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,acoRO® CERTIFICATE OF LIABILITY INSURANCE
<br />III
<br />/ATE
<br />DarE(MmmDlYvvv)
<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(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 holder in lieu of such endorsement(s).
<br />PRODUCER
<br />Anixter & Oser, Inc.
<br />License OE28888
<br />205 San Marin Drive
<br />Novato CA 94945-1227
<br />CONTACT
<br />NAME: Vanessa Weidauer / Barbara Hernandez
<br />PHONE (415)898-1600 FAX Net.(415)898-3922
<br />MAIL .vanessa@pr operlyinsured.com
<br />INSURERS) AFFORDING COVERAGE
<br />NAIC#
<br />INSURER A:Travelers Prop Cas Ins Cc
<br />36161
<br />INSURED
<br />Granicus, Inc.INSURER
<br />nn
<br />600 Harrison St. #120 1"\'"otn)3" t
<br />San Francisco CA 94107
<br />INSURER B Travelers Ind Cc of CT
<br />25682
<br />C'Zvans ton Insurance Company
<br />INSURER D:
<br />INSURER E:
<br />A
<br />INSURER
<br />X
<br />COVERAGES CERTIFICATE NUMBER:CL351510613 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 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 />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
<br />ILTR
<br />TYPE OF INSURANCE
<br />lull
<br />am
<br />POLICY NUMBER
<br />POLICY EFF
<br />MMIDDIYYYY
<br />LIMITS
<br />AUTHORIZED REPRESENTATIVE
<br />GENERAL LIABILITY
<br />Santa Ana,
<br />CA 92701
<br />EACH OCCURRENCE $ 1,000,000
<br />A
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE Fx7OCCUR
<br />X
<br />ZLP12N45052
<br />1/1/2015
<br />/1/2016
<br />DAMAGE TO RENTEDP Eoccurrence) $ 300,000
<br />MED EXP (Any one person) $ 10,000
<br />PERSONAL &ADV INJURY $ 1,000,000
<br />GENERAL AGGREGATE $ 2,000,000
<br />GEN'L AGGREGATE
<br />LIMIT APPLIES PER'.
<br />PRODUCTS - COMPIOP AGO $ 2,000,000
<br />X POLICY
<br />PRO LOC
<br />$
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />adent) 1,000,000
<br />BODILY INJURY (Per person) $
<br />B
<br />ANY AUTO
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />A3402P458
<br />1/1/2015
<br />1/1/2016
<br />BODILY INJURY (Per acldent) $
<br />X
<br />HIRED AUTOS X AU OSTEO
<br />Perry clldent ROPERTY DAMAGE $
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />EACH OCCURRENCE $ 4,000,000
<br />AGGREGATE $ 4,000,000
<br />A
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DEO X RETENTIONS C
<br />$
<br />I
<br />IZUP12N45304
<br />1/1/2015
<br />1/1/2016
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y I N
<br />ANY PROPRIETORIPARTNERIEXECUTIVE
<br />OFFICER/MEMBER EXCLUDED?
<br />(Mandatary in NH)
<br />f yes, describe under
<br />N I A
<br />UB8133PB70
<br />1/1/2015
<br />1/1/2016
<br />X I WC STATUE OTH-
<br />E.L. EACH ACCIDENT $ 1,000,000
<br />E.L. DISEASE -EA EMPLOYE $ 1,000,000
<br />E.L. DISEASE -POLICY LIMIT $ 11000,000
<br />DESCRIPTION OF OPERATIONS below
<br />C
<br />Errors & Omissions - Mi SC
<br />IT807390
<br />1/1/2015
<br />1/1/2016
<br />Each Claim $2,000,000
<br />Professional Liability
<br />Retro Date 12/13/2009
<br />1Aggregate $2,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required)
<br />City of Santa Ana, Its officers, agents, and employees are included as Additional Insured per form CGD417
<br />attached to this policy. V
<br />101,14 N
<br />CERTIFICATE HOLDER CANCELLATION
<br />ACORD 25 (2010/05)
<br />I NS025 on inner n1
<br />©1988-2010 ACORD CORPORATION. All rights reserved.
<br />Thin ACl1Rn nems and Innn arc rcnicfcrcd mcrl of Arnpn
<br />✓I,
<br />clerk@ci.santa-ana.ca.us
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />City of
<br />Santa Ana
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Maria D.
<br />Huizar, Clerk of the Council
<br />AUTHORIZED REPRESENTATIVE
<br />P C BOX 1988, M-20
<br />Santa Ana,
<br />CA 92701
<br />V I Weidauer/NESSA
<br />ACORD 25 (2010/05)
<br />I NS025 on inner n1
<br />©1988-2010 ACORD CORPORATION. All rights reserved.
<br />Thin ACl1Rn nems and Innn arc rcnicfcrcd mcrl of Arnpn
<br />✓I,
<br />
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