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AC "Ra CERTIFICATE OF LIABILITY INSURANCE <br />DA(6/2017 Y) <br />T/ <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(lies) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement, A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />NAMIIT EACT Cindy Hebert <br />Milestone Risk Management & Insurance Agency <br />PHONE �����552-0909 FAX <br />A1C, No Ext: APC No.: C9A9J'8'52-1.131 <br />License I3o. pB72766 <br />ADDRESS,chebert@mi,lestonepromise.com <br />8 Corporate Park, Suite 130 <br />INSURER(S) AFFORDING COVERAGE NAIG # <br />INSURER A;Security N'ation'al Ins. Co. 19879 <br />Irvine CA 92606 <br />INSURED <br />INSURER B: <br />Council on Aging — Southern California, Inc. <br />INSURER C.: <br />2 Executive Circle, Suite 175 <br />INSURER. D.: <br />INSURER E : <br />Irvine CA 92614 <br />INSURER F: <br />COVERAGES CERTIFICATE NU'MBER.7.7/18 WC 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 TERM'S, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSIR <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />SUBR <br />POLICY NUMBER <br />POLICY EFF <br />(MMIODNYYY <br />POLICY EXP <br />LMM/DDNYYYI <br />LIMITS <br />COMMERCIAL. GENERAL LIABILITY <br />CLAIMS -MADE OCCUR <br />1:1PREMISES <br />EACH OCCURRENCE $ <br />UREM E TO EN <br />a occurrence) $ <br />MED EXP (Any one. person) $ <br />PERSONAL 8 ADV INJURY $ <br />GENT AGGREGATE LIMIT APPLIES PER: <br />- <br />POLICY ❑ JECPROT LOC <br />GENERAL AGGREGATE $ <br />PRODUCTS - COMPIOP AGG $ <br />$ <br />OTHER <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE. LIMIT <br />Ea accident. <br />_ <br />BODILY INJURY (Per person) $ <br />ANY AUTO <br />ALL OWNEDSCHEDULED <br />AUTOS AUTOS <br />8O accident) DILY INJURY (Per accid$ <br />NON -OWNED <br />HIRED AUTOS AUTOS <br />PROPERTY DAMAGE <br />Per accident $ <br />UMBRELLA LIAR <br />HCLAIMS-MADE <br />OCCUR <br />EACH OCCURRENCE... $ <br />AGGREGATE $ <br />EXCESS LIAR <br />DED RETENTION $ <br />$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y I N <br />I PER <br />STATUTE DER""- <br />F L. EACH ACCIDENT $ 1,000,000 <br />A <br />ANY PROPRIETORIPARTNER/EXECUTIVE� <br />OFFICFRlMEMBER EXCLUDED? II ..' i, <br />(Mandatory in NH) <br />N f A <br />SH -35844 <br />1/'1/2017 <br />1/1/2018 <br />E.L, DISEASE -IEA EMPLOYE $ 1,000,000 <br />ifyes, descnbe under <br />E L NSEASE - POLICY LIMIT $ 11000,000 <br />DESCRIPTION OF OPERATIONS below <br />DESCRI..PTION'.. OF OPERATION'S I LOCATIONS 1 VEHICLES IACORD 101, Additional Remarks Schedule, may be affiached if more space Is required) <br />RE: Evidence of Coverage. <br />llopez5@santa-ana.org <br />City of Santa. Ana <br />Community Development Agency, M-25 <br />Attn: Leticia 1.,open <br />20 Civic Center Plaza, M-25 <br />Santa Ana, CA 92701 <br />ACORD 25 (2014101) <br />INS025 C2014011 <br />t..,ca Nk,t=LLA I IUN <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 />JTeLeY/CEIE I3RI' <br />�. <br />@ 1988-2014 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered' marks of ACORD <br />