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q � CERTIFICATE OF LIABILITY INSURANCE °06122720160/ Y Y'
<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(les) 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 />Marsh Risk & Insurance Services
<br />17901 Von Karmen Avenue, Suite 1100
<br />(849) 399.5800; License #0437153
<br />NTAcT
<br />NA ME,
<br />PHONE FAx
<br />Not
<br />E-MAIL
<br />Irvine, CA 92614
<br />:.
<br />-. ............... __..............._._- ....._....
<br />__INSURER(SI AFFOROING COVERAGE
<br />NAIIG
<br />Attn: NewportBeach .CeaRequest@mamh,wnvF: 212. 946.4323
<br />,„,v
<br />INSURER A. Philadelphia Indemnity Insurance Company
<br />18058
<br />093650- CSS- GAWX,16 -17
<br />INSURED
<br />Community Sarrus ero
<br />INSURER B: Zenith Insurance Company
<br />13269
<br />-.-
<br />INSURER c:
<br />PREMIGES Ea oprDao
<br />1200 N. Knolhvood Crcle
<br />Anaheim, CA 92801
<br />_
<br />INSURER D:
<br />$� 6,000
<br />INSURER R:
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: LO$- 001794448 -13 REVISION NUMRER-s
<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 />ILTR
<br />TYPE OF INSURANCE
<br />AODL
<br />INSD
<br />SUER
<br />POLICYNUM89R
<br />POLICY EFF
<br />o 1
<br />OUCyy EX
<br />MPMlD07YYVY
<br />LIMITS
<br />A
<br />X
<br />I COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE E OCCUR
<br />PHPKI516506
<br />0710112016
<br />07101(2017
<br />EACH OCCURRENCE W
<br />$ 1,000,000
<br />PREMIGES Ea oprDao
<br />S. 100,000
<br />MED.EXP (Any aria areas)
<br />$� 6,000
<br />PERSONAL &ADV INJURY
<br />$ 1,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />X POLICY 1-1 JECT D LOC
<br />GENERAL AGGREGATE
<br />5 3,000,000
<br />PRODUCTS - COMP/OP AGO
<br />$ 3,000,000
<br />OTHER:
<br />Sexual Misconduct
<br />5 1,000,000
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />PHPK1516506
<br />07101/2016
<br />01/01/2017
<br />C MBINED SINGLE LIMIT E
<br />a ewidenl
<br />$ 1,004000
<br />X
<br />ANY AUTO
<br />BED: Camp $500- Collision $1,00D
<br />BODILY INJURY (Per person)
<br />S
<br />ALL OWNED r7 SCHEDULED
<br />AUTOS AUTOS
<br />accident Per BODILY INJURY
<br />( )
<br />$
<br />NON -OWNED
<br />HIRED AUTOS AUTOS
<br />—PROPERTY —DAMAGE
<br />Pereccident
<br />$
<br />UMBRELLALIAB
<br />OCCUR
<br />EACH OCCURRENCE
<br />S
<br />AGGREGATE
<br />5
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DEC I
<br />I RETENTIONS
<br />$
<br />8
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y/N
<br />2070773207
<br />07101/2016
<br />0710112017
<br />X P R OTH.
<br />ATUT€ E
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />ANY PROPRIETOWPARTNENEXECUTIVE �N
<br />OFFICERIMEMBER EXCLUDED9
<br />/A
<br />E.L. DISEASE, EA EMPLOYEE
<br />$ 1,000,000
<br />(Mandatory In N,Q
<br />IFyy,6 describe under
<br />DE5CRIPTIONOFOPERATIONSbelow
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 1,000,000
<br />DESCRIPTION OF OPERATIONS/ LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be atfaehed if more spaee is required)
<br />The City of Santa Ana, 20 Civic Center Plaza, Sane Ana, Carfomla 92701: Its officers, employees, agents, volunteers, and representatives are Included as additional Insureds (except Workers' Compensation)
<br />where required by written contract. This Insurance Is primary and non- conklomory over any existing Insurance and limited to liability arising out of the operations of the named insured and where required by written
<br />contract.
<br />�r1 ✓�ry(
<br />CERTIFICATE HOLDER CANCELLATION
<br />City of Santa Ana
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92701
<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 />of Marsh VIA & insommew Services
<br />Jahn Graef
<br />(91988.2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
<br />
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