Laserfiche WebLink
Ac"Rb' CERTIFICATE OF LIABILITY INSURANCE <br />�...r " 6/1/2017 <br />DATE IMMIDDIYYYY) <br />6/1/2016 <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 poI''ieies may require an endorsement. A statement on this certificate sloes not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER Lockton Insurance Brokers, LLC <br />CONTACT <br />NAME: <br />arC, Na, Ext : FAX No ): <br />E -MAIL <br />ADDRESS: <br />CA License #OF15767 <br />Two Embarcadero Center, Suite 1700 <br />San Francisco CA 94111 <br />INSURER(SI AFFORDING COVERAGE <br />NAI <br />(415) 568-4000 <br />INSURER A : Valle Forge e Insurance Company <br />2050'6 <br />6/112010 <br />/+ <br />INSURED ACTIVE. Network, LLC <br />1397685 717 North Harwood St., Suite 2500_ <br />Dallas TX 75201 <br />INSURER B : The Continental Insurance Company <br />35289 <br />INSURER C ; <br />CLAIMS -MADE I lh l OCCUR <br />I X I <br />if1 ri,Err,'D <br />INSURER E <br />DAMAGE 7O RENTED <br />PREMISES Ea occurrence <br />1 .444.. <br />INSURER F: <br />MED EXP Any person <br />15,000 <br />COVERAGES 1084882 CERTIFICATE NUMBER: 13529467 REVISION NUMBER: XXXXXXX. <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 SUBJECT TO ALL THE 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 />ADDL <br />INSD <br />SUER <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />MM DD YYY <br />POLICY EXF' <br />MMIDDIYYYY <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />Y <br />N <br />6016940273 <br />6/112010 <br />6/1/2017 <br />EACH OCCURRENCE <br />1,000,000 <br />CLAIMS -MADE I lh l OCCUR <br />I X I <br />DAMAGE 7O RENTED <br />PREMISES Ea occurrence <br />1 .444.. <br />MED EXP Any person <br />15,000 <br />- nst @..jatior l..,iab. <br />.X <br />Included <br />PERSONAL & ADV INJURY <br />$ 1,000,000 <br />GENT AGGREGATE UMIT APPLIES PER <br />GENERAL AGGREGAIE.... <br />$ 2,.400,004 <br />}�. POLICY❑ JET 7 L(7C <br />PRODUCTS - COMP /CPAGO <br />$ 2,400 „444 <br />$ <br />OTHER <br />'ALITOd3�'REtIM3P <br />S <br />t 2016 <br />6(112017 <br />COMBINED SINGLE Li MIT <br />a accident <br />$ 1.000 000 <br />FODILY INJURY (Per person) <br />$ XXXXXXX <br />'.... X ANY AUTO <br />ALL OWNED SCHEDULED, <br />AUTOS AUTOS <br />PODII.Y INJURY {Peraccident <br />$ XXXXXXX <br />PPerr acidentOAh1AGE <br />$ XXXXXXX . . -- <br />HIRED AUTOS AUT©SWNED <br />X Comp S500 X Coll S500 <br />$ XXXXXXX <br />UMBRELLA. LIiA6 <br />OCCUR <br />EACH OCCURRENCE <br />$ XXXXXXX <br />EXCESS LIAR <br />CLAIMS -MADE <br />NOT APPLICABLE <br />AGGREGATE <br />$ XXXXXXX <br />DED I I RETENTION $ <br />$ <br />1 <br />1 <br />i <br />B <br />WORKERS COMPENSATION <br />AND EMP LOYERS "LIABILITY YIN <br />ANY, PR OPRI F Cr Rry io NN) EXCLUDED? EC'UTIW.. <br />ON <br />(M atoryVin NH) F <br />NIA <br />61116'940256 <br />6/1/2016 <br />- <br />6/1/24)17 <br />PER 'PR <br />X. SfiATUTE - <br />_ <br />EL 2 <br />EACH AGKIIDEN'6' <br />.$ ...... <br />1,000,000 <br />E.V., bISEA9F - FA EIMPLO'MEE <br />1,000,000 <br />yy s <br />DESCRIPTION OF OPERATIONS LO.. <br />1.1-DIS ASL- 1'al.ICVI.-11 <br />.� <br />1,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 1..01„ Additional Remarks Schedule, may be attached if more space is required) <br />RE,, City of Santa, Ana, its officers„ agents anti eniplo c es are Additional Insured to the extent provided by the policy language or endorsement issued or <br />appro'Wed by the insurance carrier. Insurance prorride to Additional Insured(s) is primary and non - contributory as per the attached cmdorseinents or. policy <br />language. <br />1)11111 RitI IaL9 -1iN 7::c0J MIDI <br />�:. rfii"�It&IG�,y ": ill�.�l cel'1�1 7s>:711w - <br />13529467 <br />City of Santa Ana <br />Attn: PRCSA <br />20 Civic Center Plaza, M -23 <br />Santa Ana CA 92701 <br />ACORI7 25 f2014/01) <br />ate; °'p��5p 'VNyy� rX .SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE 'DELIVERED IN <br />ACC'ORDANCE.. WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />@1988-2014 ACORD CORPORA N. All rights reserved <br />The ACORD name and logo are registered marks of ACORD <br />