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<br />Ac rraiao° CERTIFICATE OF LIABILITY INSURANCE DAT1281201DN5
<br />7!28125
<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 License # 0584249
<br />ieffeman Insurance Brokers
<br />i Hutton Centre Drive, Suite 600
<br />II.FirI T#]
<br />Human Options
<br />5640 -A Trabuco Road
<br />Irvine, CA 92920
<br />:(S) AFFORDING COVERAGE NAIC#
<br />Insurance Alliance of California 01184
<br />Berkshire Hathaway Homestate Insurance Company
<br />COVERAGES CERTIFICATE NUMBER:
<br />REVISION NUMBER:
<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 CONTRACTOR 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 />LTq PE OFINSURANCE p POLICY NUMBER
<br />MM /DONYYV MMIODVYYY LIMITS
<br />A X
<br />I COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE $ 1,000,000
<br />CLAIMS -MADE 11 OCCUR X 201401143
<br />09/23/2014 09/23/2016
<br />PREMISES Eaoccurrence 1 $$ 500,000
<br />MED EXP(Any one person) $ 20,000
<br />PERSDNALd ADVINURY Is 1,000,000
<br />00TILAGGREGATE
<br />LnJ7 APPLIES PER:
<br />CENERALAGGRECATE s 3,000,000
<br />POLICY JJEECCT X LOO
<br />I PRODUCTS COMPIOPAGG $ 2,000,000
<br />OTHER,
<br />EXUAL MISCONDU $ 1,000,000
<br />AUTOMOBILE LIABILITY
<br />COMBINED SINGLE LIMIT $ 1,000,000
<br />Ea accident
<br />_
<br />BODILY INJURY (Per person) $
<br />A ANYAUTG 201401143
<br />09/23/2014 09/2312015
<br />_
<br />ALL OWNED SCHEDULED
<br />BODILY INJURY (Pe, axid.,tl $
<br />X AUTOS X - NON -OWNED
<br />PROPERTY DAMA P-`� $
<br />HIRED AUTOS AUTOS
<br />Rer acci�snt
<br />)( UMBRELLA LIAR X OCCUR
<br />EACH OCCURRENCE $ 5,000,000
<br />A EXCESS LIAB CLAIMS -MADE 201401143UMB
<br />09/23/2014 09/23/2016
<br />AGGREGATE $ 6,000,000
<br />PER I X I RETENTION $ 10,000
<br />$
<br />WORKERS COMPENSATION
<br />PE
<br />X STATUTE ER
<br />AND EMPLOYERS LWBIWTY
<br />B UWC601628
<br />RARTNERAI ECUTIVE Y ®N
<br />0410112016 0410112016
<br />EL EAC AGIGCiDUU $ 1,000,000
<br />GNICE� EM Eire to
<br />1,000,00
<br />(Mandatory in NH)
<br />E. L. DISEASE EA EMPLOY $
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />EL DISEASE - POLICY LIMIT $ 1,000,000
<br />• Professional Liabili 201401143
<br />09/23/2014 09/2312015 Occurence 1,000,000
<br />• Sexual Misconduct 201401143
<br />09123/2014 09/23/2016 Occurrence 1,000,000
<br />DESCRIPTION OF OPERATIONS! LOCATIONS [VEHICLES (ACORD 161, Addalonai Remarks Scbedi ns,
<br />maybe attached If mare space Is mquImd)
<br />Re: As per Contract or Agreement on file with Insured. The City of Santa Ana, its officers, employees, agents and volunteers and representatives are named
<br />as additional insureds. With respect to claims arising out of the operations and uses performed by or on behalf of the named insured, such insurance as is
<br />afforded by this policy is primary and is not additional to or contributing with any
<br />other Insurance carried by or for the benefit of the additional insureds,`
<br />s �0�Al
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City f Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />Y ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Community Development Agency
<br />20 Civic Center Plaza, M -25 — -
<br />Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE
<br />©1988 -2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
<br />
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