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ACORbP CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MMI °° YYY)
<br />10/29/2014
<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 />CNAME: OT C
<br />PHONE aC No E.n 714 427-681
<br />Dealey, Renton & Associates
<br />P. 0. Box 10550
<br />Santa Ana CA 92711 -0550
<br />EMAIL
<br />DDR
<br />AESS: in r om
<br />INSURER(S) AFFORDING COVERAGE
<br />NAILIf
<br />3301158PO20
<br />INSURER A:Travelers Property aS alt
<br />1/912015
<br />EACH OCCURRENCE
<br />INSURED
<br />INSURER B:QQtl n Insurance Company, Inc,
<br />X COMMERCIAL GENERAL LIABILITY
<br />INSURER C:Charter Oak Fire Insurance Company
<br />5
<br />Wllldan Homeland Solutions
<br />INSURER D:
<br />2401 E. Katella Avenue, Ste. 220
<br />Anaheim CA 92806
<br />$1,000,000
<br />CLAIMS -MADE OCCUR
<br />INSURER 9:
<br />��p9r["
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: 2084374271 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. 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 />ILTR
<br />TYPE OF INSURANCE
<br />ADDLSUBR
<br />INSR
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MMIOD/9YYY
<br />POLICY EXP
<br />MMIDDIYYVY
<br />LIMITS
<br />A
<br />GENERAL LIABILITY
<br />Y
<br />3301158PO20
<br />11/912014
<br />1/912015
<br />EACH OCCURRENCE
<br />$1,000,000
<br />X COMMERCIAL GENERAL LIABILITY
<br />PREMISES Ea occurrence
<br />$1,000,000
<br />CLAIMS -MADE OCCUR
<br />��p9r["
<br />%JfI
<br />MED EXP(Any one person)
<br />$10,000
<br />PERSONAL &ADV INJURY
<br />$1,000,000
<br />X Contractual
<br />(( —� \t1 �(�g��tt t
<br />Y \40/ [. B
<br />X
<br />BFPD,XCU
<br />GENERAL AGGREGATE
<br />$2,000,000
<br />/q� {p
<br />"'�' —p �Y
<br />GEN'LAGGREGATE
<br />LIMIT APPLIES PER:
<br />PRODUCTS - COMP /OP AGO
<br />$2,000,000
<br />$
<br />POLICY
<br />X PRO- LOC
<br />111 i bbb
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />8101158P020
<br />11/9/2014
<br />1/912015
<br />Ea awlldenl
<br />1000000
<br />BODILY INJURY (Per person)
<br />$
<br />X
<br />ANYAUTO
<br />BODILY INJURY (Per accident)
<br />$
<br />ALL OWNED SCHEDULED
<br />AUTOS
<br />PROPERTY DAMAGE
<br />Peraccldent
<br />$
<br />X
<br />N N�OWNED
<br />HIRED AUTOS X AUTOS
<br />$
<br />UMBRELLA LIAB
<br />OCCUR
<br />EACH OCCURRENCE
<br />$
<br />AGGREGATE
<br />$
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED RETENTION$
<br />$
<br />IS
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANY OFFICEOPRIETEREXCLNFPJE ECUTIVE�
<br />N/A
<br />UB7D417816
<br />11/912014
<br />1/9/2015
<br />X WC STATU- OTH-
<br />OR LIMITS OF
<br />E. L. EACH ACCIDENT
<br />$1,000,0Q0
<br />(Mandatory In NH)
<br />E.L. DISEASE - EA EMPLOYE
<br />$1,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$1,000,000
<br />Professional Liability
<br />Clalms Made
<br />AED977441 116
<br />11/9/2014
<br />119/2015
<br />Per Claim n $1,000,000
<br />Annual Aggregatn.� $0,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more apace Is required)
<br />�� y y!
<br />General Liability policy excludes claims arising out of the performance of professional services. 1 %
<br />Independent Contractors are included as respects to General Liability. rn
<br />30 Day NOC /10 Day for NonPay of Prom -}'
<br />City of Santa Ana, its officers, employees, agents, volunteers and representatives are additional insured as respectsc i
<br />to General Liability as required by written contract. Primary and Non- Contributing coverage, Cross Liability :,
<br />coverage applies to GL as required by written contract. (WHS)
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />City Of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Attn: Clerk of the City Council
<br />20 CIVIC Center Plaza(M -30) / PO BOX 1988 AUTHORIZED REPRESENTATIVE
<br />Santa Ana CA 92702 j
<br />�Tkalp
<br />All rights reserved.
<br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
<br />
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