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DIGIK-1 OP ID: KN
<br />CERTIFICATE OF LIABILITY INSURANCE
<br />DATE IMMPOUYYYY)
<br />0110412017
<br />THIS CERTIFICATE IS ISSUED, AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFI'CAT'E 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: 11 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 />Brakke-Schafnitz Ins, Brokers
<br />License #0K07568
<br />28202 Cabot Road, Suite 600
<br />CONTACT
<br />NAME: Karen Lynn Van Eede
<br />PHONE:
<br />Arc NQ Ext9: 949 3365-5147 FAX No): 94'9-313-3357
<br />ADDRESS: Karen.VanPede!asig.us
<br />Laguna Niguel, CA 92677-1251
<br />INSURER(S) AFFORDING COVERAGE
<br />INSURERA:SentinelInsuranceCOmppI_gy_ �ETNAIC
<br />0
<br />INSURED A-10 Advisors, Inc.
<br />INSURERe:
<br />dila: Marketplace Solutions
<br />dbw Procure America
<br />31103 Rancho Viejo Rd. #1)2.102
<br />INSURERe:
<br />INSURER D:
<br />San Juan Capistrano, CA 92675
<br />NsuRERE:
<br />INSURER F :
<br />f" r0'r1CIr"A°TG KIHIMRII ki I`.ilUrd WUfiPIC°SCP'(.
<br />L1.N Y �,IIlRV' V V vrx • , x..v...... � AAAA...:�...
<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, 'PERM 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 />LTR
<br />AAAA. TYPE OF INSURANCE
<br />N.
<br />City Of Santa Ana
<br />POLICYNUMBER
<br />OLICYC
<br />ON
<br />MM1DD
<br />LIMITS
<br />A
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS-MADE ®`BCCI -IR
<br />X
<br />X �72SBAA.P4101SC
<br />01/0612017
<br />01/06!2018
<br />EACH CCCURPENC'E $ 2,000,00
<br />'.
<br />PREMISESA(E 7 =NLrrence) $ 1,000,00
<br />NEED EXP (Any one pWr5un) $ 10,00
<br />''.:.
<br />PERSONAL. &,DV' INJURY $ 2,000,00
<br />'., GEN'L AGGREGATE LINT APPLIES' PER.
<br />X POLIIC' r PRO LOC
<br />GENERAL AGGREGATE $ 4,000,00
<br />PRODUCTS - COMPfOP' AGG $ 4,000,00
<br />'b
<br />OTHER
<br />ALTOMOSI LIABILITY
<br />AAAA.
<br />CONFINED 51*IDLE LIMIT tI
<br />Ea accadent $ 2+00,00
<br />BODILY INJURY gPer weusnn9
<br />A
<br />ANY AUTO
<br />X
<br />X
<br />72SBAAP4101 SC
<br />01906/2017
<br />0190612018
<br />DODILY IN AJRY (Par accident)
<br />AAAA..
<br />ALL OWNED St HEC'ULED
<br />AUTO,' ! AUTOS
<br />NON -OWNED
<br />X GG
<br />HIREDAUT'U�'L: AUTOS
<br />PROPERTY DAMAGE
<br />.Per arci[denY'}
<br />—
<br />A
<br />X
<br />UMBRELLA UAB
<br />EXCESS41AB
<br />X
<br />OCCUR
<br />CLAIMS -MADE
<br />72SBAAP4101SC
<br />0110692017
<br />0110612018
<br />EACH OCCURRENCE.... $ 1,000,000
<br />AGGREGATE $ 1,000,00
<br />.v
<br />DED X DETENTION $ 10,000
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' Ll ILrrY YIN
<br />ANY PrOPRIETCRIPARTt3ERIE.'KECUTVE —1
<br />0177ICERrTAEMBER EXCLUDED?
<br />(Mandatory In NH)
<br />Ni 1 A
<br />'I
<br />PER I I 'JIM -
<br />,STATUTE ER
<br />— AAA A
<br />EL EACH ACCIDENT
<br />DISEASE - [,� EMPLO`fEE $
<br />FE, DISEASE. - POLIC"d LIMIT $
<br />4f yes, describe under
<br />DE,ti;CR4RT4t)N e^,,F OPERATICINS, below
<br />I
<br />DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is requcred)
<br />City of Santa Ana, its officers, em�loyeesy agents, volunteers and
<br />representatives are named as additional insured where required by written REVISED
<br />contract and per the attached policy farm SS0009(04105) including primary &",, )
<br />Coon -contributory wording. '� � ��.�.' � . � " ..... �
<br />ANGE21NA CAZARES
<br />r-Amf Gt 1 AT!ON
<br />+..I�ee i rriti.rr r c rrv��r=r1
<br />—•-•------ -.._...
<br />SANTAAN
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City Of Santa Ana
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE NTH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza
<br />AUTHORIZED REPRESENTATIVE
<br />Santa Ana, CA 92701
<br />U lv88-10'14 A(;QRiI t.lJrtYD" i RJN. Taxi ngnrs resefvmu,
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
<br />
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