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ACCOR �`� CERTIFICATE OF LIABILITY INSURANCE
<br />ile. .--"
<br />DATE (MMIGD013
<br />11 /21 /7.019
<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, Colrain policies may require an endorsement. A statement on this certificate dons hot confer rights to the
<br />certificate holder in lieu of such endorsement s .
<br />PRODUCER
<br />MOC Insurance Services
<br />License No. 0569960
<br />44 Montgomery St., 17th Fl..
<br />San Francisco CA 94104
<br />CONTACT Halidae Callejas
<br />PH NE (415) 957 -0600 FAC n, (415) E51-0s71
<br />EdMI ,.hoallejas @mocins. com _... -_
<br />............_m - .,T.._._.._.......- .. -.._.. _
<br />INSURER($) APFORDING COVERAGE
<br />NAICN
<br />_
<br />INSURERA:Golden Ha le Insurance Corp
<br />10836
<br />INSURED
<br />Keyser Marston Associates, Inc.
<br />160 Pacific Avenue, Suite 204
<br />San Francisco CA 94111
<br />IN$URERStRe ublic Indemnity Com an
<br />22179
<br />N$UREk C:Evanston Insurance Co
<br />25378
<br />INSURER e:
<br />INSURER S!
<br />INSURER P:
<br />$ 1,000,000
<br />COVERAGES CERTIFICATE NUMSERMASTER 2019 -2014 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, NOTIMTHSTANDINC ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,
<br />THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED IIEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.
<br />LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
<br />LTx
<br />TYPE OF INSURANCE
<br />ADGL
<br />A
<br />SUER
<br />Me
<br />POUCYNUMBER
<br />POLICYEFF
<br />MMFDCIYYYY
<br />LIMITS
<br />GENERALLIABILITY
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />A
<br />X COMMERCIAL GENERAL UABILnY
<br />CLAIMS -MADE ® OCCUR
<br />X
<br />BP8932329
<br />2/1/2013
<br />12/1/2019
<br />REMISES Ea r
<br />$ 500,000
<br />MEU CXP An ono -arson)
<br />$ 10,00
<br />PERSONAL &AOV INJURY
<br />S 1, BOB, 000
<br />a Deductible applies
<br />GFNERALAAORECATE
<br />$ 2,000,000
<br />GENT AC012EGATE LIMIT APPLIES PER'.
<br />PRODUCTS - COMPIOP AGO
<br />$ 1,000,000
<br />$
<br />POLICY X PRO- Loo
<br />AUTOMOBILE UAmLITY
<br />Fe el COMBINED SINGLE .I
<br />$ 1 000 000
<br />8001 LY INJURY (Per par Con)
<br />$
<br />A
<br />X ANY AUTO
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />NON -OWNED
<br />X HIRED AIlT05 X AUTOS
<br />X
<br />8932429
<br />12/1/2013
<br />1'2/112014
<br />BODILY INJURY (Per Impart)
<br />E
<br />PROPE DAMAGr:
<br />- ua:id,nl
<br />Us caureU,nossIst ar.Mned
<br />$ 1 000 000
<br />X Comp $$CO X C.11 $50Q
<br />X
<br />UMBRELLA (JAB
<br />I
<br />OCCUR
<br />EACH OCCURRENCE
<br />1 4,000,000
<br />AGGREGATE
<br />4,000,0001
<br />A
<br />EXCESS LIAB
<br />CLAIMS -MACE
<br />DEC I X I RETENTIONS 10 '00C
<br />$
<br />X
<br />DO 8932629
<br />12/1/2013
<br />2/1/2019
<br />D
<br />WORKERS COMPENSATION
<br />AND EMPLOYER I'LIAWLITY
<br />ANY PROPRMTORaPARTNERIEXECUTIVE YIN
<br />OFFICERIMEMBER EXCLUDED?
<br />NIA
<br />03954619
<br />12/1/2013
<br />1$/1/2014
<br />X WC SFATU- 0714
<br />E.L. EACH ACCIDENT
<br />B 1000,,000.
<br />El. DISEASE - FA FMPLOYC:
<br />$ 1 000 ODO
<br />(19andatary In NH)
<br />UFSa�RIP' 'CON OF OPERATIONS bsbw
<br />E.L. DISEASE - POLICY LIMIT
<br />.s 11000,000
<br />C
<br />Profeasional Liability
<br />0855446
<br />12/1/2013
<br />12/1/2014
<br />Each Vtongta Act $7.,000,000
<br />Retention: $26,000
<br />AOOREOATRUMIP $2,000,000
<br />DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES BdUch Acres 101, Addlllonal RemarRe Schedule, ftam apace Is r Ricirect)
<br />City of Santa Ana, City of Santa Ana Acting as Successor Agency and /or Housing Authority of the City Of
<br />Santa Ana, its officers, employees,
<br />agents, volunteers and representatives are Additional Insured with
<br />respects to the Insured's operations.
<br />Insurance provided is Primary and is not contributory with any
<br />other insurance carried. 30 bay Notice
<br />of Cancellation /10 Day for nonpayment of premium - -
<br />t
<br />VtA
<br />CERTIFICATE HOLDER
<br />CANCELLATION - ...--- -"`" "'r,'t = =_ %f'
<br />SHOULD ANY OF THE ABOVE D CRIBED,P,'%[J[(CIESCBN'6ANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF,AFA31riCE WILL BE DELIVERED IN
<br />City of Santa Ana
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Executive Director of CDA
<br />AUTHORIZED REPRESENTATIVE
<br />20 Civic Center Plaza M -25
<br />Santa Ana, CA 92701
<br />Halide® Calllejas /FICA's..ez..
<br />ACORD 25 (2010105)
<br />INS028(2o1Doi)Bm
<br />© 1988 -2910 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
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