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<br />304363
<br />'�� LP CERTIFICATE OF LIABILITY INSURANCE
<br />COVERAGES CERTIFICATE NUMBER: 19bZZ14 REVISION NUMBER: See below
<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 />DATE 71912014 vYl
<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 policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder In lieu of such endorsement(s).
<br />PRODUCER
<br />CONTACT
<br />Commercial Lines - (518) 484 -9300
<br />Wells Fargo Insurance Services, Inc. - CA Lic #: OD08408
<br />15303 Ventura Boulevard, 7th Floor
<br />PHONE FA%
<br />ic No db Alt No:
<br />E -MAIL
<br />ADDRESS,
<br />INSURERS) AFFORDING COVERAGE
<br />NAIC q
<br />Sherman Oaks, CA 91403 -3197
<br />INSURER A: Starr Surplus Lines Ins, Co.
<br />13604
<br />INSURED
<br />Ocean Blue Environmental Services., IOC,
<br />INSURER a: Starr Indemnity and Liability Company
<br />38318
<br />INSURER O:
<br />DAMAGE TO
<br />PREMISES (Ed arcs ence )
<br />925 West Esther Street
<br />INSURER D:
<br />MED SAP (Any one P.m.m
<br />INSURER E
<br />INSURER F:
<br />Long Beach, CA 90813
<br />COVERAGES CERTIFICATE NUMBER: 19bZZ14 REVISION NUMBER: See below
<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 />R
<br />TYPE OF INSURANCE
<br />ADDL
<br />SUER
<br />POLICY NUMBER
<br />M�OD�
<br />MMIODY
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE a OCCUR
<br />X
<br />SLSLEIL72035014
<br />07/0112014
<br />07/01/2015
<br />EACH OCCURRENCE
<br />$ 1.000,000
<br />DAMAGE TO
<br />PREMISES (Ed arcs ence )
<br />$ 100,000
<br />MED SAP (Any one P.m.m
<br />$ 5,000
<br />PERSONAL B ADV INJURY
<br />S 1,000,000
<br />AGGREGATE LIM IT APPLIES PER
<br />GEN ERAL AGGREGATE
<br />s 2,000,000
<br />GEN'L
<br />POLICY I JECT F1 LOG
<br />PRODUCTS - COMPIOP AGO
<br />$ 2,000,000
<br />$
<br />X
<br />OTHER: SIR: $26,000
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />SISIPCA08263414
<br />07/01/2014
<br />07/01/2015
<br />COMBINED SINGLE LIMIT
<br />S 1,000,000
<br />BODI LY INJURY (Per Person)
<br />S
<br />X
<br />ANY AUTO
<br />BODILY INJURY (Per acciden)
<br />S
<br />ALL OWNED SCHEDULED
<br />AUTOS NON OWNED
<br />HIRED AUTOS AUTOS
<br />PROPERTY DAMAGE
<br />Paraccidenl
<br />S
<br />s
<br />X
<br />MCS -90
<br />A
<br />UMBRELLA LIAR
<br />X
<br />rd
<br />OCCUR
<br />SLSLXNV73026314
<br />07/01/2014
<br />07/01/2015
<br />EACH OCCURRENCE
<br />$ 4.000.000
<br />AGGREGATE
<br />5 4.000.000
<br />EXCESS LIAR
<br />DED I X I RETENTIONS 10,000
<br />6
<br />WORKERS COMPENSATION
<br />AND EMPLOY514TUABILITY YIN
<br />I PER OTH-
<br />STATUTE ER
<br />ANY F—
<br />E.L. EACH ACCIDENT
<br />5
<br />OFFICER/MEMBER EXCLUDED ?ECUTIVE
<br />NIA
<br />(Mandatory in NMI
<br />E.L. DISEASE EA EMPLOYEE
<br />$
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS helnw
<br />E.L. DISEASE POLICY LIMIT
<br />$
<br />A
<br />Pollution Liability
<br />SLSLEIL72035014
<br />07101/2014
<br />07/01/2015
<br />Limns: $1,000,000
<br />SIR $100,000
<br />Claims Made
<br />DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be aaachad if more epaoo is required)
<br />Certificate Holder, Its officers, agents, and employees are named as Additional Insured as respects General Liability per policy forms. d
<br />This Insurance is primary and non- contribuatory with any other insurance carried by or for the benefit of the additional innssu6�,,ED �=a ".�
<br />app tJJ
<br />t City AttOrne"f
<br />I�aaa.I.rBr�
<br />City of Santa Ana
<br />Attn: Purchasing Department
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92701 -0000
<br />The ACORD name and loao are
<br />ACORD 25 (2014101)
<br />ITFI,eemaeem,emecescemn.10 10111M. eeeo, I.rlll
<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 9r �
<br />4 ACORD CORPORATION. All rights reserved.
<br />
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