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URBAFUT-01 JDERCOLE <br />,a ° CERTIFICATE OF LIABILITY INSURANCE <br />11`1 <br />OATE(MMI00/'1 YV) <br />vsnol s <br />_ <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(les) 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 />Brown & Brown of New York Inc. <br />800 Westchester Avenue, N311 <br />CONTACT <br />NAME: <br />PHONE 914 337-1833 FAx <br />FlIC No Ext:( I A/c No: (914) 337.1596 <br />Rye Brook, NY 10573 <br />EMAIL <br />ADDRESS: y info bbinsn com <br />INSURER(S) AFFORDING COVERAGE <br />NAICN <br />INSURERA:Executive Risk Indemnity Inc (Chubb) <br />35181 <br />INSURED / / <br />INSURER B: <br />Urban FUfnfeS, Inc. ✓ <br />3111 North Tustin <br />INSURER C: <br />SUITE 230 <br />INSURER D: <br />INSURER E: <br />Orange, CA 92866 <br />INSURER F' <br />COVERAGES CERTIFICATE NUMBER: 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 SUBJECTTOALLTHE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADDLSUBR <br />INSD <br />WVD <br />POLICYNUMBER <br />POLICY EF <br />MMIDDIYVT( <br />POLICY EXP <br />MMIDDNYYY <br />LIMITS <br />COMMERCIAL GENERAL LI ABILITY <br />NCE $ <br />CLAIMS -MAGE OCCUR <br />currence $ <br />M(Edoccu�snde) <br />e person) $ <br />INJURY $ <br />AGGREGATE LIMIT APPLIES PER: <br />POLICV ❑PRP ❑LOC <br />ECT <br />EGATE $ <br />GEN'L <br />PRODUCTS-COMPIOP AGC $ <br />$ <br />OTHER'. <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT $ <br />Ea accMent <br />BODILY INJURY (Per person) $ <br />ANY AUTO <br />ALLOWNE <br />AUTOS AUTOS SCHEDULED <br />BODILY INJURY ( Par accident)$ <br />HIREDAUTOS NON -OWNED <br />AUTOS <br />PROPERTY DAMAGE $ <br />Peraccident <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE $ <br />AGGREGATE $ <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED RETENTION$ <br />$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETORIPARTNER/EXECUTIVE <br />OFFICERIMEMBER EXCLUDED? n <br />_T <br />NIA <br />PER OTH- <br />STATUTE ER <br />E, L. EACH ACCIDENT $ <br />i.. DISEASE L-A GNPLOYEc $ <br />i(PJlantlelar/ W Nn) <br />If yes, describe under <br />J_. DISEASE -POLICY LIP.IIT $ <br />_ <br />DESCRIPTION OF OPERATIONS below <br />A <br />Errors & Omissions <br />R <br />6801.9352 <br />12/2312016 <br />1212312016 <br />Aggregate Limit 2,000,000 <br />A <br />Errors & Omissions <br />6801-9352 / <br />12/23/2016 <br />12/2312016 <br />Retention Each Claim 50,000 <br />✓ <br />✓ <br />DESCRIPTION OF OPERATIONSI LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if morespare is required) <br />City of Santa Ana is listed as an Additional Insured under the Errors & Omissions Liability policy. Waiver of Subrogation is included, <br />CERTIFICATE HOLDER CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />City of Santa Ana <br />Attn: Teresa Ramirez <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 Civic Center Plaza <br />AUTHORIZED REPRESENTATIVE <br />Santa Ana, CA 92701 <br />r <br />©1988-2014 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD '�� /�� <br />�t/ 3 <br />