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<br />ie_ R CERTIFICATE OF LIABILITY INSURANCE
<br />L.�
<br />DA`E' " /20' 3
<br />1/28j2013
<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 certIflcate holder Is an ADDITIONAL INSURED, the pollcy(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 />MOC Insurance Services
<br />License No. 0589960
<br />44 Montgomery St., 17th Fl.
<br />San Francisco CA 94104
<br />006TAcT Donna de Fabio
<br />NAME:
<br />PNGNE (415) 957 -0600 eIXC Nd (4]51 JS) -05»
<br />E-MaL .dcle£abio @maroevich.coa.
<br />INSURERS AFFORDING COVERAGE NAIG9
<br />INSURERA:Golden Eagle Insurance Co 0836
<br />NgUREO
<br />Keyser Marston Associates, Inc.
<br />55 Pacific Avenue Mall
<br />San Francisco CA 94111
<br />INSURER B:Re ublic Indemnity ComRany of 2179
<br />INSURERC:Evanston Insurance Co. X5378
<br />INSURER D:
<br />INSURER E'.
<br />INSURER
<br />L,UVtKAGts CERTIFICATE NIIMBER114ASTER 2U12 -13 GFV1cil1N urnnoco.
<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 VMICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO Al I THE TFRMS
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDLISUBR
<br />POLICY NUMBER
<br />POLICY EFF
<br />MMIOUIYYYY
<br />POLICY EXP
<br />MM O ,Y
<br />LIMITS_
<br />GENERAL UA61U1Y
<br />AUTHORIZED REPRESENTATNE
<br />20 Civic Center Plaza
<br />EACH OCCURRENCL
<br />f 1,000,000
<br />Santa Ana, CA 92701
<br />X COMMERDIAI GENERAL LIABILITY
<br />Donna de ee ^abio /DDF \ \�
<br />PR MI ESIEa aouunenca
<br />S 500,000
<br />A
<br />C. AIMS -MACE r—xl ocC,:R
<br />X
<br />218932329
<br />12/1/2012
<br />2/1/2013
<br />MEO EXP (Any one person;
<br />4 10,000
<br />PERSONAL S AD, INURY
<br />; 1, 000, 0c0
<br />O Daductibla applies
<br />3ENERAL AGGREGATE
<br />$ 2,000,000
<br />G N L AGC-R_GATE
<br />LIMIT APPLICS PFRI
<br />PRODUCT6-CoMPIDPAGO
<br />; 1,000,000
<br />ppLICY
<br />X PRO- T
<br />LOC
<br />;
<br />AUTOMOBILE
<br />LWBILITY
<br />CONGINCJ N' CE III
<br />1,000 ODO
<br />A
<br />x
<br />ANY AJTO
<br />BGDP -Y wduRY (POrperspn;
<br />I S
<br />ALLowNED SCHEOULEO
<br />ALTS AUTOS
<br />X
<br />A 8932429
<br />-2/1/2012
<br />12/1/2013
<br />6001LY w1URY (Par a.:IaunG3
<br />X
<br />YR X NON OWNED
<br />WO FUTOS
<br />FROpEHTY DnMA ;E
<br />AUTOS
<br />r c ^men
<br />i 3
<br />X
<br />comp SSOa x Con;sCO
<br />oci nsurnd Mamr'ni Cnma�na,
<br />S 1,000,000
<br />X
<br />UMBRELLA LAB
<br />X
<br />OCCUR
<br />-EACH OCCURRENCE
<br />; 4 , 000 , 000
<br />A
<br />EXCESS DAa
<br />CLAIMS MADE
<br />AGGREGATE
<br />; 4,000,000
<br />DED I X I RETENTION $10,00
<br />;
<br />X
<br />PC 8932629
<br />2/1/2012
<br />12/1/2013
<br />13
<br />WORKERS COMPENSATION
<br />WCSLIA I6 OTI-
<br />X ` r r R
<br />AND EMPLOYERS' LIABILITY YIN
<br />N EACH ACCIp BI'
<br />; 1,000,000
<br />ANY PRCPRIETOR,PARTNERIEXECU'IVE
<br />❑
<br />N/A
<br />OFFICERiM ?NRER EXCI UDEDJ
<br />IMandamry In NH)
<br />03954618
<br />12/1/20]2
<br />12/111013
<br />-_
<br />Ir yes. dercrlpe "Is-
<br />` OISEA.3E- EAEVILCY=I3000
<br />E.L. DISEASE -POL', LPAI':3
<br />1 0 10 -000
<br />DcSft,RTL.N OF OPERATIONS peluw
<br />C
<br />Professional Liability
<br />C- 852060
<br />12/1/2012
<br />12/1/2013
<br />Edcn WrongleiI AV $',000,000
<br />Retention: $50,000
<br />R.tr. Date 11/11/19'x6
<br />AGGREGAT=-J?/IT $2,000,000
<br />OES CRIPNONGFOPERAnONS /LOCAnONSIVEHICLES IAB]ch ACOR0101,Addldnml Remarks Schedule, If more space is required)
<br />City of Santa Ana, City of Santa Ana Acting as Successor Agency and /or Housing Authority of the City of
<br />Santa Ana, itS afficerS, employees, agents, volunteers and representatives are Additional Insured w iJj
<br />respects to the Insured's operations. Insurance is Primary
<br />provided and -,a not contributory wit�on£
<br />uther insurances carried. 30 Day Notice of Cancellation /10 Day for
<br />nonpayment of premium. RS
<br />Ypg0v�
<br />I�
<br />`c.15�ap
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLIr.KS BE CANCELLED BEFORE
<br />City of Santa Ana
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS,
<br />Executive Director of PHA
<br />AUTHORIZED REPRESENTATNE
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92701
<br />Donna de ee ^abio /DDF \ \�
<br />ACORD 23 (2010i0S) © 1588 -2010 ACORD CORPORATION. All rights reserved.
<br />IN 50251m uas p' The ACORD name and logo are registered marks of ACORD
<br />
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