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ACOI " CERTIFICATE OF LIABILITY INSURANCE
<br />DATE /DDIYYYY)
<br />TYPE OF INSURANCE
<br />9
<br />05/19/2017
<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(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 LIC $0056172 1-888-845-2248
<br />CONTACT
<br />McSherry & Hudson
<br />05/19/1
<br />PHONE FAX
<br />C No Ext: 408-550-2130 AIC No: 408-550-2119
<br />160 West Santa Clara Street
<br />E-MAIL
<br />ADDRESS:
<br />Suite 715
<br />PERSONAL & ADV INJURY $1,000,000
<br />San Jose, CA 95113
<br />INSUREI AFFORDING COVERAGE NAIL #
<br />INSURERA: TRAVELERS PROP CAS CO OF AMER 25674
<br />PRODUCTS - COMP/OP AGG $2,000,000
<br />INSURED
<br />INSURER B: HISCOX INS CO INC 10200
<br />Tanko Street Lighting, Inc.
<br />LIABILITY
<br />ANY AUTO
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />HIRED AUTOS y{ NON -OWNED
<br />AUTOS
<br />DBA: Tanko Lighting
<br />C:
<br />-INSURER
<br />INSURER D:
<br />220 Bayshore Blvd,
<br />INSURER E:
<br />San Francisco, CA 94124
<br />INSURER F:
<br />BODILY INJURY (Per accident) $
<br />COVERAGES CERTIFICATE NUMBER: 49895248 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,
<br />ILTR
<br />TYPE OF INSURANCE
<br />1M
<br />SU D
<br />POLICY NUMBER
<br />POLICY EFF
<br />POLICY
<br />LIMITS
<br />A
<br />GENERAL LIABILITY
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE Ix I OCCUR
<br />X
<br />X
<br />630-4E925604-17
<br />05/19/1
<br />05/19/18
<br />EACH OCCURRENCE s2,000,000
<br />AMAGE TO RENTED
<br />PREM SES Ea occurrence) $100,000
<br />MED EXP (Any one person) $10,000
<br />PERSONAL & ADV INJURY $1,000,000
<br />GENERAL AGGREGATE $4,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />X POLICY PEO LOC
<br />PRODUCTS - COMP/OP AGG $2,000,000
<br />$
<br />A
<br />AUTOMOBILE
<br />X
<br />X
<br />LIABILITY
<br />ANY AUTO
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />HIRED AUTOS y{ NON -OWNED
<br />AUTOS
<br />X
<br />X
<br />BA -8470L003-17
<br />05/19/1
<br />05/19 18
<br />Ee Mold DtSINGLE LIMIT 1,000,000
<br />_
<br />BODILY INJURY (Per person) $
<br />BODILY INJURY (Per accident) $
<br />PROPERTY DAMAGE $
<br />Per accident
<br />$
<br />A
<br />X
<br />UMBRELLA LIAB
<br />EXCESS LIAB
<br />X
<br />OCCUR
<br />CLAIMS -MADE
<br />CUP -4J603425-17
<br />05/19/1
<br />05/19/18
<br />EACH OCCURRENCE $ 3,000,000
<br />AGGREGATE $ 3,000,000
<br />DED J I RETENTION $
<br />$
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITYf
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE YIN
<br />OFFICER/MEMBER EXCLUDED?
<br />(Mandatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />N I A
<br />X
<br />UB -4E963854-17
<br />05/19/1
<br />05/19/18
<br />X WOCSTATU- 0TH -
<br />RY LIMIT.,ER
<br />E.L. EACH ACCIDENT $ 1,000,000
<br />EL. DISEASE - EA EMPLOYE $ 1,000,000
<br />E.L. DISEASE - POLICY LIMIT $ 1,000,000
<br />B
<br />Professional E&O
<br />MPL 4 5 4.17
<br />0
<br />1
<br />Eac Aggregate 2,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
<br />RE: Analyses.
<br />Additional Insureds: City of Santa Ana, its City Council, boards, commissions, their officers, employees and agents.
<br />REVIEWED BY: 61XX EUNICE HEREDIA (PG I OF �I)
<br />[rJq►tll7l91alli Oil] aa
<br />City of Santa Ana
<br />Attn: Ross Annex
<br />Civic Center Plaza, 3rd Floor Reception
<br />Santa Ana, CA 94087
<br />USA
<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 />6��o
<br />©1988-2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
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<br />49895248
<br />
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