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CERTIFICATE OF LIABILITY INSURANCE DATE (MMlDD!'YIIYY)5/l1/2017
<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(lies) 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 I CDNTACT 4Sanr!v♦•ey t.4-1 rmmvor
<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.
<br />LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />....
<br />LTR ''..... TYPE OF INSURANCE ADDL SUBR ----. _--POLICY EFF POLICY EXP
<br />ILTR POLICY NUMBER MMIDDIYYYY MMIDDIMY LIMITS
<br />,....
<br />X COMMERCIAL GENERAL LIABILITY
<br />;'- EACH NE
<br />CH OCCURRENCE $
<br />1,000,000
<br />1
<br />A - CLAIMS -MADE X '.. OCCUR
<br />DAMAGE TO RENTED ..
<br />PREMISES (Ea occurrenc..e) $ _
<br />1,000,000
<br />X
<br />1 1711015848 5/8/2017 5/8/2018 MED EXP (Any one person) $
<br />10,000
<br />t1 ADV INJURY $
<br />1,000,000
<br />GEN'L AGGREGATEPERSONAL
<br />LIMIT APPLIES PER j
<br />GENERAL AGGREGATE $
<br />2,000,000
<br />POLICY �XX� PRO-
<br />JECT J LOC
<br />PRODUCTS - COMPIOP AGG $
<br />2,000,000
<br />OTHER:
<br /># Employee Benefits it $
<br />1,000,000
<br />AUTOMOBILE LIABILITY
<br />COMBINED SINGLE LIMIT $
<br />. (Ea accident) ---
<br />1,000,000
<br />X ANY AUTO
<br />BODILY INJURY (Per person) $
<br />A
<br />t ALL OWNED ---.; SCHEDULED
<br />'AUTOS AUTOS '..
<br />71101584.8 '.. 5/8/2017 5/8/2018 1 BODILY INJURY (Per accident) $
<br />-- NON OWNED
<br />X HIRED AUTOS "X AUTOS
<br />-
<br />PROPERTY DAMAGE
<br />(Per accident) $._
<br />- .. .....
<br />_
<br />...........
<br />I
<br />X...... UMBRELLA LIAB X --I OCCUR
<br />EACH OCCURRENCE _ $ ----.
<br />6,000,000
<br />EXCESS LIAR
<br />A I CLAIMS MADE( �
<br />AGGREGATE $
<br />6, 000, 000...
<br />DED '..... X, � RETENTI ON$ 01
<br />----.
<br />.5848 5/8/2017 $
<br />711015/8/2018
<br />WORKERS COMPENSATION I
<br />i. X PER OTR-
<br />AND EMPLOYERS'LIABILITY YfN ..LITY
<br />_ STATUTE ER
<br />......... ._._.
<br />ANY PROPRIETOWPARTNEWEXECUTIVE I
<br />OFFICIERWEMBER EXCLUDED? pj
<br />E,L.EACH ACCIDENT $ ....
<br />1 000 000
<br />.---. .....
<br />A (Mandatory ini
<br />�WC406044542 5/8:/2017 5/8/2018 El DISEASE EAEMPL.OYE61,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />—
<br />(including CA Cov A) E.L. DISEASE- POLICY LIMIT $
<br />-.
<br />11000,000
<br />A E&O, Information Risk
<br />ITS760010008- Claims Made i 5/8/2017 5/8/2018 Combined Liability Limit
<br />$5,000,000
<br />& Communication Liability
<br />� $25,000 Retention � Maximum Policy Aggregate
<br />$5,000,000
<br />DESCRIPTION OF OPERATIONS ! LOCATIONS ! VEHICLES iACORD 101., Additional Remarks Schedule, may be attached it more space is required)
<br />City of Santa Ana, It's Officers,
<br />employees, agents, volunteers and representativeh additionalp
<br />insured as indicated, and coverage
<br />is primary, non --contributory when required b ten con tr
<br />t er
<br />attached forms VCG207 (11/13)
<br />�}
<br />City Of Santa Ana
<br />20 Civic Center Plaza M-30
<br />Santa. Ana,, CA 92701
<br />SHOULD ANY OF THE A 3OVE DESQfS D POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANICE WITH THE (POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />Cy Stattlemyer✓LIES F-a , _, F4 rra P2�
<br />@ 1988-2014 ACORD CORPORATION. All rights reserved'..
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
<br />NS0251:>01Ar i
<br />
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