tiles a CERTIFICATE OF LIABILITY INSURANCE dA;E (MMpDDfYYYY)
<br />05/0212017
<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($).
<br />PRODUCER I
<br />'or"" STEVE SCHNEID'ER.
<br />NAME:
<br />_
<br />PHONEn. Exll:(714) 838-0693 j Noy: (714) 838-943$
<br />Silver Creek insurance Agency, Inc.
<br />E-MAIL .com
<br />sieve Silvercreeka enc
<br />ADDRESS: g y
<br />17742 Irvine Blvd
<br />INSURERS t AFFORDING COVERAGE
<br />Suite 203
<br />INSURERA: SENTINEL INS CO LTD 11000
<br />Tustin CA 92780
<br />INSURED
<br />a :
<br />_INSURER
<br />INSURER c
<br />White Nelson Diehl Evans LLP
<br />ollsuRER o
<br />2875 Michelle Ste 300
<br />INSURER E :.
<br />�..� T 0 9
<br />Irvine CA 9260ti
<br />INSURER F HL_
<br />COVERAGES CERTIFICATE NUMBER. REVISION NUMBER:
<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 />LTR
<br />n.._...,
<br />TYPE OF INSURANCE
<br />A'r�DL
<br />5 11BF!
<br />.._ ... POLICY NUMBER
<br />M. DDY EFF
<br />MI
<br />POLICY EXP
<br />LIMITS
<br />Santa Ana CA 92701
<br />X COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 1,000,4700
<br />CLAIMS -MADE D OCCUR
<br />4
<br />DAMAGE TGRENTED
<br />PREMISES nca
<br />$ 1,000,000
<br />MED EXP (Any ore person)
<br />$ 10,000
<br />PERSONAL a ADV INJURY
<br />S 1.000,000
<br />A
<br />57SBABV15586
<br />06/01/2017
<br />06101/2018
<br />GEN'L AGGREGATE LIMIT APP PER:
<br />GENERAL. AGGREGATE
<br />S 2,000,00 11
<br />�LIES
<br />-
<br />1 POLICY r
<br />JEGOT Y' LOC
<br />PRODUCTS - COMPIOP AGG
<br />s 2,000,000
<br />S
<br />OTHER:
<br />AUTOMOBILE
<br />LIABILITY
<br />E, MBIIIED4SINGLE. LIMIT
<br />$ 1,000,000
<br />BODILY INJURY (Per person)
<br />S
<br />ANY AUTO
<br />A
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />57SBABH5586
<br />06/01/2017
<br />06/01/2018
<br />BODILY INJURY (Per aecddenil'S
<br />PROPERTY DAMAGE
<br />Per accident
<br />S.
<br />HIRED I NON -OWNED
<br />AUTOS ONLY 4 AUTOS ONLY
<br />S
<br />d
<br />UMBRELLA LIAR
<br />X
<br />OCCUR
<br />EACH OCCURRENCE
<br />s 4,000,000
<br />AGGREGATE
<br />s 4,000,000
<br />A
<br />EXCESS LIAO
<br />oLAIMS-MADE
<br />57SBABH5586
<br />06/0112017
<br />06/01/2018
<br />DED X RETENTIONS 10000
<br />PRICOMP OPS AGG
<br />s 4,000,000
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABIUTY YIN
<br />ANY PROPRIETOR/PARTNEPJEXECUTIVE �N°
<br />OFFICEWMEMSER EXCLUDED? i
<br />'(Mandatary in NH)
<br />N I' A
<br />�
<br />57WECDX4233
<br />06/01/2017
<br />06/0112018
<br />PER OTH..
<br />STATUTE ER
<br />E.L.. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L. DISEASE - EA EMPLOYEO
<br />S 1,000,000
<br />IP yes, desCrihc under
<br />DE86RIPTIONOFOPERATIONS below
<br />`t
<br />E.L. DISEASE - POLiCYLIMIT
<br />$ 1.,000„000
<br />I
<br />DESCRIPTION OF OPERATIONS 1 LOCATIONS i VEHICLES (AC ORD 101'., Additional Remarks Schedule, may be attachedif more space is required)
<br />Those usual to the insured's operations. The City of Santa Ana, its officers, employees, agents, volunteers and representatives are named as additional insured
<br />per additional Insured form 55000080405 attached to this policy. Business liability waiver of subrogation applies, Coverage is primary and non-contrubutory. 30
<br />day advanced notice of cancellation, 10 day for non-payment.
<br />CERTIFICATE HOLDER CANCELLATION
<br />ACORD 25 (2016103)
<br />(D 1988-2015 ACORD CORPORATION„ All rights resented.
<br />The ACORD name and logo are registered marks of ACORD
<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
<br />AUTHORIZED REPRESENTATIVE
<br />20 Civic Center Plaza
<br />Santa Ana CA 92701
<br />ACORD 25 (2016103)
<br />(D 1988-2015 ACORD CORPORATION„ All rights resented.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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