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<br />acoR`72* 111 IFICATE OF LIABILITY INSURANCE
<br />DATE(MW/0221201512015YYY)
<br />THIWP ED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CER rF �y,QI AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BEL E 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 />Aon Risk Services Northeast, Inc.
<br />Boston MA Office
<br />CONTACT
<br />NAME:
<br />)AIC No. Ext): (866) 283-7122 aC. Ni (800) 363-0105
<br />One Federal Street
<br />Boston MA 02110 USA
<br />E-MAIL
<br />ADDRESS:
<br />INSURER(S) AFFORDING COVERAGE NAIC N
<br />Santa Ana
<br />INSURED
<br />INSURER A: The Charter Oak Fire Insurance Company 25615
<br />IDEXX Laboratories, Inc.
<br />INSURER B: Travelers Property Cas Co Of America 25674
<br />One IDEXX Drive
<br />Westbrook ME 04092-2041 USA
<br />INSURER C: Federal Insurance Company 20281
<br />INSURER D: NoetiC Specialty Insurance c0 17400
<br />INSURER E:
<br />PREMISES Es occurrence $2,000,000
<br />INSURER F:
<br />ULPILKAGOS GCKIIFICA fE NUMBER: b/UUDBbt44ZU5 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 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. Limits shown are as requested
<br />LTR
<br />TYPE OF INSURANCE
<br />INSD
<br />WVD
<br />POLICY NUMBER
<br />MMIDDIYYYY
<br />MMIDDIYYYV LIMITS
<br />C
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />Santa Ana
<br />36019228
<br />U6/30/20J.
<br />6/ 01201 EACH OCCURRENCE $2,000,000
<br />CLAIMS -MADE R❑OCCUR
<br />PREMISES Es occurrence $2,000,000
<br />MED EXP (Any one peson) $10,006
<br />PERSONAL &ADV INJURY $1,000,000
<br />GENERAL AGGREGATE $2,000,000
<br />GEN-LAGGREGATE LIMITAPPLIES PER:
<br />POLICY ❑X PRO [ X] LOC
<br />JECT
<br />PRODUCTS - COMP/OP AGG EXcl Uded
<br />OTHER:
<br />C
<br />AUTOMOBILE LIABILITY
<br />7358-07-90
<br />06/30/201506/30/2016
<br />COMBINED SINGLE LIMIT $1,000,000
<br />Ea accident
<br />X ANY AUTO
<br />BODILY INJURY( Per person)
<br />ALL OWNED SCHEDULED
<br />BODILY INJURY (Per accident)
<br />AUTOS AUTOS
<br />HIREDAUTOS NON -OWNED
<br />- PROPERTY DAMAGE
<br />AUTOS
<br />Peraccident
<br />C
<br />X
<br />UMBRELLA LIAR
<br />X
<br />OCCUR
<br />79890079
<br />06/30/2015
<br />06/30/2016 EACH OCCURRENCE $10,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />AGGREGATE $10,000,000
<br />DED I IRETENTION
<br />A
<br />WORKERS
<br />LIABILATION AND
<br />Tc20UBIOIDIC0615
<br />01/01/2015
<br />01/01/2016 X STATUTE ERH
<br />EMPLOYERS YIN
<br />WE (AOS)
<br />B
<br />ANYPROPRIETORI PARTNER/ EXECUTIVE
<br />NIA
<br />TR]UB1U1D101$15
<br />U1/D1/2g1$
<br />E.L, EACH ACCIDENT $1,000,000
<br />D1/D 1/2D16
<br />OFFI CERIMEMRER EXCLUDED'
<br />(Mandatory in NH)
<br />WE (MA,WI)
<br />E.L. DISEASE -EA EMPLOYEE $1,000,000
<br />If yea describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE -POLICY LIMIT $1,000,000
<br />o
<br />Products Liab
<br />NISME380003
<br />06/30/2015
<br />06/30/2016 Aggregate $10,000,000
<br />SIR applies per policy ter if
<br />s & conditions
<br />Per Occurrence $10,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be atteehed if more space is required)
<br />The City of Santa Ana and their respective officers, employees, agents, volunteers and representatives are included as
<br />Additional Insured on the General Liability policy, but only with respect to liability caused by the acts or omissions of IDEXX
<br />Laboratories Inc. in the performance ongoing operations of or in connection with premises owned or rented by IDEXX Laboratories
<br />Inc. coverage afforded by the General Liability policy shall be Primary and Nan -contributory for the Certificate Holder with
<br />respect to work performed by IDEXX Laboratories Inc.
<br />CERTIFICATE HOLDER
<br />CANCELLATION
<br />©1988.2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
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<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
<br />EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE
<br />POLICY PROVISIONS.
<br />The City
<br />Of Santa Ana
<br />AUTHORIZED REPRESENTATIVE
<br />20 Civic
<br />Center Plaza - M23
<br />Santa Ana
<br />CA 92701 USA
<br />C.J4r07b a/LGNG e/f42Ki"64 c/ /CCI ✓ 92Q
<br />©1988.2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
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<br />95
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