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- -, - CERTIFICATE OF LIABILITY INSURANCE
<br />GP.re1MMrODIrYYV)
<br />00!30(2018
<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
<br />Aon Risk Services Northeast, Inc.
<br />New York NY Office
<br />CONTACT
<br />NAME:
<br />tpIC NO. EZI: (866) 233 -7122 ,No.l: (800) 3G3-0105
<br />199 Water- Street
<br />New York NY 10038 -355L USA
<br />E-MAIL
<br />ADDRESS:
<br />INSURER(5) AFFORDING COVERAGE
<br />NAICI
<br />INSURED
<br />INSURER A: Liberty Mutual Fire Ins CO
<br />.- .-- ..— ._..._...._.___
<br />33035
<br />care W. trader Service,
<br />Care AnlbUlante Service. Inc.
<br />1517gW CA 92868 LISA
<br />..___.._
<br />INSURER In Liberty insurance Corporation
<br />_�. —.._.
<br />42404
<br />INSORERC: 1- Cyd'S Syndicate No. 2623 ��
<br />,1,11128623
<br />INSURER D: Steadfast Insurance Company
<br />26387
<br />INSURER E:
<br />u L
<br />PPEMEES IEa octiV Nncol
<br />INSURER IF
<br />NED ESP 1A, orw person(
<br />COVERAGES CERTIFICATE NUMBER: 570055353066 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. Limps shown are as requested
<br />LTR
<br />TYPE OF INSURANCE
<br />INSD
<br />AWO
<br />POUCYNUMeER
<br />MMIDOIYYY
<br />MMIOOIYYYy
<br />LIMITS
<br />C
<br />X
<br />COMMERCIAL GENERAL LIABIUTy
<br />1447,8102
<br />I( J
<br />, 1
<br />EACHOCCURRENCE
<br />$2,000,000
<br />CLAIMSAADE OCCUR
<br />u L
<br />PPEMEES IEa octiV Nncol
<br />5100,000
<br />NED ESP 1A, orw person(
<br />_
<br />55,000
<br />X
<br />PNUOCI- Clabii6Mede
<br />_
<br />PERSONALS ADV INJURY
<br />Included
<br />GEN'L AGGREGATE LIMIT APPLIES PER
<br />GENERAL AGGREGATE
<br />$2,000,000
<br />X POLICY PRO- II-7� LO
<br />�HO- u
<br />PRODUCTS - COMPrOP AGO
<br />$2,000,000
<br />OTHER:
<br />r
<br />A
<br />AU fOMOBILE LIABILITY
<br />A52- 631 - 510005 -024
<br />10/01/2011111101
<br />/2015
<br />COMBINED SINGLE LIMIT
<br />e ar Tae
<br />5210801090
<br />BODILY INJURY l Pnr person)
<br />AI NY AUTO
<br />X
<br />ALL DINNED SCHEDULED
<br />AUTOS AUTOS
<br />HIRED NO FOS NON-OWNED
<br />AUTOS
<br />BODILY INJURY (Per Iradene
<br />PROPERTY DAMAGE
<br />POf 3CGi4flnll
<br />0
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />UMB541477001.
<br />10 /01 ✓2014
<br />10/01 /2015
<br />EACFI CCCURRENcc
<br />510,000,000
<br />EXCESS LIAB
<br />CLAINISIMADE
<br />AGGREGATE
<br />510,000,000
<br />DEO
<br />RETENTION
<br />8
<br />WORKERS COMPENSATION AND
<br />EMPLOYERS'LIABILITY YIN
<br />ANVPROPRIETOR:PARTNERIEXECUTIVE
<br />OFFICERAS1,15ER E.XCLUDEDF
<br />NIA
<br />WA76305JD005014
<br />10/01/2014
<br />10 /0 U? 15
<br />PER OTH-
<br />Y` E1'AR)iE
<br />E1, EACH ACCIDENT
<br />$1 „000,000
<br />F,L. DISEASE EA EMPLOYEE
<br />$1,000,000
<br />(Mandmary In NF)
<br />Ryyes' describe dndaT
<br />0 SCRIPTIONOFOPF,RATIONSbalaw
<br />E.L. DISEASE -PCUCY LIMIT
<br />$110001000
<br />C
<br />Nisc Ned Prof
<br />W1 4387140201
<br />10/01/2014
<br />10/012015
<br />Ea. Medical incTden'
<br />$2,000,000
<br />Aggregate Limit
<br />52,000,000
<br />AbusaOMOl =station
<br />$2,000,000
<br />DESCRIPTION OF OPERATIONS /LOCATIONS' VEHICLES (ADORN IDI, Additional RomaAa Smbedeii may be a tachod it mom space is reynioun
<br />Tile City of Santa Ana and OCFA, and their' respective officers. Offi CIa15, employee.$, representative And Volunteer's are included
<br />as Additional IGSUred pot' COntraCC Or Agreelnent5 With the City Of Santa Ana in accordance with the policy provisions Of the
<br />General Liability and Autmobile Liability policies,
<br />The Policies evidenced herein are Primary and Nor- coilzributory to other instranco, available to an Additional Insured, but only
<br />in acc01'dance with the polity's provisions.
<br />A waiver of suhrogation is granter! in favor of The City of Santa Ana and OCPA, their respective officers, officials, employees,
<br />representatives and volunteers in accordance With the policy provisions of the Workers compensation policy.
<br />CERTIFICATE HOLDER
<br />CANCELLATION
<br />01988 -2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (201,1101) The ACORD name and logo are registered marks of ACORD M11(' 4I 30t zaI i
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<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
<br />EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED W ACCORDANCE WITH THE
<br />POLICY PROVISIONS.
<br />The City Of Santa Ana and OCFA
<br />F1nanCL cc Manag6ment SLI -ViCPS Agency
<br />20 Civic Center P132a - M -17
<br />v0 Box 1983
<br />AUTHORIZED RFPRESENTARVE
<br />�/.7 ,{,/"�d.
<br />Sanata Ana CA 92702 USA
<br />c.j�c to C.,f�' c%t2rlcc"[tcil'VO 7ZZP
<br />01988 -2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (201,1101) The ACORD name and logo are registered marks of ACORD M11(' 4I 30t zaI i
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