INTERNATIONAL CITY MANAGEMENT ASSOCIATION RETIREMENT CORPORATION (ICMA) (CITY MANAGER) 1C -2015

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® DAM (MMIDD/YYYYI CE TI ICATE ®F LIA ILITY INSU NCE OB D420,4 IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS THIS CERTIFICATE CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endomement(s). .ODUCER - CONTACT NAME: PHONE FAX aIc No: MARSH USA INC. SUITE400 E-MARESS: 1255 23RD STREET, N.W. INSURERS AFFORDING COVERAGE NAIC # WASHINGTON, DC 20037 INsuRER A : Phoenix Insurance Company 25623 10356—EO+FI-1415 SURED INSURERS: NIA NIA INSURER O: Travelers Casualty Insurance Co. Of America 19046 ICMA RETIREMENT CORP. ATTN: DJUANATHOMIAS 777 NORTH CAPITOL ST., NE INSURER 0 Federal Insurance Company 20281 INSURER E: St. POUI Fire & Marine Insurance Co. 24767 WASHINGTON, DC 20002 gilm F: nicr�reicery A-ra all lannco. CIP-M771g194-1F REVISION NUMBER:5 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. EOFINSURANCE LIABILITY ADOL SUER wyn POLICY NUMBER 6306E588375 M-0IDDYEFF OBI011Z014 MWDDIYYYY 0810112015 LIMITS EACH OCCURRENCE $ 1,000,000 -RENTED ITAMAGE TO PREMISES Eacccuence $ 1,000,000 IAL GENERAL LWBILTIY S-MADE � OCCUR UAL COV. INCL. WEILOC MED EXP(Any one person) $ 10,000 PERSONAL &ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 ATE LIMIT APPLIES PER: PROOUCTS- COMPIOP AGG $ 2,000,000 $ PRO- JECTLOC MOBILE "ABILITY COMBINED SINGLE LIMIT 'Ea accident BODILY INJURY (Per person) $ NYAUTO BODILY INJURY (Per accident) $ FALLOWNED SCHEDULED AUTOS AUTOS NON OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ UMBRELLA "AB OCCUR EACH OCCURRENCE S AGGREGATE s EXCESS UAB CLAIMS-MADEI DED RETENTION$ a C WORKERS COMPENSATION U86508M894 08/0112014 0810112015 X I WC STATU- I OTH- E.L. EACH ACCIDENT $ 1,000,000 AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE N OFFICERIMEMBER EXCLUDED? (Mandatory in NH) If yes, desaibe under DESCRIPTION OF OPERATIONS bola. NIA E.L. DISEASE -EA EMPLOYE $ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 D BANKERS PROF. LIAR. 8211-6261 06/3012014 0613012015 $7,500,000 plo$12,500,000 E SIR: $1,000,000 7107549 0013012014 0613012015 $5,000,000 pro $12,500,000 IESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Addhional Remarks Schedule, If more space is required) CITY OF SANTA ANA ATTN: EXECUTIVE DIRECTOR OF PERSONNEL SVS 20 CIVIC CENTER PLAZA M-34 SANTA ANA, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. ACORD 25 (2010105) Manashi Mukhedeea-^ate- ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD