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VENTTEC -02 SENGUPTASU
<br />DATE (MMIDD /YYYY)
<br />CERTIFICATE OF LIABILITY INSURANCE 7112/2016
<br />THIS CERTIFICATE IS ISSUED AS MATTER OF INFORMATION... ............................................................................................................................. ............................... ..,,.
<br />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, subjecito
<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 IxharAC•r Willis Towers Watson Certificate Center
<br />NAME:
<br />Willis of Texas, Inc. PHONE 877 945 -7378 - FAX
<br />c/o 26 Century Blvd (AIC„ No, Ext). ( ) JWC, No): (888) 467 -2378
<br />P.O. Box 305191 AIDD E-MAIL.
<br />Nashville, TN 37230 -5191 Air /ORES certificateswillis.com
<br />COVERAGES _ CERTIFICATE NUMBER: REVISION NUMBER:
<br />THIS I5 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 />IN: R I 1111. 'ADOLISUBR 1111. POLICY, EFF ( POLICY EXq� _.. 1111. 1111 1111..
<br />...La rd - ..... -4t`9.'I�,.NW'�Tt,� 1111.. �.... 1111 ............ ..,,. ... -- __.. ,. _... - EACH ....... S
<br />CLAIMS-MADE Y SURXNO� C;L`U6& 1 X 1 X 360335 J2 POLICY NUMBER 105/1y1�120YY) ,o�NIP1.tXryY"3"Y9 LIMIT
<br />------ 1111...-- - ---
<br />A X.. COMMERCIAL GENERAL LIABILITY $, 1,000,000!
<br />(DAMnTr TO RI NTI.I) 1,000,000
<br />1 - -_ -1 f _4?lil MO Ia; (E ;q ocrowremoe) $1111 1111... _...
<br />16 05/11/2017
<br />l RAE D EXI' (Any one personp $ 10 000
<br />PI RSONAI.. & ADV INJURY $ 1,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER: GI IgER:AI.. AGGREGA FE $ 2,000,000
<br />X POLICY PR'3. LOC 1 PRODUC I S CONAIFVOl Ar < $ 1,000,000
<br />JLC. "I'
<br />OTHER $ _
<br />AUTOMOBILE LIABILITY GJIM8TIIiEJe'$INr".'LLkfhW161 $ 1,000,000
<br />(Ea dr ritB Wi °oI)
<br />A ANY AUTO 73593885 05/11/2016 05/11/2017 BODILY INJURY (Per person) $
<br />ALL OWNED SCHEDULED BODILY INJURY (Per eccddemt)
<br />AUTOS I AUTOS
<br />X X NON OWNED PROPER v,, DANIAG $
<br />HIRED AUTOS 1111... ,... ... —..
<br />........ l AUTOS....... 11...11 ......... $
<br />X UMBRELLA LIAB X Occuisg z ( EACH OCCURRENCE $ 10,000,000
<br />I1111.. 1111...
<br />B EXCESS LIAB CI AIM MADE 79895906 05/11/2016 05/11/2017 AGGREGAFIs $ 10,000,000-
<br />DFDRETENTIONS 1111. ! ... _ 1111.._ - .....1...- - . "---1111. ....,,w ,a. �°..... 111.................... „............... .....,,,.,,
<br />WORKERS=.._._ 1111 _ „ . ......... ..............____.________
<br />C IANYDPROPRIIEEOR /PAR NOR /EXECUTIVE YIN - 71754946 05/11/2016 05111/2017 I.� Pc�plAcclr:p NT I $ 1,000,000
<br />X alru
<br />OFFICER /MEMBER EXCLUDED? I N N/ A 1 ,000,000
<br />(Mandatory In NH) E L DISEASE - EA EMPN OYEE') $
<br />If yyes, describe under
<br />!DESCRIPTION OF OPERATIONS below i E L CM EASE • G "TPLJCY LIMIT $ 1 ,000,000
<br />......... ...m. .. __. - -` --- ----- - --- -- ..- -- ---- ,- . .... _
<br />D Primary Cyber E &O G25543518001 0511112016 05/11/2017 !Limits, 15,000,000
<br />E Excess Cyber E &O 596694963 05/11/2016 1 05/11/2017 Limit: 10,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
<br />City of Santa Ana and its officers, employees, agents and volunteers are included as additional insureds in regards to their General Liability policy as
<br />required by written contract. A Waiver of Subrogation applies in favor of City of Santa Ana and its officers„ nmiployees„ a ents and volunteers with respect to
<br />the General Liability policy, as required by written contract. 9
<br />d
<br />Additional Named Insured:
<br />Ventiv Technology, Inc,
<br />lz"l
<br />Ventiv Technology Companies, Inc.
<br />,rl
<br />SEE ATTACHEDACORD101,T�
<br />- - -�
<br />... N ..� � t G7L,it�lf";!a D cAN E ,
<br />CERTIFICATE HOLDER CA_N CANCELLATION
<br />._.,�..,m SHOULD
<br />CE ... .
<br />ULD ANY OF THE ABOVE L ", � CJ�r
<br />THE EXPIRATION DATE Tf9EIEOF, NOTICE IL.L BE EL.IVE'R'.D
<br />ACCORDANCE WITH THE POLICY PROVISIONS,
<br />_. ......... ....................... ......... ... .
<br />AUTHORIZED REPRESENTATIVE
<br />City of Santa Ana r'
<br />20 Civic Center Plaza, M- 30•�°--
<br />(Santa Ana. CA 92701 n _
<br />—. .............� ........... ©.... --- ----------
<br />1988 -2014 ACORD CORP ..
<br />ORATION. All rights reserved.
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
<br />INSURER(S) AFFORDING COVERAGE NAIC #
<br />INSURERA:Great Northern Insurance Company 20303
<br />INSURED
<br />INSURER B: Federal Insurance Company '20281
<br />Ventiv Technology, Inc.
<br />INSURER C: Chubb Indemnity Insurance Company 12777
<br />227 W. Monroe Street
<br />INSURER D: Illinois Union Insurance Company 27960
<br />Chicago, IL 60606
<br />INSURER E; Continental Casualty Company 20443
<br />......... ......... 1111... ........
<br />INSURER F ;
<br />COVERAGES _ CERTIFICATE NUMBER: REVISION NUMBER:
<br />THIS I5 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 />IN: R I 1111. 'ADOLISUBR 1111. POLICY, EFF ( POLICY EXq� _.. 1111. 1111 1111..
<br />...La rd - ..... -4t`9.'I�,.NW'�Tt,� 1111.. �.... 1111 ............ ..,,. ... -- __.. ,. _... - EACH ....... S
<br />CLAIMS-MADE Y SURXNO� C;L`U6& 1 X 1 X 360335 J2 POLICY NUMBER 105/1y1�120YY) ,o�NIP1.tXryY"3"Y9 LIMIT
<br />------ 1111...-- - ---
<br />A X.. COMMERCIAL GENERAL LIABILITY $, 1,000,000!
<br />(DAMnTr TO RI NTI.I) 1,000,000
<br />1 - -_ -1 f _4?lil MO Ia; (E ;q ocrowremoe) $1111 1111... _...
<br />16 05/11/2017
<br />l RAE D EXI' (Any one personp $ 10 000
<br />PI RSONAI.. & ADV INJURY $ 1,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER: GI IgER:AI.. AGGREGA FE $ 2,000,000
<br />X POLICY PR'3. LOC 1 PRODUC I S CONAIFVOl Ar < $ 1,000,000
<br />JLC. "I'
<br />OTHER $ _
<br />AUTOMOBILE LIABILITY GJIM8TIIiEJe'$INr".'LLkfhW161 $ 1,000,000
<br />(Ea dr ritB Wi °oI)
<br />A ANY AUTO 73593885 05/11/2016 05/11/2017 BODILY INJURY (Per person) $
<br />ALL OWNED SCHEDULED BODILY INJURY (Per eccddemt)
<br />AUTOS I AUTOS
<br />X X NON OWNED PROPER v,, DANIAG $
<br />HIRED AUTOS 1111... ,... ... —..
<br />........ l AUTOS....... 11...11 ......... $
<br />X UMBRELLA LIAB X Occuisg z ( EACH OCCURRENCE $ 10,000,000
<br />I1111.. 1111...
<br />B EXCESS LIAB CI AIM MADE 79895906 05/11/2016 05/11/2017 AGGREGAFIs $ 10,000,000-
<br />DFDRETENTIONS 1111. ! ... _ 1111.._ - .....1...- - . "---1111. ....,,w ,a. �°..... 111.................... „............... .....,,,.,,
<br />WORKERS=.._._ 1111 _ „ . ......... ..............____.________
<br />C IANYDPROPRIIEEOR /PAR NOR /EXECUTIVE YIN - 71754946 05/11/2016 05111/2017 I.� Pc�plAcclr:p NT I $ 1,000,000
<br />X alru
<br />OFFICER /MEMBER EXCLUDED? I N N/ A 1 ,000,000
<br />(Mandatory In NH) E L DISEASE - EA EMPN OYEE') $
<br />If yyes, describe under
<br />!DESCRIPTION OF OPERATIONS below i E L CM EASE • G "TPLJCY LIMIT $ 1 ,000,000
<br />......... ...m. .. __. - -` --- ----- - --- -- ..- -- ---- ,- . .... _
<br />D Primary Cyber E &O G25543518001 0511112016 05/11/2017 !Limits, 15,000,000
<br />E Excess Cyber E &O 596694963 05/11/2016 1 05/11/2017 Limit: 10,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
<br />City of Santa Ana and its officers, employees, agents and volunteers are included as additional insureds in regards to their General Liability policy as
<br />required by written contract. A Waiver of Subrogation applies in favor of City of Santa Ana and its officers„ nmiployees„ a ents and volunteers with respect to
<br />the General Liability policy, as required by written contract. 9
<br />d
<br />Additional Named Insured:
<br />Ventiv Technology, Inc,
<br />lz"l
<br />Ventiv Technology Companies, Inc.
<br />,rl
<br />SEE ATTACHEDACORD101,T�
<br />- - -�
<br />... N ..� � t G7L,it�lf";!a D cAN E ,
<br />CERTIFICATE HOLDER CA_N CANCELLATION
<br />._.,�..,m SHOULD
<br />CE ... .
<br />ULD ANY OF THE ABOVE L ", � CJ�r
<br />THE EXPIRATION DATE Tf9EIEOF, NOTICE IL.L BE EL.IVE'R'.D
<br />ACCORDANCE WITH THE POLICY PROVISIONS,
<br />_. ......... ....................... ......... ... .
<br />AUTHORIZED REPRESENTATIVE
<br />City of Santa Ana r'
<br />20 Civic Center Plaza, M- 30•�°--
<br />(Santa Ana. CA 92701 n _
<br />—. .............� ........... ©.... --- ----------
<br />1988 -2014 ACORD CORP ..
<br />ORATION. All rights reserved.
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
<br />
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