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A r'"'° '0 DATE (MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 212f2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLIC'IE'S BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on thin certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME Danielle Diaz _.... Arthur J. Gallagher & Co. PHONE 818 - 539' -2300 .__..._. .... ...... FAX $1 �- 539 -2301 Insurance Breakers of CA. Inc. LIC # 0726293 rvlv®w.Era)- 8 - '11oI�..... 505 N Brand Blvd, Suite 600 to ADDRESS; Danielle_D az@ajg.com .......... Glendale CA 91203 — ...__ INSURER {S) AFFORDING COVERAGE NAIC 14 INSURED Public Law Center 601 Civic Center Drive Santa Ana, CA 92701 INSURER A :Nonprofits' Insurance Alliance of C INSURER C Cr"3VFRAGFR CFRTIFI( ATF NIIMRFR• 442280832 RFVIgIC7N Nf llaal THIS IS TO CERTIFY THAT THE POLICIES OF (INSURANCE LUSTED BELOW HAVE BEEN ISSUED TO THE INSURED) NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS„ EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR LTR TYPE OF INSURANCE INSD VYP'VD POLICY NUMBER POLICY YY MMIDDIYYYY POLICY EXP MMIDDIXXYY L {MTTS A X COMMERCIAL GENERAL LIABILITY Y 20162205ONPO 211/2016 2/112017 EACH OCCURRENCE $1,000,000 CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES ®cctrrrenc50C},OiiO X . NED EXP (Any one person) ....m...m.._._ $20,000 ABUSE.._..._.__.._.._...... PERSONAL BADVINJURY $1,000,000 X '..., $1MM1$1MM '.. GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 I POLICY E�] PRO JECT u LOC PRODUCTS COMP)OPAGG $2,000,000 $ OTHER: A ALIT AUTOMOBILE 201622050NPO 2f1f2fl16 211/2017 MBINED SINGLE Eaacc�demt $1,000,000 _ ANY AUTOS URY (Per person) BODILY INJURY .___.._ $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accidenp). $. — NON-OWNED HIREDAUTOS X AUTOS X .. .._.._.__..._._ PROPERTY DAMAGE Peracctlent _ A X __.,. UMBRELLA LAB X ._.. OCCUR 2016- 22050 -UMB 2/1/2016 2112017 EACH OCCURRENCE $1,000,000 EXCESS LIAB CLAIMS -MADE AGGREGATE $1,000,000 DEC) I X RETENTION $10,1000 $ WORKERS COMPENSATION AND EMPLOYERS" LIABILITY YIN PER 0TH- STATUTE ER__ E L EACH ACCIDENT ANY PROPRIETORIIPARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? N NIA E.L. DISEASE EA EMPLOYE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E1 DPSEA'SE - POLICY LIMIT _...r._.., .__ $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHgCLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) The City of Santa Ana, its officers, employees, agents, volunteers and representatives are named additional insured with respect to the operations of the named insured per the attached CG 2026 endorsement. Such insurance is primary and non- contributory. CERTIFICATE HOLDER CANCFI I ATION @ 1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza Santa Ana CA 92701 USA AUTHORIZED REPRESENTATIVE @ 1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD