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ICLEI -2 OP ID: Z8
<br />CERTIFICATE OF LIABILITY' INSURANCE D 02 /02 /2015Y,
<br />02!02/2015
<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(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 />`"'`°."'"'`"
<br />NAME K tl y Moresca
<br />San Francisco P&C
<br />Ha of California Ins Service
<br />PHONE 650- 393 -2000
<br />FA 650- 393 - 2001
<br />50
<br />13 Bayshore Hwy, Suite 218
<br />E -MAIL
<br />ADORES.
<br />CLAIMS
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
<br />Burlingame, CA 94010
<br />'.
<br />POLICY E �� P(LI0 -- Y E( P
<br />LTR TYPE OF INSURANCE i uan rn i POLICY NUMBER IMMIDDIYIM2 —mmm YYYY,),
<br />Mary Griffith
<br />INSURER(ST AFFORDING COVERAGE
<br />NAIC #
<br />EACH OCCURRENCE $
<br />INSURER A: Federal Insurance Company
<br />10281
<br />INSURED ICL.EI USA Inc.
<br />INSURERS: Hartford Underwriters Ins Co
<br />30104
<br />414 13th Street, Suite 400
<br />1,00 0
<br />Oakland, CA 94612
<br />INSURERc
<br />GENERAL AGGREGATE } $ , �,.
<br />INSURER D:
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />PRODUCTS - COM..PI. O, P ACC., $
<br />INSURER E ¢
<br />,.
<br />COVERAGES CERTIFICATE NUMBER:
<br />REVISION NUMBER:
<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
<br />WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL
<br />THE TERMS,
<br />CLAIMS
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
<br />'.
<br />POLICY E �� P(LI0 -- Y E( P
<br />LTR TYPE OF INSURANCE i uan rn i POLICY NUMBER IMMIDDIYIM2 —mmm YYYY,),
<br />_.. .. ..._- ..m
<br />° LIMITS
<br />_
<br />GENERAL LIABILITY
<br />EACH OCCURRENCE $
<br />1,000,006
<br />A X ; COMMERCIAL GENERAL LIABILITY X X ;3589 -39 -74 WCE 11(2612014; 11/26/2015
<br />(
<br />LE
<br />„,.
<br />i,000,000
<br />CLAIMS-MADE } OCCUR
<br />M D EXP ( An y one person) i $
<br />1,00 0
<br />ERSONAL & AOV INJURY r $
<br />1,000 000
<br />GENERAL AGGREGATE } $ , �,.
<br />2,000,00..
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />PRODUCTS - COM..PI. O, P ACC., $
<br />2,666,66
<br />PaLtc > i PRO- Lac'
<br />$
<br />AUTOMOBILE LIABILITY [
<br />._
<br />rce' NIEHNFOSpla@GI.F- twr"C `
<br />1,060,00
<br />A ANY AUTO X 7354 -99 -72 11/26/2014 ! 11/2612015
<br />BODILY INJURY (Pw person) $
<br />ALLOWNED _' " DIYi..EC'
<br />AUTO
<br />:Auras ,AUTOS
<br />BODILY INJURY (Per accident) , $
<br />: NON -OWNED
<br />X
<br />PROPFI2'TY' DF'aMACe. $
<br />? HIRED AUTOS X_„ „AUTOS
<br />(PER tP, ACtC�)IC;P+& Y 5 ..
<br />$
<br />X I UMBRELLA LIAR : X OCCUR � .� �
<br />I EACH OCCURRENCE < $
<br />2,000,00 �.
<br />A EXCESS LIAR CLalhrs -MADE! X '7983 -82 -51 1112612014 11126/2015
<br />AGGREGATE $
<br />2,000,00
<br />DED t RETENTION$
<br />WORKERS COMPENSATION � - .. ��
<br />WCSTATU- jOTH --
<br />X,
<br />AND EMPLOYERS' LIABILITY YIN
<br />7 RY I IM�TR , ,.�° .....
<br />,._.... .
<br />B ' ANY PROPRIETORIPARTNER rE:XECUTIVE { 57WECLX9368 11101/2014 11/01 /2015
<br />EA, EACHAC;C°IDCNI $
<br />1,000,00
<br />,NtA
<br />OFFICER/MEMBER EXCLUDED? I.
<br />(Mandatory in NH)
<br />E.L. DISEASE - EA EMPLOYEE $
<br />1,000,000
<br />? 11 yes, describe under
<br />;DESCRIPTION OF OPERATIONS below
<br />-.. _. ..._. _, ..
<br />E.LDISEASE - POLICY LIMIT $
<br />_..., ..
<br />1,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space Is required),,, ,,,,,,,,,,
<br />,,,_... .,..._._..__.. ,... ._ ...,,.. ,,._ .... ......_�......._...
<br />..,.
<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 days only./
<br />1CLD USA A -2013 -193 REVIEWED BY: ° .. w.,.,., � EUNICE HIS REDIA (PG, 1 of 5)
<br />
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