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4286 Wlsepiace, a Ca Carp Certificate of Insurance
<br />(page 1 of 1) 02/04/2016'12:37:01 PM
<br />CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MMIDDAYYY)
<br />2/4/2018
<br />THIS CERTIFICATE I$ 18SUED 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 I1,18URER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER,
<br />IMPORTANT! If the curllfloate holder Is an ADDITIONAL INSURED, the pollcy(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 endorsemont(s).
<br />PRODUCER
<br />ONAOUN CT
<br />SaeCtSolutlons Insurance Services. LLC
<br />#0127711
<br />1380 Carlback Avanue
<br />PHaNH 888.500.8869 c No: 868 8048448
<br />M
<br />INGURERa AFFORDING COVERAGE NAICq
<br />Walnut Creek, CA 84698
<br />sURERAt New Yolk Marine &Genome Insurance 6608
<br />INSURED
<br />INBUReae PhIladolDbig [odgmnItyInsurance Compan
<br />Weeplace, a Cs Corp
<br />1411 N, Broadway
<br />Santa Ana, CA 92708
<br />II4BU RG;
<br />sURERDI
<br />INsu e e
<br />BURS F:
<br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WTH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IB SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUOED BY PAID CLAIMS,
<br />ITR
<br />L
<br />TYPE OFNSURNOE
<br />D
<br />B BR
<br />OLO U BB
<br />ppO C
<br />MMI00
<br />POICY EXPY
<br />aLW% Y
<br />U14ITS
<br />COMMERCIAL GENERAL LIAEILIIY
<br />CLAIMS MADE E OCCUR
<br />�7%Cl.GTi �4.4.G4Li9.Ni
<br />EAOHOCCURRENOE $ 1,000,000
<br />$ 100,000
<br />MEtl Eltp n°nspsnory $6,000
<br />PEReaNALa POVINJURY 5
<br />a
<br />Ves
<br />PHW1438862
<br />Vlooie
<br />1IIM01]1.000,000
<br />GEN'LAGGREGATE UMITAP-U"PER:
<br />_ POLICY L00
<br />_
<br />UeNERALAGGREGATE $ 2.000,0W
<br />PRODUCTS-COMPIOPAGG 421000100J
<br />S
<br />2 H5
<br />AUTOMOBILE
<br />LIABILITY
<br />2ff DoINUMLIUMEf Mt$ 1000000
<br />ANY AUTO
<br />ODDLY INJURY (Por parson) 3
<br />AUTosNED AUTOS LEO
<br />PHPK1490002
<br />111/2018
<br />91!2017
<br />MDILY INJURY (ParacddaDq $
<br />a
<br />HIReOquTos A01MZANED
<br />Yes
<br />9
<br />UMBRELLAUAO
<br />OCCUR
<br />EACHOCCURRENCE $ 1400.00)
<br />B
<br />EXCESS LlAn
<br />CLAIMS -ME
<br />Y0°
<br />PHU09297eB
<br />111f201s
<br />1nnC17
<br />gGOREOATE $ 1,000,000
<br />DED RE1'EM'IUN$
<br />$
<br />A
<br />WORKERS COMPENSATION
<br />EMPLOYERS' LIABILITY yIN
<br />MY PROPRIETORIMRTNER1EXECUTIVE
<br />OFFIONUMEMBER EXCLUDED? Y�
<br />(Mondale nNH)
<br />NIA
<br />MC2N0000683a
<br />311312010
<br />311612010
<br />K"
<br />A 1E E_
<br />__LC
<br />E.L. EACH AMOUNT $ 1,000,000
<br />E.LOGEASE-ENEMPLOYE $ 1,000,000
<br />p 1,000,000
<br />E.L. DfiEA6E- POLICY LIMIT ¢
<br />DESCIf RIPTION OFF
<br />DESCRIPTION OF OPERA IONS eIOW
<br />e
<br />P;mfo.ionol L10,111ty BY1mand OIUIW s)
<br />PHPKPIoU*2
<br />iltY1018
<br />1!1!201]
<br />$1i00tl,000!$2,000,000
<br />DE3OMP1'ION OP OPEMMONS I LOCATIONSI VEHICLES (ACnRD 101, AtldiliOnal Remarks 6ohotlulo, may be aaaohetl if mom spoao is raqulrotl)
<br />The City of Santa Ana, Its officers, employees, agents, volunteors and representatives are named Rs Additional Insured with respect to General Liability policy
<br />per attached endarsoment.Thisinsuranco Is Prlmery and Non-contributory to any other Insurance provided as mspecha General Hablllly, policy per attached
<br />endorsement, The Professlor al Liability Limits Shown represent the Per Claim/Aggregate Llmlts of Llabllily.
<br />CERTIFICATE HOLDER CANDDI I ATIr1N
<br />©1888-2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANOELLEDDEFORE
<br />The City of Santa Ana
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BB DELIVERED IN
<br />20 CIVIo Center Plaza
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Santa Ana, CA 92701-
<br />._...._._
<br />AUTHORIZED REPRESENTATIVE
<br />�7%Cl.GTi �4.4.G4Li9.Ni
<br />©1888-2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
<br />
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