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<br />CERTIFICATE OF LIABILITY INSURANCE J
<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(ites) 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 enclorsernent(s),
<br />PRODUCER CONTACT
<br />MARSH USA INC. NAME:.....
<br />FAX
<br />1050 CONNECTICUT AVENUE, SUIT E 700, (Arc, No, Ext): FAIC, No).
<br />INASHINGTON, DC 20036-5386 AE-MDAIL
<br />DI
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC Ii
<br />040356-FINPR-FD+FI-16-17
<br />INSURER A
<br />ee Pho'X r'SUranCe CouTailY
<br />�25623
<br />INSURED
<br />INSURER B
<br />NIA
<br />ICVA RETIREMENT CORP
<br />ATTN. UJUANA THOMAS
<br />INSURER C
<br />llavplers Casually IfsUfanCe CO3 01 America
<br />19046
<br />777 NORTH CAPITOL ST, NE
<br />INSURER D.
<br />Fedeial Insurance Company
<br />i
<br />�20281
<br />WASHINGTON, DC 20002
<br />INSURER E
<br />St. Paul Fire & I Insurance Co
<br />24767
<br />COVERAGES CERTIFICATE NUMBER: CLE-004640666 23 REVISION NLJMRFR-5
<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
<br />WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL.
<br />"THE TERMS
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN
<br />REDUCED BY PAID CLAIMS
<br />INSR ADDLSUBRI
<br />POLICY EFF POLICY EXP
<br />LTR TYPE OF INSURANCE INSD VVVO POLICY NUMBER
<br />IM 4ID01Yyyyl tMMIDE)Iyyyyl LIMITS
<br />A X COMMERCIAL GENERAL LIABILITY
<br />j6306E588375
<br />W01/2015
<br />08/01/2016 FACT I OCCURRENCE is
<br />1000 000
<br />x
<br />DAMTO TE D i
<br />RE N
<br />CLAIM, MADE I OCCUR
<br />PREIAGE
<br />occurrence) 5
<br />1.000000
<br />X CONTRACTUAL COV INCL.
<br />MED EXP (Any one person) S
<br />10,000
<br />I
<br />PERSONAL & ADV INJURY S
<br />1,000,000
<br />GENT AGGREGATE jIMIT APPLIES PER
<br />GENERAL AGGREGATE
<br />2000000
<br />X FOC PRO
<br />POLICY JFCY I
<br />PRODUCTS - COMPIOP AGG
<br />2,000.000
<br />1 OTHER:
<br />AUTOMOBILE LIABILITY1
<br />COMBINED SUIX31-F, LIMIT
<br />(Ea accidpnll
<br />I! ANY AUTO
<br />BODILY INJURY (Per person)
<br />LI, OWNED SCHEDULED
<br />A AUTOS I, AUTOS
<br />BODILY INJURY (Per accldeW) $
<br />NON -OWNED
<br />PROPERTYDAMAGE
<br />HIRED AUTOS AUTOS
<br />(Per accident)
<br />UMBRELLA LIAS i OCCUR
<br />EACH OCCURRENCE s
<br />EXCESS i
<br />AGGREGATE $
<br />DED RETENTION S
<br />C
<br />WORKERS COMPENSATION
<br />UB6508MB94
<br />08/01015
<br />00112016 PER OTH-
<br />AND EMPLOYERS' LIABILITY YIN
<br />E
<br />SIATUrER
<br />ANY PROPRIETORYPARTNER)EXECUTIVE
<br />i
<br />E1 EACH! ACCIDENT
<br />S
<br />1,000,000
<br />OFFICEFUMEMBER EXCLUIDEW FE
<br />N/A
<br />(Mandatory in NH)
<br />I E.L. DISEASE - EA EMPLOYEE
<br />1,000,000
<br />If yes d scribe urder.
<br />0
<br />I DESCRIPTION OF OPERATIONS below
<br />I E L DISEASE - POLICY LIMIT
<br />1,000,000
<br />D
<br />BANKERS PROF HAB
<br />8211-6261
<br />106/3012016
<br />106130017 $7 500,000 P/0 $12500,000
<br />F
<br />SIR $1,000,000
<br />7PL-71M07549-16-N2
<br />i D613012016
<br />106130/2017 $5,000,000 p/o $12,500,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may
<br />be attached R mare space is required)
<br />cry I H-PI/A 1 1: r1ULUII k,,AI'0,r-LI-A I IUN
<br />CIITY OF SANTA ANA
<br />ATTN: EXECU TIVE DIRECTOR OF PERSONNEL SVS
<br />20 CIVIC CENTER PLAZA M-34
<br />SANTA ANA, CA 92702
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS,
<br />AUTHORIZED REPRESENTATIVE
<br />of Marsh USA Inc.
<br />Manashi MUli _r-`L.--.—
<br />(0 1988-2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
<br />
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