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DATE (MMIDDrlYYY)
<br />2/2/2016
<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 />J. Gallagher & Co.
<br />ice Brokers of CA. Inc. LIC A 0726293
<br />Brand Blvd, Suite 600
<br />INSURED
<br />Public Law Canter
<br />601 Civic Center Drive
<br />Santa Ana, CA 92701
<br />COVERAGES CERTIFICATE NtIM SFR: 442280832 RKVIgInN NI IMRPIQ�
<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 1'O 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 />.___,
<br />INSFd
<br />LTR
<br />TYPE OF INSURANCE
<br />/NSD
<br />WVD
<br />_......................._..................
<br />POLICY NUMBER
<br />i'4LICYEPF
<br />MMIDDIV YY
<br />POLICY EXP
<br />MMIDDNVYYI
<br />__,_,.,..,,...,.,............_
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL 4I ABILITY
<br />_ CLAIMS MAGE n OOGIJR
<br />Y
<br />20162205ONPO
<br />21112016
<br />21112017
<br />EACH OCCURRENCE
<br />$1.,000,000
<br />TM_ _.._,,-
<br />PAI:hiiE.Sw9:$.9srk.a
<br />�.__.._..
<br />$500,000
<br />AIJm,.... ...... ._.,__
<br />MED E.LAAny_ Person)
<br />PERSONAL ADV INJURY
<br />$1,0001000
<br />X
<br />siMMl$1MM
<br />GENT_ AGGREGATE DMITAPPUES PER
<br />POLIGY[] ECT LOC
<br />GENERAL AQ6REGATE
<br />PRODUCTS- COMPIOP AGO
<br />$2,000,000
<br />$2,000,000Mwww
<br />$
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />20162205ONPO�
<br />2/112016
<br />2JI12017
<br />_COMBINED S __,,.,INGLE LIMIT
<br />?1,000,000___.
<br />ANY AUTO
<br />BODILY INJURY (Per pOcmr)
<br />$
<br />ALL OWNED Afd'ITIeTJULErI
<br />BODILY INJURY (Per accident)
<br />S
<br />X
<br />_
<br />HIUURED Am'OS X ON,O55WNED
<br />_ AUi'PS
<br />'PI{OPERTY DAMAGE
<br />-!_Peracddantl
<br />--------__---
<br />....
<br />AX
<br />_
<br />UMBRELLA LIAR
<br />X
<br />OCCUR
<br />ZU'10-22060-LIMB
<br />211t2g18
<br />2!1/2017
<br />FA_CH_Do FUR NCE
<br />$1,000,0_0_0_
<br />EXCESS UAB
<br />CLAIMSMADE
<br />AGGREGATE~`
<br />$1,000,000,...._,.
<br />DEDIX I RETENTION$ 10,000
<br />$ _
<br />WORKERS COMPENSATIONP'
<br />AND EMPLOYERS'LIABILITY YIN
<br />ANY PROPRIETOWPARTNEIVEXECUTIVE
<br />OFFICEWMEMBER EXCLUDED?
<br />MIA
<br />TI -
<br />77 5TA N:i ER__,__„____,___—,___
<br />E.L. EACH ACCIDENT
<br />,,,,,,,,,,,,,,__.—......._..
<br />$
<br />(Mandatory In NH)
<br />da,mlbe under
<br />E.L. DISEASF,-EAEMPLOYL_
<br />E.L. DISEASE -POLICY LIMIT
<br />_$
<br />$
<br />Nes,
<br />SCRIPFIONOEOPERATIONS below
<br />µ
<br />DESCRIPTION OF OPERATIONS I LOCATIONS i VEHICLES (ACORO 1d1,Additlgnai Romafke SeOadula, maybe aRteaned It moeo ePao9le Yequlfodi
<br />The City of Santa Ana, Its officers, employees, ac eats, volunteers and representatives are named additional insured with respect to the
<br />operations of the named Insured per the attached CG 2026 endorsement, Such insurance is primary and non-contributory.
<br />CERTIFICATE HOLDER CANCELLATION
<br />ACORD 25 (2914101)
<br />O 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 />ACCORDANCE WITH THE POLICY PROVISIONS,
<br />20 Civic Center Plaza
<br />Santa Ana CA 92701 USA
<br />AUTHORIZED REPRESENTATIVE
<br />17
<br />ACORD 25 (2914101)
<br />O 1988-2014 ACORD CORPORATION. All rights reserved,
<br />The ACORD name and logo are registered marks of ACORD
<br />
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