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<br />CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MMIDDIYYYY)
<br />10/1512015
<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 Tech Serve Alliance Services Corp.
<br />1420 King Street; Suite 610
<br />AleXandrta,A 22314
<br />NAMEACT
<br />PHONE FAX
<br />N x : 703 -997 -4271 {AFC No): 703.997.7727
<br />E -MAIL
<br />ADDRESS:
<br />INSURER (S) AFFORDING COVERAGE
<br />NAIC #
<br />�/'
<br />www.techserveallilance.org
<br />INSURER A : Star Insurance Company
<br />6!15/2015
<br />INSURED
<br />Comdyn Group Inc., The
<br />100 E, Thousand Oaks Blvd.
<br />INSURER B: ProCentury Insurance Company
<br />$ 1,000,000
<br />Irlsu�e� c
<br />CLAIMS -MADE ® OCCUR
<br />Suite 284
<br />INSURER D : National Specialty Insurance Company
<br />Thousand Oaks CA 91360
<br />_.._
<br />INSURER E :
<br />INSURER F
<br />$ 1,000,000
<br />COVERAGES CERTIFICATE NUMBER: 26942735 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 />INSR
<br />LTR
<br />TYPE OF INSURANCE....
<br />ADDL
<br />SU'..BR
<br />POLICY NUMBER.
<br />POLICY IIYYYY
<br />7M�FDdfY'rYPY
<br />.. LIMITS
<br />D
<br />*/
<br />COMMERCIAL GENERAL LIABILITY
<br />�/'
<br />NDA0791984
<br />6!15/2015
<br />6/15/2016
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />CLAIMS -MADE ® OCCUR
<br />DAMAGE TO RENTED
<br />PREMISES Ira occlarrenoe'
<br />$ 1,000,000
<br />MED EXP IAny one person)
<br />$ 10.,000
<br />PERSONAL : ADV INJURY'
<br />$ 1,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />✓ POLICY I JECT PRO-
<br />LOG
<br />PRODUCTS ..- COMPIOPAaiG
<br />2,0'00 000
<br />$
<br />OTHER:
<br />D
<br />AUTOMOBILE
<br />...
<br />LIABILITY
<br />/
<br />NDB0791984
<br />6/15/2015
<br />6/15/2016
<br />C4)MaINFD SINGLE LIMIT
<br />Eaacc'udent
<br />� 1,000,000
<br />_..
<br />BODILY INJURY' (Per person) ..,..,$
<br />.....
<br />ANY AUTO
<br />ALLLIWNED SCHEDULED
<br />AUTOS AUTOS
<br />BODILY INJURY (Per accident)
<br />$
<br />PROPERTY DAMAGE-
<br />Per accident.
<br />$
<br />NON -OWNED
<br />HIRED AUTOS ✓ AUTOS
<br />A
<br />UMBRELLA LAB
<br />✓
<br />OCCUR
<br />UM0791984
<br />6/15/2015
<br />6115/20,16
<br />EACH OCCURRENCE
<br />„ YAGGREGATE_._
<br />$ 1,000,000
<br />EXCESS LAB
<br />CLAIMS- MADE
<br />_..
<br />$ 1,000,000'...
<br />DED I ✓ I RETENTION' $10,000
<br />'.,.... $ .. .
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETORIPARTNERJEXIECUTIVE — YIN --
<br />WC0791984
<br />6/1512015
<br />611,5/2016
<br />,/` STATUTE OTRH-
<br />..-
<br />E.L EACH ACCIDENT
<br />Iii $ 1 ,0000000
<br />OFFICERIMEMBER EXCLUDED? ❑
<br />'... (Mandatory in NH)
<br />NIA
<br />... ....... ......
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />If yes describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE. - POLICY LIMIT
<br />�..._..,__.__.
<br />$ 1,000,000
<br />D
<br />!E&O/Professional Liab
<br />NDA0791984
<br />6/15/2015
<br />(311512016
<br />$1,000,000 Ea Claim /$1,000,000 Aggregate
<br />A
<br />Crime - 3rd Party Blanket
<br />CR0791984
<br />6/15/2015
<br />6/15,2016
<br />$25,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES IACORDII 101, Additional Remarks Schedule, may be attached If more space is required)
<br />City of Santa Ana,. its Officers, Agents and Employees are Additlonal Insured as respects to General Liability
<br />per attached CG2010 1093 Additional Insured Endorsement. 'Should any of the above described policies be cancelled or reduced before the expiration
<br />date thereof, the issuing insurer and/or agent will endeavor to mail 30 days written notice the the Certificate Holder, but failure to do so shall
<br />impose no obligation or liabillty of any kind upon the insurer, its agents or representatives.
<br />CERTIFICATE HOLDER CANCELLATION
<br />Client
<br />City O Santa Ana,
<br />y
<br />Its Officers, Agents, and Employees
<br />20 CIVIC Center Plaza
<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 />Santa Ana CA 92702
<br />AUTHORIZED REPRESENTATIVE
<br />Mark B. Roberts
<br />4S
<br />1988 -2014 ACORD CORPORATION. All rights reserved.
<br />i
<br />ACORD 25 (2014101) The ACORD name and logo are regstered marks of ACORD 7 1
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<br />r, 77- M�
<br />
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