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g MARSH
<br />Certificate of Insurance
<br />No.: GWLA- 2014 -63 Dated: December 11, 2014
<br />This document supersedes any certificate previously issued under this number
<br />This is to certify that the Policy(ies) of insurance listed below ( "Policy" or "Policies ") have been issued to the Named Insured identified below
<br />for the policy period(s) indicated. This certificate is issued as a matter of information only and confers no rights upon the Certificate Holder
<br />named below other than those provided by the Policy(ies).
<br />Notwithstanding any requirement, term, or condition of any contract or any other document with respect to which this certificate may be issued
<br />or may pertain, the insurance afforded by the Policy(ies) is subject to all the terms, conditions, and exclusions of such Policy(ies). This certificate
<br />does not amend, extend, or alter the coverage afforded by the Policy(ies). Limits shown are intended to address contractual obligations of the
<br />Named Insured.
<br />Limits may have been reduced since Policy effective date(s) as a result of a claim or claims.
<br />Certificate Holder: Named Insured and Address:
<br />City of Santa Ana Great -West Life & Annuity Insurance Company and its subsidiaries
<br />Finance & Management Services, 8515 East Orchard Road
<br />20 Civic Center Plaza, M17, PO Box 1985 Greenwood Village, CO 80111
<br />Santa Ana, CA 92702
<br />Atm.: c/o Francisco Gutierrez, Executive Director
<br />This certificate is issued regarding_
<br />Recordkeeping & Communication Services 457b DC Plan # 98280 -1
<br />Additional Information:
<br />City of Santa Ana is included as an Additional Insured. But the insurance provided for such Additional Insured is restricted to apply solely
<br />to liability arising out of the premises or operations referred to under said contract, and only for the location/event listed above.
<br />When required by written contract Commercial General Liability Policy no. OGLG24455105 will apply on a primary basis and will not
<br />seek contribution from the other insurance available to the certificate holder.
<br />Policy no. OGLG24455105 was placed by Seabtuy & Smith, Inc. Marsh Canada Limited has only acted in the role of a consultant to the
<br />client with respect to this placement, which is indicated here for your convenience.
<br />Notice of cancellation:
<br />The insurer(s) affording coverage under the policies described herein will not notify the certificate holder named herein of the cancellation
<br />of such coverage.
<br />lviarsll uana(da Llttllte(I Marsh Canada Limited
<br />70 University Avenue
<br />Suite 800
<br />Toronto, ON M5J 2M4
<br />Telephone: 416- 349 -4535 rpf r
<br />Fax: 416- 349- 4506'",,;:?,��"j?nr.,..,,(,:... u;.c.v.✓'t...... -.. -.
<br />kendall.r.peart @marsh.com By:
<br />Kendall Peart
<br />Cyo.p -3
<br />Policy
<br />Effective/
<br />Type(s) of Insurance
<br />Insurer(s)
<br />Number(s)
<br />Expiry Dates
<br />Sums Insured Or Limits of Liability
<br />COMMERCIAL GENERAL
<br />LIABILITY
<br />• Including Cross Liability,
<br />Contractual Liability, Personal
<br />Injury, Fire Legal Liability
<br />ACE American Insurance Company
<br />OOLG24455105
<br />Jun 01, 2014 to
<br />Jun 01, 2015
<br />Each Occurrence
<br />USD 1,000,000
<br />Aggregate with respect to
<br />Products &Completed
<br />Operations
<br />USD 1,000,000
<br />General Aggregate
<br />USD 1,000,000
<br />Additional Information:
<br />City of Santa Ana is included as an Additional Insured. But the insurance provided for such Additional Insured is restricted to apply solely
<br />to liability arising out of the premises or operations referred to under said contract, and only for the location/event listed above.
<br />When required by written contract Commercial General Liability Policy no. OGLG24455105 will apply on a primary basis and will not
<br />seek contribution from the other insurance available to the certificate holder.
<br />Policy no. OGLG24455105 was placed by Seabtuy & Smith, Inc. Marsh Canada Limited has only acted in the role of a consultant to the
<br />client with respect to this placement, which is indicated here for your convenience.
<br />Notice of cancellation:
<br />The insurer(s) affording coverage under the policies described herein will not notify the certificate holder named herein of the cancellation
<br />of such coverage.
<br />lviarsll uana(da Llttllte(I Marsh Canada Limited
<br />70 University Avenue
<br />Suite 800
<br />Toronto, ON M5J 2M4
<br />Telephone: 416- 349 -4535 rpf r
<br />Fax: 416- 349- 4506'",,;:?,��"j?nr.,..,,(,:... u;.c.v.✓'t...... -.. -.
<br />kendall.r.peart @marsh.com By:
<br />Kendall Peart
<br />Cyo.p -3
<br />
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