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EPICLAN-01 MCGRAWM
<br />,4CORn CERTIFICATE OF LIABILITY INSURANCE DATE(M
<br />9/29/201YYY)
<br />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 have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br />PRODUCER License # OE67768 CONTACT Dana Schwartz
<br />NAME:
<br />IOA Insurance Services PHONE FAX
<br />4370 La Jolla Village Drive (A/C, No, Ext): (619) 574-6223 50203 (A/C, No):(619) 574-6288
<br />Suite 600 E-MAIL
<br />ADDRESS: Dana.Schwartz@ioausa.com
<br />San Diego, CA 92122
<br />,. INSURER(S) AFFORDING COVERAGE NAIC #
<br />INSURED
<br />Epic Land Solutions
<br />2601 Airport Drive Suite 115
<br />Torrance, CA 90505
<br />INSURERA-.:Valley. Forge Insurance Company
<br />INSURER B: Transportation Insurance Compan 120494
<br />INSURER C :_Underwriters at Lloyd's London (KY) -_ 32727
<br />INSURER D :
<br />I
<br />INSURER F :
<br />rn%1PDAMP4 !`CDTICIf'ATF pit IMRGD- DC\/I421AKl Kit n1AD1=0.
<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
<br />WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL
<br />THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE
<br />BEEN REDUCED BY PAID CLAIMS.
<br />INS - ADDLSUBR: ..POLICY
<br />- POLICY EFF -.f POLICY EXP --
<br />-
<br />TYPE OF INSURANCE NUMBER
<br />LTR D WVD
<br />MM D Y LIMITS
<br />A X COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE $
<br />2,000,000
<br />__ CLAIMS MADE X ', OCCUR �14031022253
<br />X
<br />10/01/2017 �1 DAMAGE TO RENTED
<br />10/011201$ pRE.MISEs (Ea_occurrence) ... $
<br />1,000,000
<br />--
<br />X Cont Liab/Sev of Int
<br />10,000
<br />MED EXP (Any one person) _ $
<br />PERSONAL & ADV INJURY $
<br />2+000+000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE $
<br />4+000+000
<br />POLICY X PEO LOC
<br />PRODUCTS - COMP/OP
<br />4,000,000GG
<br />'i OTHER:
<br />Deductible $
<br />0
<br />A OMOBILE LIABILITY
<br />AUTacci
<br />COMBINED SINGLE LIMIT
<br />1,060,000
<br />ANY AUTO 14031022253
<br />10/01/2017 10/0112018 BODILY INJURY,(Perperson) $
<br />OWNS SCHEDULED
<br />AUTOONLY AUTOS,
<br />BODILY INJURY (Per accident) $
<br />p oyy
<br />X AUTOS ONLY X..' AUTOS ONt �
<br />(Per accitlent�AMAGE $
<br />XNo Co. Owned
<br />Autos
<br />.. $
<br />B X UMBRELLA LIAB OCCUR
<br />EACH OCCURRENCE $
<br />6,000,000
<br />EXCESS LIAB CLAIMS -MADE' 6014253989
<br />j
<br />_
<br />10/01/2017 10/01/2018
<br />AGGREGATE _„ _. $
<br />6,000,000
<br />DED X RETENTION $
<br />$
<br />A i WORKERS COMPENSATION'S
<br />X,..STATUTE
<br />AND EMPLOYERS' LIABILITY
<br />Y/N 594617867
<br />'
<br />'. ERH
<br />10/01/2017 10/011201$
<br />1,000,000
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE i
<br />OFFICEOPRIET R/PARTNER/E
<br />NIA,
<br />E.L. EACH ACCIDENT $
<br />(Mandatory in NH) ',�
<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 />1,000,OOU
<br />C Prof Liab/Clms Made PGIARK06632-01
<br />10/01/2017 10/01/2018 Per Claim
<br />3,000,000
<br />C Ded.: $25k Per Claim !PGIARK06632-01
<br />10/01/2017 10/01/2018 ',Aggregate
<br />4,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule,
<br />may be attached if more space is required)
<br />Re: All Operations
<br />City of Santa Ana, its oficiers, employees, agents, volunteers and representativs are Additional Insureds with respect to General Liability per the attached
<br />endorsement as required by written contract. Insurance is Primary and Non -Contributory.
<br />30 Days Notice of Cancellation with 10 Days Notice for Non -Payment of Premium in accordance with the policy provisions.
<br />�.
<br />RFVL WE:D BY: Il UNIf E HEREDIA (FG OF y)
<br />1 C r1ULUC
<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 />City of Santa Ana AUTHORIZED REPRESENTATIVE
<br />20 Civic Center Plaza (M-36) (( ' + _ `
<br />P.O. Box 1988 �` l �
<br />ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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