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ACIO►/'`L7® CERTIFICATE OF LIABILITY INSURANCE
<br />DATE /YYYY)
<br />09127/2017/2017
<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
<br />Marsh Risk & Insurance Services[
<br />17901 Von Karman Avenue, Suite 1100I
<br />CONTACT
<br />NAME:
<br />ado PHONE o EXt : FAA/C No
<br />(949) 399-5800; License #0437153F
<br />Irvine, CA 92614
<br />E-MAIL
<br />ADDRESS:
<br />INSURERS AFFORDING COVERAGE
<br />NAIC #
<br />INSURER A: Hartford Accident & Indemnity Co.
<br />22357
<br />CN 1 02452723-STND-GAUWP-1 7-
<br />INSURED
<br />Overland, Pacific &Cutler, Inc.[
<br />INSURER B :
<br />INSURER C : See Additional Page
<br />3750 Schaufele Avenue]
<br />Suite 1501
<br />Long Beach, CA 90808
<br />INSURER D : QBE Insurance Corporation
<br />39217
<br />INSURER E : Hartford CasualtyInsurance Company
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER: LOS-002277376-16 REVISION NUMBER: 16
<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 LTR
<br />TYPE OF INSURANCE
<br />jt=
<br />WVD SUER
<br />POLICY NUMBER
<br />MM/DDIYYYY
<br />MM DD//YYYY
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE M OCCUR
<br />X
<br />1000NHF0064
<br />08/10/2017
<br />08/10/2018
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />DAMAGE T O RENTED
<br />PREMISES Ea occurrence
<br />$ 300,000
<br />MED EXP (Any one person)
<br />$ 10,000
<br />PERSONAL & ADV INJURY
<br />$ 1,000,000
<br />AGGREGATE LIMIT APPLIES PER:
<br />POLICY IT JECOT- LOG
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />GEN'L
<br />PRODUCTS - COMP/OP AGG
<br />$
<br />$
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />IODUNHF0064
<br />08/10/2017
<br />08/10/2018
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$ 1,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />(Per accident)
<br />) BODILY INJURY (Pidt
<br />$
<br />NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />HIRED EX
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />xi
<br />COMP $1000 COLL $1000
<br />1
<br />1$
<br />X
<br />UMBRELLA LIAB X
<br />OCCUR
<br />IORHUJAB919
<br />08/10/2017
<br />08/10/2018
<br />EACH OCCURRENCE
<br />$ 2,000,000
<br />AGGREGATE
<br />$ 2,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED X RETENTION $ 10,000
<br />$
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANYPROPRIETOR/PARTNER/EXECUTIVE Y / N
<br />OFFICER/MEMBER EXCLUDED? ❑N
<br />(Mandatory in NH)
<br />N / A
<br />1OWEAS9914
<br />08/10/2017
<br />08/10/2018
<br />X IPER OTH-
<br />STATUTE ER
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<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 />$ 1,000,000
<br />D
<br />Professional Liability
<br />OPLO714889
<br />07/10/2017
<br />07/10/2018
<br />Each Claim / Aggregate
<br />2,000,000
<br />Deductible
<br />50,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS IVEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required)
<br />RE: Property Acquisition, Relocation & Management Services Agreement. A-2016-010, A-2015-165, A-2017-226, A-2017.228ii
<br />City of Santa Ana, its officers, employees, agents, volunteers and representatives are included as additional insured where required by written contract with respect to General Liability. This insurance is primary and
<br />non-contributory over any existing insurance and limited to liability arising out of the operations of the named insured subject to policy terms and conditions with respect to General Liability.lu
<br />REVIE:tVED IBY. FI,.tPdli C f IERF fYIA Pt
<br />t,cm rrit,m r c ntlLVCr% t,1A1Vl,CLLA I I JIN
<br />City of Santa Anal'
<br />P.O. Box 1988E
<br />20 Civic Center Plaza (M-36).l
<br />Santa Ana, CA 92702
<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 />of Marsh Risk & Insurance Services
<br />Manashi Mukherjee —1VLA1%A1_Aa "-,JA+,,_tc..,11�
<br />©1988-2016 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />
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