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CQh'L? CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) AD EFF POLI -EXP MIGU MMIDDlYYYY1 LIMITS 06!0912015 THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(9), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the polloy{les) must bo endorsed, If SUBROGATION IS WAIVED, subJeDl tD the terms and conditions of the policy, certain policies may require an endorsement, A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsements), PRODUCER NATIONWIDE SALES SOLUTIONS INC _q NIACT AMEN__ PHONE FAX .LNc Nn exd' — –N9.No1: " EMAIL App3,eSS: 1200 LOCUST ST DES MOINES IA 50391-9995 INSURER(S) AFFORDING COVERAGE NAICp INSURER AI DEPOSITORS INSURANCE COMPANY 42587 INSURED INSURER BI INSURER Q : S CHAMBERS GROUP, INC INSURER o: 5 HUTTON CENTRE OR STE 750 INSURERS:SANTA ANA CA 92707-8720 1 NSURERFI COVERAGES CEKIIFIGAIt NUMLdiol<: RFVIRV1Md WHIMAVD. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATEC. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 19 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIM9, INSR TYPE 9PINSURANCE 'A56L1aTIeR�— P POLICY NUMBER AD EFF POLI -EXP MIGU MMIDDlYYYY1 LIMITS COMMERCIAL GENERAL LIABILITY ---� CLAIMS -MADE `_ OCCURS I EACHOCCURRENCE S Y'R''--�-� ON0.1pd'EBwENY@Yi P E.M1tGF9-Lifortrenpol S MED EXP(AnYone PBnia� h�^.• _._.— _— ............. ..._..-_ i PERSONAL& ADV INJURY S I GEN'LAGOREGATEMNITAPPLIESPER: r POLDY, "111T , I LOC I GENERAL, AGGREGATE $ PRODUCTS-COMPIOPAOC S S OTHER; AUTOMOe1LE LIAEILITY I EaNISIN 0STINGL LIMIT - 5 1,000,000 A XANY x AUTO ,ALL OWNED F- SCHEDULED - AUTOS y AUTOS j ACP RAPID 2545OB4678 HIRED AUTOS iXy AUTOS F0 06101/2015 BODILY INJURY (Pon poniard S �—'-'--" 06101/2016 i OODILY INJURY (For oo-nent) 5 eOPERffffdTYiii AMAGE- S UMBRELLA UAa i= OCCUR j EACH OCCURRENCE S EXCESS LIAM_ _ CAIMS-MADE RETENTIONS AGGREGATE $ - S OED WORKERS COMPENSATION IAND EMPLOYERS' LIABILITY YIN,i I OFF(CERINIEMDER EXCLUDE 01 ❑;NIA,' (Miadamry In NH) IlyoN s, deorriOFOPERATIONS belowE.L. SC IPTID EOF O E DTH- UT AANYPROPRIETOWPARTNEWEXECUTNE E.L EACH ACCIDENT 3 S.L. DISEASE - EA EMPLOYE S DISEASE -POLICY LIMIT 5 DESCRIPTION OF OPERATIONS) LOCATIONS I VEHICLES (ACORN 101, Additional Ramarka SchodIA0, may bo allaahad If mom epaap la aXtUa,d) City at Santa Anna IS jiated eS Certllleate holder only. Waiver of subrogation applies per form CA0444. CHAMBERS GROUP A-2013-007-02 REVIEWED BY: (/� �v EUNICE HEREDIA (PG 5 OF 5) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL RE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Santa Anna•Publlc Works Agancy M36 20 Civic Plaza StephanieZED SoppRUPREeENTATIVE Stephanie Soppe t� Santa Anna CA 92702 < ,r_ V ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD reserved,