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OP ID: Z8
<br />'`'kk. " CERTIFI' .ATE OF LIABILITY INSU'-
<br />DATE
<br />" "'
<br />,ANCE
<br />11 /12D,YY
<br />11/12/13
<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 650-393-2000
<br />CONTACT
<br />NAME:
<br />San Francisco P &C 650- 393 -2001
<br />PHONE FAx
<br />Hays of California Ins Service
<br />0TExtl: — - __-- .I NC_No):
<br />E -MAIL
<br />_ -
<br />1350 Bayshore Hwy, Suite 218
<br />ADDRESS:
<br />CUSTOMER
<br />CUSTOMER ID M:ICI -EI-2
<br />Burlingame, CA 94010
<br />INSURER(S) AFFORDING COVERAGE NAIC p__
<br />Kathy MDreSAo ___ _
<br />INSURED ICLEI USA Inc
<br />INSURERA:Hartford Underwriters Ins CID 30104
<br />414 13th Avenue, Suite 400
<br />_
<br />INSURERS; Federal Insurance Company 20281
<br />Oakland, CA 94607
<br />INSURER C; National Union Fire Ins. Co.
<br />_19445
<br />INSURERS
<br />INSURER E:
<br />INSURER F
<br />COVERAGES CERTIFICATE NUMBER: - 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 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 />INSR TYPE OF INSURANCE ADDL'.SUBR POLICYEFF POLICYEXP
<br />LTR POLICY NUMBER MMIDDIYYYY MMIDDIYYYY LIMITS
<br />GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br />B X COMMERCIAL GENERAL LIABILITY X X :35693974 11/26/13 11/26114 D MANGE O RENTED '-
<br />PREMISES (Ea occurrence) $ 1,000,000
<br />CLAIMS MADE X OCCUR MED EXP (Any one person) $ 10,000
<br />I PERSONAL &ASV INJURY $ 1,000,000
<br />_.
<br />GENERAL AGGREGATE $ 2,000,000
<br />GEN'LAGGREGATE LIMIT APPLIES PER PRODUCTS -COMPIOPAGG $ 2,000,000
<br />X POLICY PRO- LOC _ —.III _.
<br />AUTOMOBILE LIABILITY X COMBINED SINGLE LIMIT $ 1,000,000
<br />B -- ANYAUTO !73549972 11/26/13 11/26/14 (Ea accident)
<br />BODILY INJURY (Per person) $
<br />X .. ALL OWNED AUTOS
<br />BODILY INJURY(Par acod.,t) $
<br />SCHEDULED AUTOS
<br />PROPERTY DAMAGE $
<br />X
<br />HIRED AUTOS (Per accident
<br />X NON -OWNED AUTOS
<br />NO OWNED AUTOS - - - -a- - --
<br />X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 2,000,000
<br />EXCESS LIAB CLAIMS MADE AGGREGATE $ 2,000,000
<br />B --- — X 17983 -82 -51 11126113 11126/14 - -- -
<br />DEDUCTIBLE $
<br />RETENTION $ $
<br />WORKERS COMPENSATION WC ST 'OTH
<br />X -.
<br />_TORY luT
<br />AND EMPLOYERS' LIABILITY YIN - TORY LIMITS EI1_ _
<br />A ANY PROPRIETORIPARTNERIEXECUTIVE 11/01/13 11/01114 EL EACH ACCIDENT 1,000,000
<br />� NIA _$
<br />OFFIC ERIMEMBER EXGLUDEOP -
<br />(Mandatory lnNH) _ EL DISEASE EA EMPLOYEE '$ 1,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below E . DISEASE - POLICY LIMIT $ 1,000,000
<br />C 'Errors & Omissions 01- 423 -70 -01 11/26/12 11/26/13 'E & O 1,000,000
<br />bed. 10,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, AddlHanal Remarks Schedule, If more 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 da s only.
<br />CERTIFICATE HOLDER CANCELLATION
<br />P 'Rt iv r; AS TO Ut 1
<br />t
<br />-
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />!�
<br />City of Santa Ana (et al) � '� J f
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />_
<br />(see below)
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Attn: Christy Kindlg L LI L
<br />AUTHORIZED REPRESENTATIVE
<br />.i
<br />,
<br />P. 0. Box 1988, M -21 syi;ta.nt 'City
<br />Santa Ana, CA 92702
<br />© 1988.2009 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD
<br />
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