF LIABILITY INSURANCE <br />TE (MMI <br />DA16/20014 ) <br />1n6�2D14 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICAT�E DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. TjiIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANI : If the certificate holder is an ADDITIONAL INSURED, the policy(les) 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 iiolder in lieu of such endorsement(s). <br />PRODUCER <br />Hayward Tilton & Rolapp Insurance Associates, <br />CA Dept. OE Ins. Lic.. {'0614:365 <br />BBB S. Disneyland Dr., Ste 400 <br />Anaheim CA 92802-1846 <br />ONTAC Sue Reams <br />NAME; <br />RHONE xt: ('714)905-1923 AIC No:($19)905-1910 <br />ADDRE suer@htrinsure.com <br />INSURER(S) AFFORDING COVERAGE NAICM <br />INSURERA:Travelers Indemnity Company 5658 <br />INSURED <br />Mullen & Affisociates, Inc. <br />1200 N. � effersOn Street <br />Suite D ^^�9 {y <br />Anaheim , CA 92807 -"t?C� (/ <br />INSURER B:Preferred Eirl Ins CO 10900 <br />INSURERC:V S S ecialt Ins CO 9599 <br />INSURERD: <br />INSURER E: <br />INSURER F: <br />THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />THIS IS TO FERTIFY <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR 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 />EXCLUSION AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />CTR <br />TYPE OF INSURANCE <br />triflylilifurR <br />POLICYNUMBER <br />MMIDDIYVYY EFF <br />MMIDDIYYY <br />LIMITS <br />GENERAL(ABILITY <br />EACH OCCURRENCE $ 1,000,000 <br />PREMISES Ea occurrence $ 300,000 <br />X COM <br />ERCIAL GENERAL LIABILITY <br />MED EXP (Any one person) $ 5,000 <br />A <br />LAIMS-MADE®OCCUR <br />X <br />Y <br />5802DZ91163 <br />7/24/2013 <br />7/24/2014 <br />PERSONAL &ADV INJURY $ 1,000,000 <br />GENERAL AGGREGATE $ 2,000,000 <br />GEN'L AG <br />EGATE LIMIT APPLIES PER: <br />PRODUCTS - COMP/OP AGO $ 2,000,000 <br />$ <br />LE LIMIT <br />X POLABIYF <br />PRO LOC <br />Ea accNdEDtS <br />$ 1,000,000 <br />BODILYINJURY(Perper5on) $ <br />A <br />ANY <br />ALL 0 <br />UTO <br />NED SCHEDULED <br />802D291163 <br />7/24/2013 <br />7/29/2019 <br />BODILY IN JURY (Per accident) $ <br />POILIABILITY <br />AUTO <br />NON OWNED <br />PROPERTY DAMAGE $ <br />Perac e t <br />HIRE <br />AUTOS M AUTOS <br />$ <br />UMBRELLALIABOCCUR <br />EACH OCCURRENCE $ <br />AGGREGATE $ <br />EXCE <br />3LIA6 <br />CLAIMS -MADE <br />DED <br />RETENTION <br />WC STATU- OTN- <br />B <br />WORKERS <br />COMPENSATION <br />X <br />ELC-ACH ACCIDENT $ 1,000,000 <br />AND EMPL <br />YERS' LIABILITY YIN <br />ANY PRO <br />FRIETORIPATNERIEXECUTIVE <br />EL DISEASE - EA EMPLOYE $ 1,000,000 <br />OFFICER/A <br />MBER EXCLUDED? <br />NIA <br />KN 133295-8 <br />02/9/2019 <br />02/4/2015 <br />(Mandato <br />In NH) <br />E.L. DISEASE - POLICY LIMIT $ 11000,000 <br />If pas descr <br />DESCRIPTI <br />be under <br />N OF OPERATIONS below <br />C <br />Profis <br />ional Liability <br />USS1424571 <br />01/4/2014 <br />01/4/2015 <br />Each Claim Limit 1,000,000 <br />Errors <br />& Omissions <br />Retention : $15,000 <br />Aggregate 1,000,000 <br />DESCRI PTIO10OPERATION <br />S I LOCATIONS I VENICE ES (Attach AC ORD 101, Ad dltional Re mark c S ched ule, if more s pace is require d) <br />Included as Additional Insured as respects <br />City of S <br />nta Ana, its officers, agents & employees are <br />General LI <br />-ability is Primary and Non Contributory per Form CG D381 0907 attached. *CANCELLATION:10-days <br />Notice fo <br />Non -Payment of Premium/Non-Reporting of Payroll/30 days for all other reasons. <br />APPROVED AS TO FORM <br />i <br />I <br />(714) 0476956 Ld Ura Stair S9leedy __ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />ASatStant City Attorney THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Cit of Santa Ana <br />Public Works Agency AUTHORIZED REPRESENTATIVE <br />Att : Suzi Furjanic <br />20 Civic Center Plaza, 3r Flr, <br />Ross Annex <br />San a Ana, CA 92701 Sue Reams/S[ffi� <br />ACORD25( 010/05) Q 1988.2010 ACORD CORPORATION. All rights reserved <br />INs1175(9immI ni The am Rn nani...,Ilen. .'l i. rcirIIGf PeCA M.'1fUC of am Rn <br />