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7 E r ' <br />p <br />CERTIFICATE N <br />DATE 1DDYYYYJ <br />0930)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 <br />CONTACT <br />NAME: <br />MARSH RISK & INSURANCE SERVICES <br />PHOI <br />345 CALIFORNIA STREET, SUITE 1300 <br />a. xfl _ JAIC No): <br />CALIFORNIA LICENSE NO. 0437153 <br />E -MAIL <br />SAN FRANCISCO, CA 94104 <br />ADDRES s -- <br />Attn: Gene Williams (415)743 -8320 <br />INSURER(S) AFFORDING COVERAGE NAIC # <br />19025 - BLX- WC -14 -15 <br />INSURER A, Twin City Fire Insurance Co 129459 <br />INSU'RED <br />INSURER, e Hartford' Accident & indemnity Co . . <br />22357 <br />BLX Group, LLC <br />MED EXP (Any one person) S <br />777 South Figueroa Street, Suite 3204 <br />INSURER, C Hartford Casualty Ins Co <br />29424 <br />Los Angeles, CA 90017 <br />INSURER D : Sentinel Insurance Company <br />INSURERS : <br />yy ..ID <br />'I <br />GENERAL AGGREGATE S' . <br />. _...., <br />GENL AGGREGATE .LIMITAV'PL9E5PER. <br />l <br />INSURER F <br />COVERAGES CERTIFICATE NUMBER: SEA- 002187565 -15 REVISION NUMBER: 18 <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 POLICY E F F POLICY EXP 1 ._ ... ..............� <br />LTR TYPE OF INSURANCE INSR MJVD POLICY NUMBER MMIDDI'YYYY MM /DDlYYYY I LIMITS, <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />GENERAL LIABILITY <br />AUTHORIZED REPRESENTATIVE.. <br />of Marsh Risk &. Insurance Services <br />Gene Williams <br />EACH OCCURRENCE S. <br />DAMAGE TO RENTED ��� ........... <br />_ COMMERCIAL GENERAL LIABILITY <br />PREMISES (Ea accurrence� „, <br />CLAIMS -MADE OCCUR <br />MED EXP (Any one person) S <br />i <br />_ <br />PERSONAL & ADV INJURY � 5 <br />GENERAL AGGREGATE S' . <br />. _...., <br />GENL AGGREGATE .LIMITAV'PL9E5PER. <br />PRODUCTS .- Ci7�MPfOPAGCa $ <br />PRO - <br />POLICY I LOC <br />T <br />..... _. <br />S <br />AUTOMOBILE LIABILITY <br />COMBINED SINGLE LIMIT <br />E. I S <br />ANY AUTO <br />BODILY (Per person) S <br />ALL OWNED SCHEDULED <br />.....! AUTOS AUT'OS <br />BODILY INJURY <br />URY (Per accident) S <br />- -- - ... <br />r NON-OWNED <br />MIRED AUTOS t <br />RROf'ERTY DAMAGE 5 <br />'..,. <br />$ <br />UMBRELLA LIAR <br />OCCUR <br />EACH OCCURRENCE $ <br />, EXCESS LIAR <br />F <br />MS-MADE <br />'..'',.� AGGREGATE $ <br />DED RETENTION 5 <br />$ <br />A <br />WORKERS COMPENSATION <br />57 WE DZ7249 (AOS) (FL,NY,WA( 10/0112014 1010112015 X , WG STATU- OTH <br />AND EMPLOYERS' LIABILITY YIN <br />; TORY LIMITS ._— _.....8.13.......... . � <br />�57 <br />B <br />ANY PROPRIETORIPARTNERIEXECUTIVE <br />WE DZ7249 CO,DC,OR,VOA,MN,WV 1010112014 1010112015 1,,000,000 <br />i E_L EACH ACCIDENT $ <br />C <br />OFFICER /MEMBER EXCLUDED? <br />(Mandatory in NH) N <br />NIA <br />57 WE DZ7249 (TX and AZ( 110101/2014 10/010015 E -L D15EASE EA EMPLOYES S 1,000,000 <br />D <br />It yes descrdhe under <br />.._.... .... <br />57 WE DZ7249 (CA) 1'010112014 10101(2015 000,000 <br />DESCRIPTION OF OPERATIONS below <br />E.L DISEASE -POLICY LIMIT' I S <br />DESCRIPTION OF OPERATIONS f LOCATIONS f VEHICLES (Attach ACORD 101, Additional Remarks SchedWa, if more space Is required) <br />Professional Services Contract. <br />CERTIFICATE HOLDER CANCELLATION <br />City of Santa Ana <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />Attn: Bich Ta <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />20 Civic Center Plaza„ M -2 5 <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Santa Ana, CA 92701 <br />AUTHORIZED REPRESENTATIVE.. <br />of Marsh Risk &. Insurance Services <br />Gene Williams <br />ACORD 25 (2010105) <br />O 1988-2010 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />