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INSURER(S) AFFORDING COVERAGE NAI <br />. . ....... . . . .... . . ........ . ... .... INSURER A: Coverys Specialty Insurance Company 15686 <br />INSURED —INSURER B; Greenwich Insurance Company 22322 <br />Care Ambulance Services, Inc. INSURER C: Steadfast Insurance Company 26387 <br />1517 West Braden Court INSURER D:XL Insurance America, Inc. 24554 <br />Orange, CA 92868 INSURER E:: <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDABOVE 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 />�j� . ..... ..... ... ....... . . . . ....... ADD L. .. .. .... ... <br />LTR TYPIE OF INSURANCE DE un POLICY NUMBER LIMITS <br />(MMIDDrVrYYY <br />jk-,- _T ­C_ _0MME­RC1A_LGEN`ERAL LIAWLITY EACH OCCURRENCE $ 1,0100,000 <br />"DAMAGETCRENTED <br />CLAIMS -MADE F OCCUR X 5-10,013 1010112015 10101120116 $ 100:,000 pFFpJpS <br />Products Claims Made MED EXP (Any one person) $ 6,000 <br />Included <br />GEN'L AGGREGATE LIMIT APPLIES PRO- <br />PER: GENERAL AGGREGATE S 21010010001 <br />X POLICY PRO- ELOC <br />AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT i'mo,000 <br />X_ _(�a �ib_cLq�51....._._....- .... . . .. . <br />ANY AUTO X RADS000476 10101/20,15 101011/201�6 BODILY INJURY (Per person) S <br />ALL OWNED SCHEDULED BODILY INJURY (Per acdclent) <br />AUTOS AUTOS <br />NON-OWNED PROPERTY DAMAGE <br />HIRED AUTOS AUTOS Per accident <br />$ <br />... ... . . ......... . ..... ... . .. ..... . ...... . ............ <br />UMBRELLA LIAR OCCUR EACH OCCURRENCE $ 15,000,000 <br />C EXCESS LIAR CLAIMS-MADE X UMB 5414770-02 1010112015 10/0112 AGGREGATE GREGATE $ 15,0010,000 <br />DEL} � I RETENI . .... <br />WORKERS COMPENSADON <br />AND EMPLOYERS' LIABILITY Y�N =XS1 <br />D ANY PROPRII ETC R/PARTNFR/EXEG UTrVE RWD3000955 1010112015 10101/2016 E L. EACH ACCIDENT $ 1,0100,000 <br />OFFICER�MEMBER EXCLUDED? NIA <br />(Mandatory in NH) E Lr DISEASE.. -EA EMPLOYEE $ 1,0�00,000 <br />If gs, describe under —1 ­ ­ -­­- <br />D SCROWTION OF OPERATIONS below E L DISEASE » POLICY LIMIT $ 1,000,000 <br />A Misc Medical Prof. 5-10013 10101/2015 10101120116 See Attached <br />DESCRIPTION OF OPERATIONS; LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) <br />THIS VOIDS AND REPLACES PREVIOUSLY ISSUED CERTIFICATE DATED 11/241201I5 <br />Umibrella/Excess Follows Form. The City of Santa Ana and OCFA, and their respective officers, officials, employees, representative and volunteers are <br />included as Additional Insureds per Contract or Agreements with the City of Santa Ana in accordance with the policy provisions of the General Liability, <br />Automobile Liability, and Umbrella /Excess Liability policies. The Policies evidenced herein are Primary and Non-Contributory to other insurance available to <br />Additional Insureds, but only !in accordance, with the pollcy's provisions. <br />Excess coverage of $15,000,000 applies as Excess coverage over Commercial General:, Liability, Products; Medical Professional Liability and Automobile <br />Liability coverage. <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />I THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />A ACCORDANCE WITH THE POLICY PROVISIONS, <br />01,L,61 <br />e.. AUTHORIZED REPRESENTATR/E <br />The City of Santa Ana and OCFA <br />555 E. Memory Lane <br />San!aita Ana, CA 92702 <br />@ 1988-2'014 ACORID CORPORATION. All rights reserved. <br />ACO,RD 25 (2�014101) The ACCORD name and logo are registered marks of ACORD <br />