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<br />CERTIFICATE OF LIABILITY INSURANCEDATE
<br />(MMfDDPYYYY)4!3/2017
<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 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 />CONTACT
<br />NAME: Lydia Castro
<br />FAX
<br />PHONE (866) 500-6359 11 c Nn: (925) 951-0077
<br />Sel,ectSolutions insurance Services
<br />ADDRESS:y s' 1 daac@selectalution'sins.comt
<br />1350 Carlback AvenueE-MAIL
<br />INSURERS AFFORDING COVERAGE NAIC fl
<br />Suite 100
<br />$NSURERAPhiladel hia Consolidated Holdin
<br />Walnut Creek CA 94596
<br />INSURED
<br />INSURER B -New York Marine & General Insurance 16608..
<br />INSURER C:
<br />Wis'eplace , a Ca Corp
<br />INSURER D :
<br />141..1 N. Broadway
<br />INSURER E:
<br />INSURER F:
<br />Santa Ana CA 92706
<br />COVERAGE'S CERTIFIICATE NUMBER:1,7-18 Master 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 />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />'ADDL
<br />SU4"SR,I
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM OD YYY
<br />POLICY EXP.........
<br />MMPODfYYYY
<br />LIMITS
<br />X COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE $ 1,000,000
<br />A
<br />CLAIMS -MADE OCCUR
<br />DAM'AGETO RENTED 100,000
<br />PREMISES Ea occurrence
<br />MFDEXP(Any one person) $ 5,000
<br />X
<br />PHPKIS96372
<br />1/1/2017
<br />1/1/2018
<br />PERSONAL & ADV INJURY $ 1,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER::
<br />GENERAL AGGREGATE, $ 2,000,000
<br />POLICY ❑ E 0 EJ LOC
<br />I
<br />PRODUCTS - COMP/OP AGO $ 2, 000, 000
<br />$
<br />OTHER.
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE (LIMIT $ 1,000,000
<br />Ea accident
<br />BODILY INJURY (Per person) $
<br />.
<br />X
<br />ANY AUTO
<br />AOWNED SCHEDULED
<br />AUTOS AUTOS
<br />PHPK1596372
<br />,'...� 1/1/2017
<br />'...
<br />1/1/2018
<br />BODILY INJURY (Per accident) $
<br />NON-OWNED
<br />HIRED AUTOS AUTOS
<br />PROPERTY
<br />PROPERTY DAMAGE
<br />accident $
<br />$
<br />XUMBRELLALIA6
<br />X OCCUR
<br />EACH OCCURRENCE $ 1,000,000
<br />AGGREGATE $ 1,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED X ..:RETENTION$ 10,000
<br />$
<br />1
<br />PHUB569220
<br />1/1/2017
<br />1/1/2018
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />X PER OTH-
<br />STATUTE ER
<br />E.L, EACH ACCIDENT $ 1 .
<br />0_0010 0 0
<br />B
<br />ANY PROPRIETORYPARTNERIEXECUTiVIE
<br />OFFICERWEMBER EXCLUDED? �
<br />(Mandatory In NH)
<br />If yes, describe under
<br />N P A
<br />WC201600006833
<br />8/15/2016
<br />8/15/2017
<br />E,L. DISEASE - EA EMPLOYEE_1 1,000,000
<br />DESCRIPTION OF OPERATIONS bellow
<br />E.L. DISEASE - POLICY LIMIT 1''...... $ 1,000,000
<br />A
<br />Professional.. Liab (E&O)
<br />PHPK1.596372
<br />1/1/2017
<br />1/1/2018
<br />$i,000,000 $2,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule,, may be attached if more space Is required)
<br />City of Santa Ana is included as additional insured on General Liability policy per attached endorsement.
<br />General Liability coverage is primary and non-contributory per the attached endorsement.
<br />CERTIFICATE HOLDER CANCELLATION
<br />ACORD 25 (2014101)
<br />INS025t?n anri
<br />@ 1988-2014 ACORD CORPORATION. All rights reserved,
<br />The ACORD name and logo are registered marks of ACORD
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City of Santa Ana,
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />Community Development Agency
<br />ACCORDANCE WITH THE POLICY PROVISIONS,
<br />Attn: Sylvia Vazquez
<br />AUTHORIZED REPRESENTATIVE
<br />20 Civic Center Plaza, M-25
<br />Santa Ana, CA 92701
<br />/ 4✓t %i
<br />Leticia Trevino/NORJA fid✓
<br />ACORD 25 (2014101)
<br />INS025t?n anri
<br />@ 1988-2014 ACORD CORPORATION. All rights reserved,
<br />The ACORD name and logo are registered marks of ACORD
<br />
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