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Client#: 160973 WESTHART ACORD. CERTIFICATE OF LIABILITY INSURANCE F-DATF CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 3/19/2/DDnvrr) 3/19/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS 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 endorsement(s). PRODUCER CONTACT NAME: USI Southwest PHONE 713 490-4600 A Est: alc, Not,713.490.4700 Three Memorial City a MAIC°' 840 Gessner, Suite 600 ADDRESS: EACH OCCURRENCE $1 000000 INSURERS) AFFORDING COVERAGE NAIC# Houston, TX 77024 INSURERA: Gemini Insurance Company 10833 INSURED INSURER B: Safety National Casualty Corp 15105 Town of West Hartford 50 South Main Street INSURER C: West Hartford, CT 06107 INSURER D: INSURER E: INSURER F: MED EXP (Any one person) COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 CONTRACTOR 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. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DOIYYYY POLICY EXP MMIDDfYYYYJ LIMITS A GENERAL LIABILITY PEMOOOOOOG02 07/01/2014 07/01/2016 EACH OCCURRENCE $1 000000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence S X CLAIMS -MADE Al OCCUR MED EXP (Any one person) $ PERSONAL&ADV INJURY $ X $250,000r�yv� Retained limit GENERAL AGGREGATE $1,000,000 pp�� "y �Q/v \G✓�" q�j GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGO $ POLICY PRO ECT LOC $ AUTOMOBILE LIABILITY /+ arj .O M INEDI SINGLE LIMIT $ BODILY INJURY (Per person) $ ANY AUTO \,J�e ALL OWNED SCHEDULED HIRED SAUTOS AUTOS S�`v,ac P ((jj CC�� PC's` J ,y�r.� \"," BODILY INJURY (Per accident) $ Parreccident AMAGE $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ E%CESS LIAB CLAIMS -MADE DED RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEY/N OFFICERIMEMBER EXCLUDED? L N]NIA SP4051177 07/01/2014 07/01/201 XWC STATU-ORTH- E.L EACH ACCIDENT $1,000000 E.L. DISEASE - EA EMPLOYEE $ (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS belaw E.L. DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Effective Date: March 19, 2015 Description: Consultant Agreement- Institute of Museum and Library Services (IMLs) Leadership Grant The City of Santa Ana, its officers, employees, agents and representative are named as Additional Insured with respects to the General Liability, where required by written contract. City of Santa Ana 20 Civic Center Plaza Santa Ana, CA 92701 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 ACORD 25 (2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD #S1464981SIM12856917 BZLHA