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- „,�..QLACEWORKS AGR # TBD REVIEWED BY: r EUNICE HEREDIA (PG 1 OF 7)
<br />A�&� CERTIFICATE OF LIABILITY INSURANCE
<br />AT9(Mote men
<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 />EELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED.
<br />REPRESENTATIVE OR PRODUCER, AND T14E CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the polfcy(les) must be endorsed. If SUBROGATION IS WAIVED, sub)eot 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 Ifeu of such endomement(s ).
<br />PRODUCER
<br />Marsh Risk & Insurance Services
<br />17901Von Kalman Avenue 8ulle1100
<br />(949) 3995000; L1ca- nse #N7153
<br />1949, CA 92614
<br />CONTACT
<br />NAMI
<br />PRO TO.Esfi: FAR xo:
<br />E-MAIL - -” "-
<br />ADDRESS:
<br />INSURERM AFFORDING COVERAGE
<br />-
<br />NAIGa
<br />X
<br />INSURER A: DDIM a FOmhr SPA01811Y haamnce 00
<br />44520
<br />980627.01.01.161.16
<br />INSURED
<br />PIBGBWelk9
<br />INSURER 0:Thuffigr5 Property Casualty Company OlAmerlaa
<br />2.5.674
<br />INSURER C:
<br />$ 6000,000
<br />Dba: The Planning Center
<br />Design Continually & Envlornment
<br />S Maukthur Place, Suite 1100
<br />INSURER D:
<br />$ 50,000
<br />X
<br />MED EXP An one orlon)
<br />Santa Ana, CA 92707
<br />INS F:
<br />PERSONAL &AOV INJURY
<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 MAYRAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR
<br />_
<br />"TYPEOFINBUYtANCE -
<br />__... __. __ _.
<br />POUDYNUMBER
<br />_
<br />M CO
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERALLIAEILITY
<br />CLAIMS -MADE OCCUR
<br />01 & PD Dad, $5.000
<br />X
<br />X
<br />EPK-09168
<br />0710112015
<br />0710112016
<br />EACH OCCURRENCE
<br />$ 6000,000
<br />RE e S Eon
<br />$ 50,000
<br />X
<br />MED EXP An one orlon)
<br />S 5,000
<br />PERSONAL &AOV INJURY
<br />GENL AGGREGATE LI MIT APPLIES PER
<br />POLICY JFCT I� we
<br />OTHER:
<br />GENERAL AGGREGATE
<br />PRODUOTa- COMP /OPAGG
<br />ConUactors Pollution
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />ANYAUTO
<br />AUTOOSNEO AUT09N ED
<br />HIRED AUTOS NON- 8WINEO
<br />AUTOS
<br />X
<br />X
<br />BA7E37618715CAC
<br />07!0112016
<br />07;0112016
<br />0 BIrI D I G ELIMIT ea acnldant
<br />q51,00D,000
<br />BODILY INJURY(Perpoosm)
<br />BODILY INJURY(Peracaldam)
<br />PRO ftTYDAMAGE
<br />Per ecU race
<br />X
<br />UMBRELLAUAe
<br />EXCESS LIAR
<br />X
<br />OCCUR
<br />CIAINIB-MAOE
<br />EX- 7E376167-TIL -15
<br />0710112015
<br />07;0112016
<br />EACH OCCURRENCE
<br />§ 4,a66,6g6
<br />AGGREGATE
<br />$ 4,000,000
<br />DED
<br />RETENTION
<br />§.
<br />B
<br />ANDEMRSCOMPENATION YIN
<br />ANY PROpRIETOPUPARTPIERIEXECUTIVE f N
<br />OFFICER /MEMBER EXCLUDED? (. �,)
<br />(Mandatory in NH)
<br />Iryae deswlUe under
<br />OESCF2IPTION OF OPERATIONS UOImv
<br />NIA
<br />U8- 7E37616.7 -15
<br />!01205
<br />0710112016
<br />X sER u. H
<br />E.L. EACH ACCIDENT
<br />$, 1,000,000
<br />E.L. DISEASE-EA EMPLOYEE
<br />$ 1,000,000
<br />E.L. DISEASE - POLICY LIMIT
<br />R 1,000,000
<br />A
<br />Errous; lsslcnh Clelms Made
<br />EPK- 109158
<br />0710112019
<br />07/0112016
<br />Each ClalmlAggregate 6,000,000
<br />DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES 1ACORD 101, Addmonal Remarks Schedule, MAy De eUAahod If morn apaco le roqulred)
<br />Re: Operations performed by the named Insured for the cenl0oeteholder
<br />City of Same Ana, Its ol6cem, egank, employees, and volunisem are Included as addl0unal Insured ebore required by writlsn conlraolwith mapedt to Cenral and Auto Liability. This Insurance Is pridearf and non -
<br />conhihalory near any existing Insurt nce and ilm ud to liability sdlsing out ofthe oparetlons of the named insured and where required by wdlten contract vdth respect D General Llnbil[IA Walverof subrogation Is
<br />applicable whom rankled by vidken conimcl with respect to General and Auld 11011iy,
<br />City of Santa Ana
<br />20 Civic Center Plan, M -36
<br />Santa Ana, CA 92.701
<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 POLICYPROVISIONS,
<br />AUTHORIZED REPRESRNTATIVE
<br />of Marsh Risk &hmuranoo Services
<br />John Greet
<br />O 1988.2014 ACORD CORPORATION. All richta
<br />ACORD 25 (2014161) The ACORD name and logo are registered marks of ACORD
<br />
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