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ACCP 'Q®
<br />l-, CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MM/DD/YYYY)
<br />4/14/2017
<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(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 endorsements .
<br />PRODUCER
<br />Dealey, Renton & Associates
<br />199 S Los Robles Ave Ste 540
<br />Pasadena, CA 91101
<br />Lic #0020739
<br />CONTACT
<br />NAME: Marie Swaney______
<br />PHONE �FAX
<br />IA/C No,.EXt) 626-844 3070 L.IA/c No).
<br />E-MAIL mswane deale renton.com
<br />-ApDRE s Y@ Y
<br />INSURERS AFFORDING COVERAGE NAIC #
<br />INSURERA:Travelers Indemnity Co. of Connecti 25682
<br />INSURED PROJEPART
<br />INSURER B :Travelers Property Casualty Co of A 25674
<br />Project Partners
<br />23195 La Cadena Drive, Suite 101
<br />Laguna Hills, CA 92653
<br />INSURERC;U.S. Specialty Insurance Company 29599
<br />INSURER Indemnity
<br />INsuRERD:Travelers Indemnity COmpany 25658
<br />------
<br />INSURER E :
<br />949 852-9300
<br />INSURER F :
<br />COVERAGES CERTIFICATE Nt1MRFR- 1785023871
<br />RFVlglnhl NI IMRPR-
<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 />-------
<br />TYPE OF INSURANCE
<br />INSD
<br />UR
<br />WVD
<br />----
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM/DD/YYYY
<br />POLICY EXP
<br />MM/DD/YYYY
<br />------ -------_..-._ ----
<br />LIMITS
<br />B
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE •• OCCUR
<br />Y
<br />Y
<br />680OJ543236
<br />4/18/2017
<br />4/18/2018
<br />EACH OCCURRENCE
<br />DAMAGE TORENTEDPREMISES Ea occurrence)00000
<br />+$2,000,,o000
<br />X Contractual Liab
<br />MED EXP (Any one person)
<br />$10,000
<br />X XCU Included
<br />PERSONAL & ADV INJURY
<br />$2,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICY PE LOC
<br />OTHER:
<br />GENERAL AGGREGATE
<br />$4,000,000
<br />PRODUCTS - COMP/OP AGG
<br />$4,000,000
<br />$
<br />A
<br />AUTOMOBILE LIABILITY
<br />Y
<br />Y
<br />BA93611484
<br />4/18/2017
<br />4/18/2018
<br />COMBINEDEa lSINGLE LIMIT
<br />$1,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />ANY AUTO
<br />I
<br />AUTOS NED SCHEDULED
<br />AUTOS$
<br />X HIRED AUTOS X NON -OWNED
<br />AUTOS
<br />BODILY INJURY (Per accident)
<br />PROPERTY DAMAGE
<br />Per accident
<br />$ —
<br />X NoOwnedAutos
<br />$
<br />B
<br />X UMBRELLA LIAB
<br />X
<br />OCCUR
<br />Y
<br />Y
<br />I CUP8833Y649
<br />4/18/2017
<br />4/18/2018
<br />EACH OCCURRENCE
<br />( $1,000,000
<br />EXCESS LAB
<br />CLAIMS -MADE
<br />AGGREGATE
<br />$1,000,000
<br />DED ''.. X RETENTION $0
<br />$
<br />D
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />AOFFICER/MEMBER EXCLUDED?
<br />N / ANYPROPRIETOR/PARTNER/EXECUTIVE
<br />I
<br />UB3J809976
<br />4/18/2017
<br />4/18/2018
<br />PER OTH-
<br />X STATUTE ER
<br />E.L. EACH ACCIDENT
<br />--
<br />$1,000,000
<br />-- ---_
<br />E.L. DISEASE - EA EMPLOYEE
<br />----------
<br />$1,000,000
<br />(Mandatory in NH)
<br />If yes, describe under
<br />-----------------
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$1,000,000
<br />C
<br />Professional Liability
<br />USS1727622
<br />4/18/2017
<br />4/18/2018
<br />$1,000,000 Per Claim
<br />Claims Made Form
<br />$1,000,000 Annual Aggregate
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />Insured owns no company vehicles; therefore, hired/non-owned auto is the maximum coverage that applies. Umbrella policy is a follow -form
<br />to underlying General/Hired&Non-Owned Auto/Employers Liability Policies. AM Best's Rating for all policies listed are: A/XII or greater.
<br />Re: All operations of named insured -- The City of Santa Ana, its officers, employees, agents, volunteers and representatives are named as
<br />additional insured as respects general and hired/non-owned auto liability for claims arising from the operations of the named insured as
<br />required per written contract or agreement. Coverage afforded the additional insured is primaryand on -contributory as respects to general
<br />See Attached... _ __..._._ ..._..._..
<br />REVIEWED D By. EUNIt 4 Hi RE DIA (I: CGJ O6 �
<br />VGRI n'IVHIC r1ULUCr% VAI1k I=LLAIIUIV UU UdY Ivkjl'/ IV UdV IVI IVUIIr-dV UI r-ICIII
<br />City of Santa Ana
<br />120 Civic Center Plaza - M36
<br />Santa Ana CA 92701
<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 />© 1988-2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
<br />
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