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CERTIFICATE OF LIABILITY INSURANCE I GATE28 /2 113
<br />10/28/201 M3
<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($), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER,
<br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must he endorsed, If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policles may require an endorsement. A statement on this certificate does not confer rights to the
<br />PRODUCER L•B32•s7 t -eVVU
<br />N,a�i
<br />N_gNIE
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />Aon Risk Serviaaa Southwest, Inc.
<br />PHONE
<br />GENERALLIABIUTY
<br />(A/Q NP�H$tl____...__
<br />_.._... .t!vE,..Np).1.._ .........
<br />......
<br />5555 San Felipe, Suite 1500
<br />EWAII,
<br />OMMERCIAL GENERAL LIABILITY
<br />_..
<br />Houa tan, TX 77056 -9089
<br />..,,
<br />...I,N9URERS AFFORDING COVERAGE
<br />_S) ...
<br />NAICA .,.
<br />I
<br />J CLAIMS•MADE M OCCUR
<br />I
<br />INSURERA
<br />INSURANCE CO OF THE STATE OF PA
<br />19429
<br />INSURED
<br />INSURER a:
<br />NBN HAMPSHIRE INS CO
<br />23841
<br />Clear Channel Outdoor, Inc.
<br />----
<br />-- .... _ .... .... _ .............. ....__..._..__._. -,_..,
<br />INSURER C:
<br />PER80NAL 8 ADV INJURY
<br />C/o 200 East Bases Rd.
<br />IN!tURERO:
<br />.._____..._ .... ................................. _.._,..._.__.,_
<br />San Antonio, TX 78209
<br />IN80RER E:
<br />i
<br />GENERAL AGGREGATE
<br />SURE P:
<br />0EN14 AGGREGATE LIMIT APPLIES PER:
<br />__1111. 1111..
<br />COVERAGES CERTIFICATE NUMBER- 36620633
<br />RFVICInm NIIMRPP�
<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 />INii'_.__'"__ ,_" "'- ". ".. "'_'_...__.— _____... _..._ BL STIB.R _.��..._��....,- ..__.u..._ _____-......_...._ .................. .........__.__......._...._._..
<br />LR! TYPE OF WE- WV ROUGY NUMBERIGb EYY P6TftYE%P_ UMITS
<br />A
<br />GENERALLIABIUTY
<br />GL 6819413
<br />11/01/1
<br />11/01/14
<br />EACHOCCURRCNCE
<br />$ 2,000,000
<br />OMMERCIAL GENERAL LIABILITY
<br />_..
<br />P. SEMJ $Es4.IFa9.- P£u�1.59RCe2.__..
<br />I, 000, 000
<br />?._.
<br />I
<br />J CLAIMS•MADE M OCCUR
<br />I
<br />MED EXP(An�(,Mpp Tn) _
<br />_ ..
<br />..__
<br />$ Excluded
<br />......._ 1._111.- _._...._._
<br />PER80NAL 8 ADV INJURY
<br />$ 2,000,000
<br />.._____..._ .... ................................. _.._,..._.__.,_
<br />i
<br />GENERAL AGGREGATE
<br />3.2,000,000
<br />0EN14 AGGREGATE LIMIT APPLIES PER:
<br />__1111. 1111..
<br />PRODUCTS- COMP)OPAGG
<br />$2,000,000
<br />Pft0-
<br />POLICY LOC
<br />.__....._........_....,
<br />._._........_._._......_.,.....
<br />$
<br />A
<br />AUTOMOBILE
<br />UABILITY
<br />CA 6579520 (ADS)
<br />1 1
<br />/1
<br />MBINEd D IkINNG�LE LIMIT
<br />..(1<8.89c1,49nty_ �
<br />2,040.000
<br />X-
<br />ANY AUTO
<br />SOOILY INJURY (Pefparsan)
<br />$
<br />_
<br />ALL OS SCHEDULED
<br />AIRED 1,111_ AUTOS
<br />BODILY INJURY Per accident
<br />( I
<br />$
<br />X
<br />NON-OWNED
<br />H
<br />HIRED AUTOS 'x AUTOS
<br />....... AUTOS
<br />PROP R DA A E
<br />Per aabltlentl ___ ...................__._..__
<br />$ 1111._.
<br />$
<br />UMBREI.LALIAH OCCUR
<br />--
<br />1111
<br />_
<br />EACH OCCURRENCE
<br />$
<br />EXCESS WIA8 CLAIMS -MADE
<br />._........__....-....._.... _.........._.____.._.�..a____
<br />AGGREGATE
<br />-.
<br />$
<br />"0 __j.RETENTIbN$___..
<br />_$.__...,_._..,- ,1_____1_1_1
<br />B
<br />WORKERS COMPENSATION
<br />WC 026020470 (A08)
<br />11/01(1
<br />11/bl/14
<br />X WC STATU OTH•.
<br />1,
<br />AND EMPLOYERS• LIABILITY YIN
<br />TORYACCID '.__2R__
<br />__0 „01,,1,,,,,1,,,_ - 1,11,,1,,,
<br />ANY PROPRMTORWARTNERMXECUrVE
<br />OFFICER /MEMBER EXCLUDED?
<br />NIA
<br />01.]]71
<br />E.L. EACH ACCIDENT
<br />$ 1x000,000
<br />$
<br />in NH).
<br />ii�_
<br />(Mandatary
<br />EMPLOYE
<br />S 11000,000
<br />If yyes, deecnbe under
<br />- - ° °- ° °-- - -----
<br />_,000,000
<br />DESCRIPTION OF OPERATIONS below
<br />E.L E- I�l'
<br />e San
<br />OJ'Ajo.
<br />DESCRIPTION OFOPERATIONS lLOCATIONSI VEHICLES (Attach ACORD 101, Additional Remarks 9chadulq ll mars SPacem cm.1r,m) Wty At y�n��,. W
<br />rn atf
<br />RE1 Santa Ana Agreement - Bus Shelters and Bus Benches. City Attorney, the City of Santa Ana, the `9'AYAna City
<br />Council, its officers, agents, and employees are additional insured(s) on the liability policies, end ouch insurance is
<br />Primary, but only with respect to liability that arises out of the acts or omissions of the Named Insured; or, those
<br />persons or organisations with whom the Named Insured has agreed to provide this insurance under written contract, but
<br />only to the extent of the liability assumed under such contract. Workers Compensation is evidenced for employees of the
<br />for employees of the Named Insured Only. 30 days notice of cancellation as required by written contract.
<br />City of Santa Ana
<br />20 Civic Center Plaza - Rosa Annex (M -85)
<br />Santa Ana, CA 92701
<br />USA
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS,
<br />AUTHORIZED REPRESENTATIVE
<br />UPa 1Ca9R.<%^.aK/n�Pt�u�W�"� 4`�w•
<br />reserved.
<br />AGORD Z5 jZUT GIGS) The ACORD name and logo are registered marks of ACORD
<br />Dholdon
<br />36620633
<br />
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