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9
<br />11
<br />DATE (MMM IYYYY)
<br />AC R" CERTIFICATE OF LIABILITY INSURANCE
<br />3/19/21318 3/10/2017
<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 have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain pollckes may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s),
<br />PRODUCER CONTACT
<br />L,ockton InSUrance Brokers, LLC:' _NAME: .....—
<br />License 1101715767
<br />PHONEAo E (AIC, No):.m..
<br />475 EXeCutiue SCILtare, Suite 600 E-MAIL
<br />(La
<br />58)I587la -10003? ADDRESS:
<br />... INSURER(S)„AFFORDING COVERAGE MAIC id
<br />IINSURERA. National Fire Insnran-c-c Co of Hartford, 20478
<br />INSURED 31'5 Ci' -011p, file. _INSURER B Tlie Contnnenta0 Iiisuranc;e C'omlattiay _ 35289
<br />1377909 7737 Kenamar Court INSURER D Indian Harbor- Insurance Corapart _ 36940
<br />........
<br />San Diego CA 92121 INSURER D:
<br />rnTiclaAnC:Q TncrTana f T:DrICIrArG KIIIRAPFP— I1QI201r. Pr-%Il:filnN M11MRIPP. yy.'Xyyyy
<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,
<br />TERM OR CONDITION, OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE
<br />INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT To ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. (LIMITS
<br />SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />(NSR ................ .. .......... FA661ISIJIBRf
<br />LTR : TYPE OF INSURANCE = IN. WVD
<br />POLICY EFF POLICY EXP'
<br />POLICY NUMBER MWDD1YYYY MMfDDJYYYY LIMITS
<br />✓1 X COMMERCIAL GENERAL LIABILITY y N ]
<br />�I,
<br />4034952.942 ' 3/19/2017 ' 3/19/'2018 EACH DCCURRENGE -_- S 1,000 0130
<br />AMAGE I'D
<br />CLAIMS -MADE �.. OCCUR
<br />PREMISES Faocrlir�rence I z_
<br />MED (SES
<br />rsrr
<br />� S 10100000
<br />XP r�e '1)
<br />4
<br />_
<br />PERSONAL & ADV _ 00 000 .
<br />GEN L AGGREGATE LIWT APPLIES PER:
<br />GENERALAGGREGATERY1,0'00,000
<br />� t 1 I
<br />PRO .LOG
<br />POLflCY X JECT I-
<br />PRODUCTS' - COMPIOP AGG $ 1�OaCi�
<br />--
<br />OTRE.R:
<br />5
<br />A AUTOMOBILE LIABILITY N N
<br />INGLE LIMIT
<br />11BdiDe!lS 113011,000
<br />X ANY AUTO,
<br />BODILY INJURY per person) 5 xxxxxx
<br />OWNED 1 ..... SCHEDULED 1
<br />1
<br />)
<br />BODILY INJURY Per acadenl $ XXXXX.c`�;.
<br />AUTOS ONLY -- AUTOS
<br />HIRED NDN -OWNED
<br />;.. PROPERTY DAMAGE S XXiX rr
<br />. AUTOS ONLY ' AUTOS ONLY
<br />(Per aceiden l7
<br />X Call. $500 X CONT . S 1110
<br />S vaxxx,X
<br />UMBRELLA LAB
<br />H XX OCCUR N N 1
<br />40349S240349529903/10/:2017 3/191201 XEACH OCCURRENCE _ S 15 1,%Q'_�a 000
<br />....__—� - _-
<br />EXCESS LAB CLAtMS-MADE.,
<br />—
<br />1 AGGREGATE...S.._.15.000L000 „
<br />., .... -
<br />DED.._ RETENTIONS 10,000.!
<br />C �- $.�iXxxxxx
<br />WORKERS COMPENSATION �
<br />B AND EMPLOYERS' LIABJLITY
<br />cry X SPER TATUTE OTH-
<br />( ) 3/19/2017 1 3/19/2014 .._
<br />B YIN � N 1 A
<br />DEXECUTIVE �
<br />PRO RIFT E EXCLUDED?
<br />t
<br />�) 1==()� 11(r (AOS) ii I C�!?(117 ii 117/2(11 E.L EACH ACCIDENT
<br />G S �I0f) (j(�(�
<br />1
<br />�Y
<br />(Mandatory �
<br />E.L. DISEASE - EA EMPLOYEE( $ I ,C}N,O11CI
<br />'If yes, desenhe onder
<br />DESCRIPTION OF OPERATIONS below ''
<br />'' 1 E.L.DISEASE - POLICY LIMIT S 1,000,000
<br />C Tech L&0 -Nc¢%vCrlc l N '� N
<br />MTP0032003 7/19/20117 3/19/2018 Each Occ, 5.000,000;
<br />Privacy Media
<br />Agp . 5,000,000;
<br />Ded.: '100,000
<br />DESCRIPTION. OF OPERATIONS J LOCATIONS ! VEHICLES IACORD
<br />141.., Additional Remarks Schedule, may he attached if more space's required)
<br />Re: Enginee6ng; ofParkirap Meters. The. City ol'Sanla /wa, its
<br />officers- agents, wlwaeers, cnipluyces and representatives are nanied as ndditirn al insured, on s
<br />pilnTaryflTc I -cc iitl-ibaltc -y basis, as respects General L, ab'ilaly
<br />per attached. `ticpai,ation cif insureds a:pphes per policy frarm. 30 day cancellation nolicc applies per
<br />attaclled.
<br />If y
<br />1'=0TIrIe'ATO= unI r1C'I? rAnlrFl I... ATInAI q— 1"�LL-1hriWite
<br />128/3936
<br />The City of Santa dna, its officers, agents,
<br />SHOULD ANY OF THE ABOVE (DESCRIBED POLICIES HE CANCELLED BEFORE
<br />Volunteers, C11T 10 eCti and reat'c entativc
<br />1
<br />THE EXPIRATION DATE THEREOF NOTICE WILL BE DELIVERED IN
<br />20 Civic Centel' Plaza
<br />ACCORDANCE WITH THE POLICY PROVISIONS,
<br />Santa Ana CA 92701
<br />AUT"O:1 REPRESENTATIVE
<br />(01'9W-2015 AGORA CORPCdt�1'P01UN. All rlgnts reserved.
<br />ACORD 25 (2011'6103) The ACORD name and logo are registered marks of ACORD
<br />
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