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CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDNYYY) 10/0V2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER MARSH RISK & INSURANCE SERVICES "" CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, PHONE FAX _JA L .. N_ 0 _40� 1 — AAIC. No)� INSR 345 CALIFORNIA STREET, SUITE 1300 CALIFORNIA LICENSE NO. 0437153 E -MAIL SAN FRANCISCO, CA 94104 .ADDRESS: ------ - Attw Gene Williams (415)743-8320 INSURER(S) AFFORDING COVERAGE NAIC # WVQ INSURER A Twin City Fire Insurance Co 29459 INSURED INSURER B Hartford Accident & Indemnity Co. 22357 BLX Group, LLC INSURER C Hartford Casualty Ins Co ..... . . 29424 777 South Figueroa Street, Suite 3200 Los Angeles, CA 90017 . . ... ... INSURER D Sentinel Insurance Company 11000 EACH OCCURRENCE �_.. A f erne N- 20 i -- wq INSURER F COVERAGES CERTIFICATE NUMBER: SEA-002676925-17 REVISION NUMBER: 18 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL POLICY EFF POLICY EXP LTR TYPE OF INSURANCE JU= WVQ POLICY NUMBER IMMIDDNYYY) MM LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS -MADE 1-1 OCCUR �gq LEo g9currence)— $ MED EXP (Any one person) $ PEjR50NAL & ADV INJURY $ GENT AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ __ _ _J '*0 PCUCY [_ JECT LOG PRODUCTS AGG $ _G2M�!9P $ OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS UMBRELLA LIAR OCCUR EACH OCCURRENCE AGGREGATE $ EXCESS LIAB CLAIMS-MADE DED RETENTION ,$ $ A WORKERS COMPENSATION 57 WB P14833 (FL,NY,WA) 1010112015 10/0112016 PER -70'IH- I AND EMPLOYERS' LIABILITY Y/N _jER B ANY PROPRIETOR�PARTNER)EXECLrDVE 57 WB P14833 (CO,DC,OR:,MA,MN,WV) 10101/2015 10/0112016 E1, EACH AGCQENT A C OFFICERfMFMBER EXCLUDED? N (Mandatory in NH) P] NIA 57 WB P14833 (TX,AZ) 10101/2015 10101016 E.L. DISEASE - EA EMPLOYEE .......... $ 1,000,000 D If yes, describe under 57 WB P14833 (CA) 1010112015 1010112016 1 1,000,000 DESCRIPTION OF OPERA] IONS below E L, DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS i LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Professional Services Contract CERTIFICATE HOLDER CANCELLATION City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Alto: Bich Ta THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 Civic Center Plaza, M-2 5 ACCORDANCE WITH THE POLICY PROVISIONS. Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE of Marsh Risk & Insurance Services L 0'1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD &ViOA3 W14ANA I If