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OP ID: MB
<br />�lAR®' CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MM12 6
<br />08/03/2015
<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(ies) 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 />Brown & Brown of Florida, Inc.
<br />P. O. Box 173056
<br />Tampa, FL 33672
<br />Joseph W. LoPrestl
<br />CNTNAMEACT Mia Bush
<br />PHONE gq3-226.1337 FAx
<br />(AIC No EM: AIc No: 813-226.1313
<br />E-MAIL
<br />ADDREss'Rmbush bbtam a.com
<br />CUSTOMER 10 k: HOLLA-4
<br />INSUrl AFFORDING COVERAGE NAIC#
<br />INSURED Holland & Knight LLP
<br />INSURERA: Federal Insurance Company 20281
<br />Holland & Knight Charitable
<br />Foundation Inc.
<br />100 North Tampa Street St 4100
<br />Tampa, FL 33602
<br />INSURERS SentryInsurance 24988
<br />INSURER C: Fed.lns Co/Liberty Ins Und
<br />INSURER D: Great Northern Insurance 20303
<br />INSURERS,
<br />'N1
<br />INSURER F
<br />COVERAGES CERTIFICATE NUMBER: REVISIONNUMBER-
<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 />A
<br />POLICVNUMBER
<br />POLICY EFF
<br />MMIDDIYYYVI
<br />POLICY EXP
<br />IMMIDAYYYYI
<br />LIMITS
<br />GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 1,000,00
<br />D
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE ® OCCUR
<br />35798711
<br />08/01/2015
<br />08/01/2016
<br />PREMISES Eaoccurrence
<br />S 1,000,00
<br />MED EXP(Anyone person)
<br />$ 10,000
<br />X Insured Contract
<br />PERSONAL&ADV INJURY
<br />$ 1,000,000
<br />GENERALAGGREGATE
<br />$ 2,000,00
<br />GEHL AGGREGATE LIMIT APPLIES PER:
<br />PRODUCTS - COMPIOP AGG
<br />$ Included
<br />POLICY PIFCTRO X LOC
<br />S
<br />D
<br />AUTOMOBILE
<br />X
<br />LIABILITY
<br />ANYAUTO
<br />74986035
<br />08/01/2015
<br />08/01/2016
<br />COMBINEDSINGLE LIMIT
<br />(Ea acddem)
<br />5 1,000,00
<br />BODILY INJURY (Per person)
<br />$
<br />ALL OWNED AUTOS
<br />BODILY I NJ URY(Per accldI
<br />$
<br />X
<br />SCHEDULEDAUTOS
<br />HIREDAUTOS
<br />(PER AC /DENT)DAMAGE
<br />(PER ACCIDENT)
<br />$
<br />X
<br />NON-OWNEDAUTOS
<br />$
<br />X
<br />No Owned Autos
<br />$
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />EACHOCCURRENCE
<br />$ 49,000,000
<br />C
<br />EXCESS uAB
<br />CLAIMS -MADE
<br />79818355/1000053016-03
<br />08/01/2015
<br />08/01/2016
<br />AGGREGATE
<br />$ 49,000,000
<br />DEDUCTIBLE
<br />$
<br />$
<br />RETENTION $
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETOR/PARTNEWEXEOUTIVE YIN
<br />OFFICERIMEMBER EXCLUDED?
<br />NIA
<br />901492301/9014920302
<br />08/01/2015
<br />08/01/2016
<br />WC
<br />X TORS LI ITS OER
<br />eL. EACH ACCT
<br />IDEN
<br />$ 1,000,00
<br />EL DISEASE-EAEMPLOYEE
<br />$ 1,000,00
<br />(Mandatory In NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E. L. DISEASE -POLICY LIMIT
<br />$ 1,000,00
<br />DPersonal
<br />D
<br />Property
<br />Data Process.Equip
<br />35798711
<br />35798711
<br />08101/2015
<br />08101/2015
<br />08/01/2016
<br />08/01/2016
<br />Spec'Form 116,079,000
<br />Spec.Form `r! j 11,116,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORO 101, Additional Remarks Schedule, if more space is renal red)
<br />See "Certificate Attachment - Holland & Knight, LLP dated 8-1-15" attached.
<br />0� Alt
<br />CITYSAN
<br />City of Santa Ana
<br />David Cavazos, City Manager
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92701
<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 />11�vwl &411
<br />©1988-2009 ACORD CORPORATION. All rlchts reserved
<br />ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD
<br />
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