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ICLEIw2 OP ID: Z8
<br />All OI ,#� ►° DATE IMMJDMYYYYI
<br />.._.
<br />CERTIFICATE OF LIABILITY INSURANCE 1112112014
<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 />IMPORTANM 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 requlire an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsement(s),
<br />PRODUCER CONTACT"
<br />San Francisco P &C _NAME _ . Kathy Moresco
<br />Hays of California Ins Service PAI N Ex11 650®393 -2000 AIC No): 650- 393 - 2081
<br />1350 Ba y shore Hwy, Suite 218 E -MAIL - Burlingame, CA 94090 ADDRESS:
<br />Kathy Moresco INSURER(S) Ar NAIC
<br />INSURER A ; Federal Insurance Company 20281
<br />INSU13FD ICLEI LISA Inc., INSWRERB: 30104
<br />414 13th Street, Suite 400 INSURER
<br />Oakland, CA 941612 SURER C
<br />INSURER 0,
<br />INSURER E t . -.....
<br />INSURER F: __._._...._
<br />r`_rI111=0 Iif-PC 1'PDTi97IrAT9 MI IRX.....QIZD -. ockaicini<i rVir rHnei-o.
<br />THIS 15 TO CERTIFY THAT TFIE 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 DL' -' -'SCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS &TOWN MAY HAVE BEEN REDUCELI BY PAID CLAIMS,
<br />......
<br />.... 7iti'DL -.— ._.._. ......... _. 'POLICY EFF POLICY BX'
<br />LTR TYPE OF INSURANCE I SR POLICY NUMBER (MMIDDaYYYL MK29= LIMITS .
<br />GENERAL LIABILITY
<br />EACH OCCURRENCE ...._
<br />$ 1,000,000
<br />A
<br />_ Co &�CLP9MS-
<br />X
<br />X
<br />3589-39-74 WCE
<br />1112812014
<br />1112612015
<br />nA1lAGE TO RL" T D
<br />{Eanccu r7ca7.,
<br />1,0100,000
<br />MAOEERALLI OCCUR
<br />MF ®9VIoLS
<br />EXP {An/ OnL0n1
<br />Pm on)
<br />__, ._`.
<br />,�Y 1,000
<br />. --
<br />_._
<br />PERSONAL &ADV INJURY
<br />$ 1,000,000
<br />GENERAL AGGREGATE
<br />S 2,000,000
<br />GENT AGGREGATE LIMIT APPLIES PER:
<br />' PRODUCTS - COMPiOP AGO
<br />1 5 2,,000,000
<br />POLICY PRO too
<br />EL "T
<br />_
<br />AUTOFA0131LE
<br />..,
<br />LIABILITY
<br />COMBINED SINGLE LIMIT 1.,000,0,00
<br />Ea accident
<br />._...__$.�..
<br />BODILY INJURY (Pier peoson} $
<br />A
<br />ANY AUTO
<br />X
<br />7354 - 919 -72
<br />11126120114
<br />1112612015
<br />AU OWNED AUTOS
<br />AUTOS AUTCiS
<br />BODILY INJURY Pea' accldent
<br />( �
<br />$
<br />X
<br />NON -OWNED
<br />HIRED AUTO AUTOS
<br />PROPERTY DffA_ACL..._....�._...._
<br />IPER ACCIDENT
<br />X
<br />UMBRELLA LIAR X OCCUR
<br />EACH OCCURRENCE
<br />$ 2,0100,.000
<br />A
<br />EXCESS LIAR CLAMS-MADE
<br />X
<br />7983 -82 -51
<br />1112612014
<br />1112612015
<br />AGGREGATE
<br />$ 2,000 0001
<br />WORKERS COMPENSATION
<br />�
<br />X "NC S'1"AT °4I.._ OTI -I-
<br />TORY LIMGTS
<br />AND EMPLOYERS'° LIABILITY
<br />YIN
<br />_ . „_FR
<br />E.L. EACH ACCIDCNr
<br />.__- _ _........
<br />$ 1,000,000)
<br />B
<br />ANY PRCPR1ETOMPARTNLR&XLUUTIVE
<br />Ohl'•'ICERlMEMDErt EXCLUOL " -C7? a
<br />NP!ii
<br />57WECLX9368
<br />11/01112014
<br />111011'12015
<br />i E L DISEASE - EA EMPLOYEE
<br />$ 1,000,01100
<br />{I13andaiary Ira NH)
<br />If yes, describe u,Pdsr
<br />DESCRIPTIONOF OPERA I IONS below
<br />....... .._._.�..
<br />EL,DISEASE - POLICY LIMIT '
<br />__... —. _
<br />$ 1,000,000
<br />I
<br />(DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Sc+liedi +le, If rnc,r , space is required)
<br />The City of Santa Ana, its officers, employees, agents, volunteers and
<br />representatives are named as additional insured with regard to the liability
<br />and defense of suits arising from the operations and uses performed by or
<br />for or on behalf of the named insured. Notice of cancellation for
<br />non- payment of premium is 10 clays only,
<br />ICLEI USA,:. AGREEMENT #; -201?-193
<br />REVIEWED BY- EUNICE HEREDIA (PG. 2 Of 3)
<br />O.:AN L; ELLA I IfJ
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPMATION DATE THEREOF, NOTICE WILL 13E DELIVERED IN
<br />City of Santa Ana (et al) ACCORDANCE WITH THE POLICY PROVISIONS.
<br />(see below)
<br />Attn: Christy Kindi'g AUTHORUED REPRESENTATIVE
<br />P. O, Box 1988, M-21
<br />Santa Ana, CA 92702 ,
<br />031988.2010' ACORD CORPORATION. All rights reserved.
<br />ACORD, 25 (2010/05) The ACORD name and logo are registered marks of ACCORD
<br />
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