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CERTIFICATE OF LIABILITY INSURANCE 3 /18/2016016 DAT'DIyYYY) THIS CERTIFICATE IS 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(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the poiieypas) must be endorsed, If SUBROGATION IS WAIVED, subject to 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 endorsement(s). PRODUCER LIMITS Michael J Hall & Company A/E Insurance Services 1988010th Ave NE GIVE 5&'360-598-lJdaILB P DZ92445 EMAIL pany.c INSURER(S) AFFORDING COVERAGE NAIC # Poulsbo WA 98370 INSURER A Acradran Aut a1142— 6/26/2016 INSURED 25 INSURER B;ndan Harbor naUr, n"� CO Ci01YIDanV 8 Dudek 805 3rd Street Encinitas CA 92024 _ INSURER C: INSURER D i_ INSURER E: INSURER F: TOT PREMISE$ (Ea Deco renoe $100,000 COVERAGEa Ubl<IIHIUAItI NUMLSER:7rSIPS740 REVISION NUMBER THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTft TYPEOFINSURANCE A PO Box 1988 POLICY NUMBER MMIDE EFY MMIDRIYYYY LIMITS A GENERAL LIABILITY MXG8098626e 6128/2018 6/26/2016 EACH OCCURRENCE 31,000000 x COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X❑ OCCUR TOT PREMISE$ (Ea Deco renoe $100,000 MEDEXP An ono omonI $10,000 x OCPIXCU/BFPD PERSONAL& ADV INJURY $1,000,000 X Cross Llabllity GENERALAGGREGATE $2000,000 GEN'LAGGREGATE POLICY LIMITAPPLIES PER: X P,RR F7 LOC PRODUCTS-COMP/OP AGO $2,000000 -$ A AUTOMOBILE LIABILITY MXG80068255 812812015 6/2812016 E see tle t $1,000,000 x ANYAUTO BODILY INJURY (Per parson) 3 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY Per acoldent) $ XHIRFDAUTOS X AO 09WNED PoEacc tle DAMAGE 3 $ A X UMBRELLA LIAR X OCCUR CGX40875322 8/20/2016 8/26/2016 EACHOCCURRENCE $1000,000 EXCESS LIAB CLAIMS -MADE AGGREGATE '$1000,000 DEL) x I RETENTION 0 $ A WORKERS COMPENSATION AND EMPLOYERSLIABILITY YIN OFFICERIMEMEER EXCLUDED?ECUTIVE� (Mandatory In NHl IIyos'as"'a untlar DESGIRIPTION OF OPERATIONS polavl NIA WOW030014 8128/2016 8/28/2016 X C TD- CTM• E,L. EACH ACCIDENT $1,W0000 E.L.DISEASE-EAEMPLOYE $1000000 EL. DISEASE -POLICY LIMIT $1.000,000 B Professional Lab Claims Made Contractors Pollution Llab; Occur PE0002403108 812812016 6/26/2016 $1,000,000 Per Claim $2,000,000 Aggregate DESCRIPTION OF OPERATIONS/ LOCATIONS I VEHICLES lAffdch ACORD 101, Addltlonal Ramerke 6chetlule, it mom space Is requlradl The City of Santa Ana Its officers, employees, agents, volunteers, and representatives are an Additional Insured on the Commercial General Liability and Auto Llabllityy when required by written contract or agreement regarding activities by or on behalf of the Named Insured. The Commerclal General Llabllity Insurance is primary Insurance and any other Insurance maintained by the Additional Insured Shall be excess only and non-contributing with this insurance. A waiver of subrogation applies to the ComTdrelal General Liability, Auto Liability, Umbrella 1 Excess Liability and Workers Compensation / Employers Llabllity In favor of the Additional n d. y RFV( -10 E y EUNtCE HEREDIA (PG J OF ) LN;4 at II I WMA. L401194 V CANCFI I ATIrTN 0)19©8.2010 ACORD CORPORATION, All rights reserved, ACORD 26 (2010105) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE The City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL 13E DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, PO Box 1988 Santa Ana CA 92702.1988 AUTHORIXBD REPRESENTATIVE 0)19©8.2010 ACORD CORPORATION, All rights reserved, ACORD 26 (2010105) The ACORD name and logo are registered marks of ACORD