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h,i°!� u 1 <br />H`VK[J CERTIFICATE OF LIABILITY INSURANCE <br />O /,DD,YY " "' <br />TYPE OF INSURANCE <br />/1Q <br />9/19/2014 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. <br />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), <br />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 endorsement(s). <br />PRODUCER <br />CONTACT Julia Traughber <br />GLENDALE INSURANCE AGENCY, INC. <br />PHONE (818)244 -1144 AXN :1818)242 -5208 <br />601 E GLENOAKS BLVD, SUITE 100 <br />qp IL <br />@gleadaleins.com <br />P. O. BOX 831 <br />.Julie <br />GLENDALE CA 91209 -0831 <br />INSURERS AFFORDING COVERAGE <br />NAICq <br />INSURERA-General Ins. Co. of America <br />4732 <br />0/1/2015 <br />INSURED <br />INSURER a American. States Ins. Co" <br />9704 <br />Phoenix Group Information Systems <br />IasuRERC:Ca ital Specialty Ins. Co <br />0328 <br />2677 N. Main Street, Suite 400 <br />INSURERU:Twin City Fire Ins. Co. <br />9459 <br />INSURER E : <br />Santa Ana CA 92705 <br />INSURER F: <br />_.-- ..... ______ -___ RLVIWUN NUMtStK: <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 />rIVA <br />TYPE OF INSURANCE <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />POLICY NUMBER <br />�MLICY"YVF <br />PWpp EXy <br />LIMITS <br />AUTHORIZED REPRESENTATIVE <br />IABILITY <br />Santa Ana, CA 92702 <br />Julia Traughber /0134 <br />ACORD 9A lan4nrncl <br />COMMERCIAL GENERAL LIABILITY <br />OCCUR <br />X <br />4CC29837B40 <br />0/1/2014 <br />0/1/2015 <br />EACH OCCURRENCE <br />$ 1,000,000 <br />E. <br />PR MISES Eaomnrence <br />$ 1,000,000 <br />TACLAIMS-WDE <br />MED EXP(My dne perscn) <br />$ 5,000 <br />PERSONAL B AOV INJURY <br />$ 1,000,000 <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />REGATE LIMIT APPLES PER'. <br />X POLICY PRO TOO <br />PRODUCTS AGG <br />$ 2,000,000 <br />S <br />A <br />AUTOMOBILE <br />LIgBILITY <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />HIREDAUTOS NON -OWNED <br />AUrOS <br />24CC29837840 <br />0/1/2014 <br />0/1/2015 <br />C DINE SINGLE LIMN <br />Ea accident <br />S 1 000 000 <br />BODILYINJURY (Per Peracn) <br />S <br />BODILY INJURY (Per acudenl) <br />S <br />PROPERTY DAMAGE <br />Per IdXId.M <br />$ <br />UMBRELLA LIAR <br />EXCESS LIAR <br />OCCUR <br />CLAIMSa'MDE <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />OED RETENTION S <br />B <br />C <br />D <br />WORKERSCOMPENSATION <br />AND EMPLOYERS LIABILITY <br />ANYPROPRIETORIPARTFER EXECUTIVE YIN <br />OP- ICERIMEMBER EXCLUDED' ❑ <br />IMeddaldry In NH) <br />If Yee, describe under <br />DESCRIPTION OF OPERATIONS row <br />Errors 6 Omissions Liab, <br />Commercial Crime Coverage <br />NIA <br />IWCI0616090 <br />GCO174705 <br />028107014 <br />10/1/2014 <br />0/1/2014 <br />0/1/2014 <br />0/1/2015 <br />0/1/2015 <br />0/1/2015 <br />WC STATU- OTH - <br />S <br />EL EACH ACCIDENT <br />$ 1,000 ,00 <br />E.L DISEASE EA EMPLOYE <br />IT 1 OOO 000 <br />E L DISEASE - POLICY LIMIT $ 1 000 000 <br />$250C 00 DecudlDle $1,000,000 <br />$25.GOD 00 DeduelbN $1,000.000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS 'VEHICLES (Attach ACORO 101, Additional 1..a a SchadWe, Bdnxe spue la regWretl) <br />It is agreed that the City of Santa Ana, its officers, employees, agents, volunteers and representatives <br />are named Additional Insureds per form CG2026 (07/04) attached. It is also agreed that this insurance is <br />primary and non - contributory. All coverages are subject to the terms and of the policies, <br />1 /Conditions <br />Y't (./` l JO IL�Yf Yl <br />'° 09 1988-2010 ACORD CORPORATION. All rights reserved. <br />INS025(201D05) 01 The ACORD name and logo are registered marks of ACORD <br />rIVA <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />City of Santa Arta <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Attention: Yolanda Bautista <br />AUTHORIZED REPRESENTATIVE <br />60 Civic Center Plaza <br />Santa Ana, CA 92702 <br />Julia Traughber /0134 <br />ACORD 9A lan4nrncl <br />'° 09 1988-2010 ACORD CORPORATION. All rights reserved. <br />INS025(201D05) 01 The ACORD name and logo are registered marks of ACORD <br />