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A- 2013 -1 93 ICLEI -2 OP ID, Z8
<br />14 ?"' CERTIFICATE OF LIABILITY INSURANCE ACE
<br />DATE(MM YY)
<br />111121/2014 211201 2CI'14
<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 endorsements).
<br />PRODUCER
<br />San Francisco P &C
<br />'Hays of California! Ins Service
<br />1350 Bayshore Hwy, Suite 218
<br />Burlingame, CA 94010!
<br />Kathy Moresco
<br />CONTACT
<br />NAME: Kathy Moresco
<br />P��HO�rvN�E�., FAX
<br />J—a- .Exl):850'393 -20 ®D wC Neal: 850.39 1 -2[I0
<br />E4AIL
<br />_.
<br />INSURERM AFFORMNG COVERAGE
<br />NAIC A
<br />.........
<br />INSURER. A: Federal Insurance Company
<br />20281
<br />......m..
<br />INSURED ICLEI USA Inc.
<br />414 13th Street, Suite 400
<br />Oakland, CA 94612
<br />__.. _.. _._...
<br />INSURERS:
<br />_.........._
<br />30164
<br />INSURER C.:
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE F OCCUR
<br />INSURER D ;
<br />3589 -39 -74 WCE
<br />INSURER E:
<br />1112612015
<br />CbAI�TfiICI= `I
<br />PREMISES Ea ocot mence
<br />INSURER F
<br />HIED EXP (Any one Per on)
<br />$ 1,000
<br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED T,o THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT` OR O'T'HER 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 />.. __ -..._
<br />5
<br />._ - _.IN.
<br />TYPE OF INSURANCE
<br />S�T.!.7R
<br />WVD
<br />_...�..._ .
<br />POLICY NUMBER
<br />MMIDMYYYY
<br />MMiDDtYYYY
<br />LIMITS
<br />GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 1,00 ©,OOII
<br />A
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE F OCCUR
<br />3589 -39 -74 WCE
<br />1!1126/2014
<br />1112612015
<br />CbAI�TfiICI= `I
<br />PREMISES Ea ocot mence
<br />$'�. 1,000,000
<br />HIED EXP (Any one Per on)
<br />$ 1,000
<br />PERSGNAL l _.PV INJURY
<br />$ 1,000,000
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />PRODUCTS - COMP12P AGG
<br />S 2,00 000
<br />PRO-
<br />�) POLICY LOG
<br />___..._...
<br />$ _
<br />AUTOMOBILE LIABILITY'
<br />COMBINED SINGLE LIMIT
<br />Ea accident .....
<br />$ 1,000,000
<br />{
<br />A
<br />ANY AUTO
<br />7354 00.72
<br />11'.12612014
<br />11/2612015 BCUILY INJURY IPcr parson)
<br />$ m
<br />` ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />BODILY INJURY(P&racc!dont}
<br />$
<br />HIRED AUIOS }( NON -OWNED
<br />AUTOS
<br />PROPERTfD'P BE
<br />(PER ACCIDLN r
<br />$
<br />$
<br />X
<br />UMBRELLA LIAR X OCCUR
<br />EACH OCCURRENCE. $ 2,000,006
<br />A
<br />EXCESS LIAB CLAIMS-MADE
<br />7983 -82-51
<br />1112612014
<br />1112612015
<br />AGGREGATE $ 2,000,000
<br />$ ....._.._
<br />DI D'. RETENTION
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS 'LIABILITY
<br />ANY PROPRETORJPARTNERfEYECUTIV 'E, XI's
<br />OFFICERIMEMFIFR E=XCLUDED ?' u
<br />(Mandatary In NH)
<br />N ! A
<br />57`A'�ECLX9368
<br />11101/2014
<br />11/11112015
<br />X T CSTATU- Obi -
<br />j
<br />_ .�
<br />E.L. EACH ACC16 Nu
<br />._......
<br />�. 1,000,000
<br />$ 1,000,000
<br />m..,....._
<br />E.L. DISEASE - EA EMPLOYEE
<br />11 yyes, dasaribe under
<br />DESCMPTION OF OPERATIONS bolow
<br />-_-. ....._
<br />E.I.. DISEASE - POLICY LIMIT
<br />$ 1,000, 000
<br />DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (Atiasl, ACORD M @t, Addtt0onal Ranaarks Sckedute,. It nrnra spnca Is requiradl
<br />Certificate issued as Evidence of Liability insurance coverage for above
<br />Named insured.
<br />I I_EI USA: AGREEIVIEN"T # A- 2013 -193
<br />REVIEWED BY: � EUNICE HEREDIA (PG. 1 Of 3)
<br />City of Santa Aria Public
<br />Corks Agency
<br />P.O. Box 1988, M -21
<br />Santa Ana, CA 9270:1
<br />,�!_tWei[flLaw��1
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES OF CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS,
<br />AUTHORIZED REPRESENTATIVE.
<br />0 1 988 -201 0 ACORD CORPORATION, All rights reserved.
<br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
<br />
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