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y ® CERTIFICATE OF LIABILITY INSURANCE DATE(MM70WYYYY) 1 021,012014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: It the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in heu of such ondorsement(s), PRODUCER ADD Risk Insurance Services West, Inc. LOS AnggeleS CA Office CONTACT NAME: _ (NBC. Na. Extk (866) 283-7122 INC. NCI. 800 -363 -0105 707 wi lshire Boulevard suite 2600 EOMMi. —"-- ADDRESS: LOS Angeles CA 90017 -0460 USA INSURER(S) AFFORDING COVERAGE NAIC0 INSURED INSURER A: Federal Insurance company 20281 Tiburon, Inc. 3000 mon Ci ve Parkway, Suite 5tl0 San Ramon CA 94583 USA INSURER O: Great Northern Insurance Co. 20303 INSURER C: Pacific Indemnity co 20346 MED EXP(Any an. persoa INSURER O: Continental Casualty Company .20443 INSURER E: $1,000,000 CELL AGGREGATE LIMIT APPLIES PER POLICY EXPO ❑X LOS OTHER: INSURER F: $210001000 COVERAGES CERTIFICATE NUMBER: 57U052d86954 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as re oeated INSR L R TYPE OF INSURANCE ADDIL INSD SPUR MD POLICYNUNI POLICY SEE MMIDD POLIC LIMITS City Of Santa Ana Attn: Lori smith X COMMERCIALGENRRALLIABIUV CLAIM &MADE ❑X OCCUR 20 Civic Center Plaza Santa Ana CA 92701 USA F.ACH000URRENCE $1,000,000 HLL PREMmgaLfLa ocow,noe $11000,000 MED EXP(Any an. persoa $10,000 PERSONAL B Ate INJURY $1,000,000 CELL AGGREGATE LIMIT APPLIES PER POLICY EXPO ❑X LOS OTHER: OCNERALAGGREGATE $210001000 PRODUCTS - COMPIOP AGG $2,000,000 B AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED AUTOS SCHEDULED AUT05 HIRRDAUTOS NON -OWNED AUTOS 7355 -87 -29 09 /D1/ 201309 /01/2014 COMBINED SINGLE LIMIT ES Sorads $1,000,000 -.0 SODILY INJURY(Parperson) UOOILY INJURY (Par accidanq PROPERTYOAMAGE Par accldantl ...... D X UMBRELLALIAB EXCESS LIAR X OCCUR CLAIMS-MAOC L4030957581 09/01/2013 09/01/2014 EACHOCCURRENCE $10,000,000 AGGREGATE $10,000,000 DEO I RETENTION C WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN ANY PROPRIETOR/ PARTNER! EXECUTIVE OFPIGERIMEMEER EXCLUDED? (Mandatory In NW Iiya6descdbeandar DEBGRIPTION OF OPERATIONS below NIA 71739717 09 nl 2013 09 01 20 4 PFE OTH- X STATUTE E.L. EACH ACCIDENT $1,000,000 EL. DISFASE- EA EMPLOYEE $1,000,000 EL. DISEASE - POLICY LIMIT $1,000,000 DESCRIP'NON OF OPERATIONS I LOCATIONS I VEHICLES (ACORD Tel, Additional Ramarka Sohadule, may be attachad It moro spaoo is ng/a�lnul))j,�1ry A -rove CERTIFICATE HOLDER CANCELLATION ^— �— SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE h' EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED III V IN ACCORDANCE WITH THE 1 V POLICY PROVISIONS. City Of Santa Ana Attn: Lori smith AUTHORESS) REPRESENTATIVE 20 Civic Center Plaza Santa Ana CA 92701 USA HLL 9tG 01988 -2014 ACORD CORPO O All rights reserved. ACORD 26 (2014101) The ACORD name and logo are registered marks of ACORD v s v RU 0 a T IA m m 0 0 M1 O N U, 0 U tJ N ri Y 9'!