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ACC>R H CERTIFICATE OF LIABILITY INSURANCE DATE 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 policy(ies) 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 CONTACT NAME: Patti PIRICOW9k1 ACNNO Ex (818)257-7414 AIC No: (818)257 -74150 GNW- Evergreen Insurance Services License Number 0757776 ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC# PO Box 20005 INSURER A:Federal Insurance Co. 20281 Encino CA 91416 -0005 INSURED INSURER B:Fireman Is Fund Insurance CO 21873 INSURER C:Federal Insurance Company 20281 Keenan & Associates INSURER D: P.O. Box 4328 INSURER E $ 200,000 1 INSURER F: $ 5,000 Torrance CA 90510 COVERAGES CERTIFICATE NUMBER:CL1632245498 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. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MMIDD1YYYf POLICY EXP MMIDO LIMITS L� Gloria Dunkel /GLORTD X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE ❑X OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 200,000 MED EXP(Any one person) $ 5,000 X 35796032 4/1/2016 4/1/2017 PERSONAL& ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY❑ PECOT ❑ LOC PRODUCTS- COMP /OPAGG $ Included $ OTHER: A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS f� 74970343 ^� r✓ 4/1/2016 4/1/2017 CEOM FINED SINGLE LIMIT a accident $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURV(Peraccident) $ X NON -OWNED HIRED AUTOS X AUTOS PROPERTY DAMAGE Per accident $ t $ X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 35 000,000 AGGREGATE $ 35 000,000 B EXCESSLIAB CLAIMS -MADE DEC X RETENTION$ 0 $ SU000058032285 4 /1/2016 4/1/2017 WORKERS COMPENSATION ANDEMPLOVERS'LIABILITV YIN PER OTH- STATUTE ER E.L. EACH ACCIDENT $ ANY PROPRIETOMPARTNERIEXECUTIVE OFFICER/MEMSER EXCLUDED? ❑ NIA E.L. DISEASE - EA EMPLOYE $ (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT $ A Crime 8225 -2297 4/1/2016 4/1/2017 Urnits:$10,000,000 Deductible $ 25,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) City of Santa Ana, its officers, employees, agents, volunteers and representatives included as additional insured. Coverage is primary non - contributory. CERTIFICATE HOLDER CANCELLATION ACORD 25 (2014/01) INS025 (201401) ©1988.2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City Of Santa Ana 20 Civic Center Plaza (M -30) THE EXPIRATION DATE THEREOF, NOTICE WILL ACCORDANCE WITH THE POLICY PROVISIONS. BE DELIVERED IN P O Box 1988 AUTHORIZED REPRESENTATIVE Santa Ana, CA 97207 L� Gloria Dunkel /GLORTD - ACORD 25 (2014/01) INS025 (201401) ©1988.2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD