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Page 1 of 1 <br />°® CERTIFICATE OF LIABILITY INSURANCE DATEIMMIDDNYYY) <br />02/13/2014 <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 CONTACT <br />Willis of Illinois, Inc. NAME,.__- __- .,_._,_,_____.- _,___- .,_____ _ <br />c/o 26 Century Blvd. PHONE Extl 1_8]]- 945 -]3]B _ FqC ryo 1- 888 -46]- 23]8__ <br />P.O. Box 305191 E -MAIL <br />ADDRESS: certificateeBwillis.com <br />Nashville, IN 372305191 USA — - -- — ---- - - -I'— <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 />INSURER A. <br />Travel ere Indemnity Company of CT <br />25682 <br />INSURED evcknam -In_ fraest.r.uc_t—uz_e _ <br />Gz- o-u P Inc. - - -- <br />INSURERB: <br />II <br />Travalere Property Casualty Company of Americ _ <br />256]9 <br />3548 Seagate Way, Suite <br />230 <br />INSURER C. <br />Continental Casualty Company <br />20443 <br />Dceanaitle, CA 92056 <br />MED EXP (Any one person) $ 5 000 <br />_ <br />Y <br />6806A55628A <br />INSURER D: <br />09/16/2019 <br />_ <br />INSURER E: <br />GENERAL AGGREGATE $ 2,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER <br />INSURER F: <br />PRODUCTS - COMPIOP AGO I$ 2,000,000 <br />COVERAGES <br />CERTIFICATE NUMBER: W209859 <br />REVISION NUMBER: <br />$ <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 />SUBRJ POLICY BEE POLICY EXP LIMITS <br />ADDL POLICY NUMBER MMODIYYYY MM)D Y <br />INSR TYPE OFINSURANCE <br />LTR <br />GENERAL UABILITY <br />AUTHORIZED REPRESENTATIVE <br />The City of Santa Ana <br />EACH OCCURRENCE $ 1, 000, 000 <br />X COMMERCIAL GENERAL LIABILITY CITY <br />XVTIMy+M�VP, us'--- <br />santa Ana, CA 92701 <br />DAMAGETORENTED 00 000 <br />PREMISES _(Ed occurrence) $ 1 0 <br />A J CLAIMS MADE [ X OCCUR <br />MED EXP (Any one person) $ 5 000 <br />_ <br />Y <br />6806A55628A <br />09/16/2013 <br />09/16/2019 <br />PERSONAL BADV INJURY $ 11000,000 <br />GENERAL AGGREGATE $ 2,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER <br />PRODUCTS - COMPIOP AGO I$ 2,000,000 <br />POLICY I X PRO 0 OC <br />IFCT <br />$ <br />I AUTOMOBILE LIABILITY <br />COMBINED SINGLE LIMIT 1, 000, 000 <br />(Ea, accident)_ _ 8 <br />BODILY INJURY (Per person) $ <br />ANY AUTO <br />A <br />ALL OWNED SCHEDULED <br />6506A55626A <br />09/16/2013 <br />09/16/2014 <br />BODILY INJURY (Per accdent) $ <br />AUTOS AUTOS <br />- T <br />_ _ <br />NON OWNED <br />X X <br />PROPERTY DAMAGE $ <br />HIRED AUTOS AUTOS <br />Teracndent) _ <br />CSL incl in GL$ <br />UMBRELLA LIAB OCCUR <br />EACH OCCURRENCE $ <br />EXCESS LIAB CLAIMS -MADE <br />AGGREGATE $ <br />DEC RETENtION$ <br />$ <br />WORKERS COMPENSATION <br />X' WC STATU- OTH - <br />LIMI_TS. ER <br />AND EMPLOYERS' LIABILITY YIN <br />_�� l <br />B <br />ANY PROPRIETOR'PARTNERIEXECUTIVE <br />E.L. EACH ACCIDENT $ 11000,000 <br />OFFICERIMEMBER EXCLUDEDP A <br />NIA <br />UB379DT99A <br />09/16/2013 <br />09/16/2014 <br />(Mandatory In NH) <br />EL. DISEASE - EA EMPLOYEE$ 1000,000 <br />If yes describe under <br />DESCRIPTION OF OPERATIONS below <br />E L. DISEASE POLICY LIMIT I S 1,000,000 <br />C <br />Professional Liability <br />MCHZBS359767 <br />09/16/2013 <br />09/16/2014 <br />$1,000,000 Per Claim <br />i <br />$1,000,000 Aggregate <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Aeacb ACORD 101, Addltianal Remarks Schedule, if more space Ia required) <br />The City of Santa Ana, its officers, employers, agents, volunteers and representatives are included as Additional Insured as respects to General <br />Liability. %n// <br />l 1Z1Yt <br />A� VO <br />(15.. <br />unr nco 2 c• - Qtllk ti - reur•cl l ATlnu <br />AgSlStall t CtV <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEUVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />The City of Santa Ana <br />,1 <br />20 Civic Canter Plaza M -36 <br />XVTIMy+M�VP, us'--- <br />santa Ana, CA 92701 <br />V TJOO -LULU AL UKU L:UKVL)" I IVN. An ngn15 reserveD. <br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD <br />SR rD:2856954 BATCH:eatch k: 28937 <br />