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CERTIFICATE OF LIABILITY IN SURANCE
<br />5
<br />'-IS CERTIFiGATE RS iS'5UlED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON IHL, C:LRTIFIf;ATF HOLDER THIS
<br />CERTIFICATE E)OFS NOT AFFIRMATIVFIY OR NEGAVVELY AMEND, EXTEND OR ALTER THL COVERAGE AFFORDEn. BY THE POLi(.'lE
<br />BELOW, THIS CERTIFICATL OF INSURANCE. DOES NOT CONSTITUTE A CONIRAC7 BEIWFEN THE VSSUINO tNSURF-.R(S), AUTHORI/ED
<br />REPRF�`&NTATIVEQK PRODUCER, AND 7FIF'CERTIFICATF HOLDER . ...........
<br />IMPORTANI. If the certificate huller is an ADDITIONAL INSURED, the policy(iris) must lie endorsed If SUB r4OGAT K) NIS WAIVT�P, silhjeCt tO
<br />h4r qr,,j-*,jn4 cond4iortn of "in policy, codaw policies mly require an endorserrient. A stritemont Dn this cv�tifwate does riot Cclifer right', to the
<br />•
<br />rIP00"f(A R Exin ThOnO
<br />�Deiley, Rentc)n & Associates 1.1i.LL1_4 427 S4f8fr"10
<br />P. C. Box 10550 17 MAIL
<br />S,anta Ana GA x271,1-0550 DtNG C(iVFFZAC;F 0
<br />iNIURLD
<br />ylifldan Horneiand SoMhons
<br />2401 E Kateila AvrnIj(-, SIT' 220
<br />Anaheim CA 92806
<br />............ . _ REVISION NUMEIM
<br />COVERAGES CER11FICATIF NUMBER 2017110655
<br />"E 6 11-1[ IN$URED NAMFD AROVF F'L)i� T11F PC)l. ICY FRIOP
<br />!His
<br />—.T:51'. Is T 6 cri R, I IV Ti771ATTI WF_ ()I 7TICT S OT ri;�suf?'4 t
<br />s HAG
<br />'E
<br />No7WTHS1ANDlN(; ANY HELOCARLMENT TERM OF, CONDFIONOFANN' CC CNTRAC TOR t,i'THER DOCUM ENT 10A 110 RLSPEC I 1:0imflCH
<br />CFFITirICATE MAYBE. ISSuLD 0- MAY Pii�IAIN, TrIL �NF'L'P'ANCIE AFF()RDED BYTHE FICXICILS DEW-WRFOHEREIN l;; SII[x ,Ji-C" K) ALI. T11F ERMS
<br />FACtr 1510N,'� AND CON D� 11 ONS OF rA I(�H 1101. Ic IES� LIMITS !',I i OWN MAY ii�AV�-, REF N RF MJ".LL1 SY PA in ('LAW�,i
<br />XDIYL "TJ rM IF FF I POLIC, 'I E xr,
<br />J�p rysle OF NSURANCF
<br />:30 1 158 A" H 0" ("'l
<br />w. 'T'AVz7T 7,1 17_,777
<br />(W D (10
<br />X
<br />KS011A(�R I N I I 'J;,�r RmE (ICS{) 000
<br />RFPI) xCu
<br />tYil AM', 11 S F, FR,
<br />J3" . ..... .............. 4—
<br />014
<br />"R '000 ODD
<br />A
<br />BODILY �Po' .�Pqwn';
<br />ANYA'070
<br />yij,y INIjupy acc cier�� S
<br />Ai.i7os
<br />A V Pt",
<br />NON OaMED
<br />�X
<br />FA. -WX]CLFRENCF 1
<br />U1619PELLA LIAR CK,CL;R
<br />EXCESS LIA6 r'j. rv�"-MADF,
<br />CRKERS C1DMPF.NSJkTl0N f UR7r)417816
<br />ANr EMPI. r)YERS'LIAMILITY Y t
<br />I
<br />Asy PR0PR(ET0R1PAP7NER'EXFCU rivE �i.] MCA
<br />0'FiCERAJOAR-ER EXCiJ
<br />rUjindoory In NH)
<br />1tC121013 'I V9i2n14
<br />Im
<br />- D'Oaq
<br />E1. Mrk ASIr LA EMM OYL F' $1 00D 0100
<br />EL DISF,'SE "CKIC"' 1
<br />Per Clwrn $1 000 M �
<br />Fl,ofriswmd� _[Abitily kr0977441114 �1 1 fv2 014 .Air Aggro,qaie $2 Ono 000
<br />Claims Made Li
<br />'19120
<br />DeSCFriPr'j0N or OPERATI<)NS 1 L,CCATIONS IVEHIrLES iAitach ACORD 101, AO(jj�iv,.] R.—r5 Sc�edula, If 0 'PDC' Is leqll'-dl
<br />General Liability policy exclude:i claims arising out of the performance Of PrOtessi07)Sl Ser`Vces.
<br />Independent Contractors are included as respects to general Liability,
<br />30 Day NOG/1 0 Day for Non Pay of Prem
<br />Re Mult-year tfairong and exert; se plan ;MTFP) City of Santa Ann, its officers, (.,,FnpjOyeEs, aq
<br />' gents, volunteers and representatives are
<br />adclitionaP Insured as ��spects to General Liability as required by written contract, Primary and ccwerage, Cross LiabTly,
<br />coverage applies to CL as required by written contract, (WHS)
<br />CERTIFICATE HOLD
<br />City of Santa Ann
<br />Mtr' Clerk of the City Council
<br />20 civic Center Plaza(M-30)1 PO Box 1989
<br />Santa Ana CA 92702
<br />ACORD 25 (2010105)
<br />CANCELLATION
<br />sHow t) ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORF,
<br />THE F.XPMATr(')N DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE W1'H THE POLICY PROVISIONS
<br />AVTHORtZEO REPREGENTAI C4E
<br />,1 >
<br />k
<br />rc-, 1988.2010 ACORD CORPORA I 1UN. All r1gril!5, r'd!:iV'vVU,
<br />The ACORD name and logo are registered marks of ACORD
<br />1WZURFR 4 Cc CIA
<br />4.674-
<br />_NSk KLH a:Cattil,1 Joc,
<br />......... . . .
<br />. . ....... . . ..............
<br />N5VRFR
<br />............ . _ REVISION NUMEIM
<br />COVERAGES CER11FICATIF NUMBER 2017110655
<br />"E 6 11-1[ IN$URED NAMFD AROVF F'L)i� T11F PC)l. ICY FRIOP
<br />!His
<br />—.T:51'. Is T 6 cri R, I IV Ti771ATTI WF_ ()I 7TICT S OT ri;�suf?'4 t
<br />s HAG
<br />'E
<br />No7WTHS1ANDlN(; ANY HELOCARLMENT TERM OF, CONDFIONOFANN' CC CNTRAC TOR t,i'THER DOCUM ENT 10A 110 RLSPEC I 1:0imflCH
<br />CFFITirICATE MAYBE. ISSuLD 0- MAY Pii�IAIN, TrIL �NF'L'P'ANCIE AFF()RDED BYTHE FICXICILS DEW-WRFOHEREIN l;; SII[x ,Ji-C" K) ALI. T11F ERMS
<br />FACtr 1510N,'� AND CON D� 11 ONS OF rA I(�H 1101. Ic IES� LIMITS !',I i OWN MAY ii�AV�-, REF N RF MJ".LL1 SY PA in ('LAW�,i
<br />XDIYL "TJ rM IF FF I POLIC, 'I E xr,
<br />J�p rysle OF NSURANCF
<br />:30 1 158 A" H 0" ("'l
<br />w. 'T'AVz7T 7,1 17_,777
<br />(W D (10
<br />X
<br />KS011A(�R I N I I 'J;,�r RmE (ICS{) 000
<br />RFPI) xCu
<br />tYil AM', 11 S F, FR,
<br />J3" . ..... .............. 4—
<br />014
<br />"R '000 ODD
<br />A
<br />BODILY �Po' .�Pqwn';
<br />ANYA'070
<br />yij,y INIjupy acc cier�� S
<br />Ai.i7os
<br />A V Pt",
<br />NON OaMED
<br />�X
<br />FA. -WX]CLFRENCF 1
<br />U1619PELLA LIAR CK,CL;R
<br />EXCESS LIA6 r'j. rv�"-MADF,
<br />CRKERS C1DMPF.NSJkTl0N f UR7r)417816
<br />ANr EMPI. r)YERS'LIAMILITY Y t
<br />I
<br />Asy PR0PR(ET0R1PAP7NER'EXFCU rivE �i.] MCA
<br />0'FiCERAJOAR-ER EXCiJ
<br />rUjindoory In NH)
<br />1tC121013 'I V9i2n14
<br />Im
<br />- D'Oaq
<br />E1. Mrk ASIr LA EMM OYL F' $1 00D 0100
<br />EL DISF,'SE "CKIC"' 1
<br />Per Clwrn $1 000 M �
<br />Fl,ofriswmd� _[Abitily kr0977441114 �1 1 fv2 014 .Air Aggro,qaie $2 Ono 000
<br />Claims Made Li
<br />'19120
<br />DeSCFriPr'j0N or OPERATI<)NS 1 L,CCATIONS IVEHIrLES iAitach ACORD 101, AO(jj�iv,.] R.—r5 Sc�edula, If 0 'PDC' Is leqll'-dl
<br />General Liability policy exclude:i claims arising out of the performance Of PrOtessi07)Sl Ser`Vces.
<br />Independent Contractors are included as respects to general Liability,
<br />30 Day NOG/1 0 Day for Non Pay of Prem
<br />Re Mult-year tfairong and exert; se plan ;MTFP) City of Santa Ann, its officers, (.,,FnpjOyeEs, aq
<br />' gents, volunteers and representatives are
<br />adclitionaP Insured as ��spects to General Liability as required by written contract, Primary and ccwerage, Cross LiabTly,
<br />coverage applies to CL as required by written contract, (WHS)
<br />CERTIFICATE HOLD
<br />City of Santa Ann
<br />Mtr' Clerk of the City Council
<br />20 civic Center Plaza(M-30)1 PO Box 1989
<br />Santa Ana CA 92702
<br />ACORD 25 (2010105)
<br />CANCELLATION
<br />sHow t) ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORF,
<br />THE F.XPMATr(')N DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE W1'H THE POLICY PROVISIONS
<br />AVTHORtZEO REPREGENTAI C4E
<br />,1 >
<br />k
<br />rc-, 1988.2010 ACORD CORPORA I 1UN. All r1gril!5, r'd!:iV'vVU,
<br />The ACORD name and logo are registered marks of ACORD
<br />
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