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/-+,./-^^�'•^""�} 211OC-0000 _HBCT21
<br />DATE (MMi)DIYYYY)
<br />... CERTIFICATE OF LIABILITY INSURANCE 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 policy0es) 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 andome-m- nt s _
<br />PRODUCER License # 0564249 CONTACT Jackie Riola
<br />Heffernan Insurance Brokers PHONE -— ___- "---- FAX... ._._. _.._.-.
<br />6 Hutton Centre Drive Suite 500 A to F Ut 1_(714} 361-7700 _ _ (NC._N T; 1 {714) 381.7701
<br />2.1.1 Orange County INSURER C:
<br />1505 E. 17th Street _
<br />Suite 108 INSURER D
<br />Santa Ana, CA 92705 -INSURERS:
<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 SEEN REDUCED BY PAID CLAIMS.
<br />INSFt —____ '. ____�_�Abp1 SUER __.._.,� —__. __ POLICY 47, f`"�P6iiGl'
<br />LFR TYPE OFINSURAHCE INBD ffVb POGCY NUMBER {MMIDINYY Y) (MMlCfptYYYY) LIMITS
<br />INSURaRj$j AFFORDINe COVERAGE
<br />EACH OCCURRENCE
<br />s 1,000,0-60
<br />INsugERA Nonprofits Insurance Alliance of California
<br />,NAICN
<br />01184
<br />_._-�_
<br />$_ 500,060
<br />INSURER E: QBE Insurance Corporation
<br />39217
<br />2.1.1 Orange County INSURER C:
<br />1505 E. 17th Street _
<br />Suite 108 INSURER D
<br />Santa Ana, CA 92705 -INSURERS:
<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 SEEN REDUCED BY PAID CLAIMS.
<br />INSFt —____ '. ____�_�Abp1 SUER __.._.,� —__. __ POLICY 47, f`"�P6iiGl'
<br />LFR TYPE OFINSURAHCE INBD ffVb POGCY NUMBER {MMIDINYY Y) (MMlCfptYYYY) LIMITS
<br />A X COMMERCIAL GENERALLMBILITY
<br />EACH OCCURRENCE
<br />s 1,000,0-60
<br />CLAIMS -MADE X . occuR X 2916031 p4NP0
<br />-OA iGEi6RE_..
<br />9210172016 0210112017 NTE0
<br />EM PRs(Ee begbnagcei.
<br />_._-�_
<br />$_ 500,060
<br />..._—.--- _.. ... .- _._____-
<br />MED EXP (Any one Person)
<br />$__ 20,000
<br />AUTHORIZED REPRESENTATIVE
<br />PERSONAL &ADV INJURY
<br />S 1,000,000
<br />GENT ARGRFGATE LIMIT APPLIES PER
<br />GENERAL AGGREGATE
<br />S2,000,000
<br />_ �-
<br />X LOC
<br />POLICY PRO JECT �
<br />—.._____._ _....
<br />PRODUCTS - CONFIDE AGO
<br />_._............T_... _.__._
<br />$ 2,000,000
<br />01'HEH
<br />.........._m____..�._...�.__..�........._..._._._
<br />AUTOMOBILE LIABILITY
<br />-
<br />_.�...._._._.
<br />COMBINED SINGLE LIMIT
<br />-Lo acc)
<br />_ _...
<br />ANYAU70 2016031p4NP0
<br />.
<br />02/0112896 02101/2817 BODILY INJURY (Par person)
<br />, ._.1.,1,0()0,000_g_0
<br />__A
<br />S
<br />'.ALED
<br />AUUTTOOSS . AUTOS AUTOS
<br />INJURY(P.,
<br />BODILY ..anent)
<br />$
<br />--I NON -OWNED
<br />X : FiIkC-O X'AUTOS
<br />_ _ .____,
<br />-PROPERTY DAMAGE
<br />.., ....._..W.___'_
<br />AUT 05 _.
<br />,. iPel a..Lidant}
<br />�
<br />S.
<br />X UMBRELLA LIAS . x.. OCCUR
<br />EACH OCCURRENCE
<br />$ 2,000,000''...
<br />A E%DESS.IAB CLAIMS-G1ADE: 201603104UM$NPO
<br />92!6112816 0210112017 AGGREGATE
<br />s 2,900,000',.
<br />DED._ RCTENT70N$
<br />5
<br />WORKERS COMPENSATION
<br />..PER
<br />AND EMPLOYERS' LIABILITY YIN
<br />,___STATUTE__ ER._,._.
<br />---------
<br />ANY PROPPoETORIPARTNERIP-XECUTIVE
<br />OFFICERIMEMBER EXCLUDED? .NIA
<br />- E.L. EACH ACCIDENT
<br />S
<br />(Mardatory In NH)
<br />E.L. DISEASE- EA EMPLOYEE
<br />$
<br />If yu, das nno under
<br />_._..—_-.___.......___--_-
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE- POLICY LIMIT
<br />$
<br />B'DisabilltyAD&D-Trav MHH010307
<br />02/91/2916 02/0112017
<br />50,000
<br />A '.Prof. Liability 201603104NPO
<br />02/0112016 0210112017 Ea. Occurance
<br />1,000,000.
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORU 101. Addltlbnal Remarks Schetlule, may pe attached If Moes aRaae Ix mquiretll
<br />Re: As Per Contract or Agreement on File with Insured, City of Santa Ana, Community Development Agency Is included as an additional Insured on General
<br />Liability policy per the attached endorsement, If required.
<br />CERTIFICATE HOLDER CANCet_I ATION
<br />O 1988.2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 26 {2014101} 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 />Administrative Services Division M-26
<br />AUTHORIZED REPRESENTATIVE
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92701
<br />^�
<br />O 1988.2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 26 {2014101} The ACORD name and logo are registered marks of ACORD
<br />
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