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A� O CERTIFICATE OF LIABILITY INSURANCE D6/21/2016Y)
<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 />PRODUCER
<br />ISU Insurance Services - Centinel Agency, LLC
<br />250 Executive Park Blvd
<br />Suite 4800
<br />San Francisco CA 94134
<br />INSURED ry . _ &VU -Og�
<br />California Barricade Rentals Inc orV lV
<br />1550 E Saint Gertrude Place
<br />(415) 657 -2000 {AX- pl: (418) 651-2002
<br />cnando @isuca.com
<br />INSURER(Sl AFFORDING COVERAGE NAIC B
<br />INSURER A:SCottsdala Insurance COmpariy
<br />INSURERS Nationwide Mutual Ins Co
<br />INSURER C National Union Fire IRS CO of
<br />INSURERD:State Compenaatl6n Ins. Fund
<br />INSURER E:
<br />Santa Ana CA 92705 Ana CA 927051INSURERF IFI
<br />COVERAGES CERTIFICATE NUMBER:16 -17 GL, WC, Auto, XS REVISION NUMBER:
<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 ALI, THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />I O R
<br />POLIC'TE F POLICY EXP
<br />TYPE OF INSURANCE , POLICY NUMBER MM100fYYYY MMIDDIYYYY LIMITS
<br />LTR
<br />! XI COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE ',$ 1,000,000
<br />._ .—
<br />A _j CLAIMS -MADE . X OCCUR
<br />_UAMAGETO RENTED _.• . - - -_.
<br />PREMISES (Ea aaunenca). _.; �_ 100,000
<br />X WS0033435
<br />I, 7/1/2016 : 7/1/2017 MEDEXP(Anyonepemon) '.$ Excluded
<br />'..
<br />: PERSONAL& AOV INJURY $ 1,000,000
<br />GEN'L AGGREGATE LIMITAPPLIES PER
<br />GENERAL AGGREGATE $ 2,000,000
<br />X POLICY jRCT '.._ LOC
<br />: PRODUCTS - COMP/OP AGO $ 2,000,000
<br />'- OTHER '
<br />Employee Seirefils It 11000,000
<br />AUTOMOBILE LIABILITY "'
<br />: COMBINED SINGLE LIMIT '.$ 1,000,000
<br />(Ea __acrldam) ...
<br />X'ANY AUTO
<br />BODILY IWURY(Per pusan }',,$
<br />B
<br />BALL OWNED SCHEUULED ACP 307745240
<br />4 AUTOS ; AUTOS X
<br />1 7/1/2016 7/1/2017 BODILY IWURY(Peraccrdenr) $
<br />_ -- _ _
<br />R X NONANMED
<br />j PROPERTY DAMAGE
<br />HIRED AUTOS ! A11T05
<br />$
<br />(Perawdon9 _ -------- _
<br />$
<br />__', UMBRELLA LIAB X OCCUR
<br />EACH OCCURRENCE "': $ 5,0001000
<br />C X_EXCESS LIAB CLAMS -MADE
<br />AGGREGATE '.$ 5,000,0_0.0_
<br />DED 'RETENTION $ EEO 012013646
<br />7/1/2016 7/1/2017
<br />WORKERS COMPENSATION
<br />PER OTH-
<br />p'
<br />AND EMPLOYERS' LIABILITY YfN
<br />STATUTE _ ER ....__.__..
<br />ANY PER)MEMTORI —'
<br />E.L. EACH ACCIDENT $ 1,000,000
<br />ER EXCLUDED? 'NfA
<br />EXCLUDED?
<br />-
<br />D (Mandatory NH) - 9063600 -2016
<br />(Mandatory In
<br />7/1/2016 7/1 /2017 EL D15EASE EA EMPLOYEES _ 1 00,000
<br />DISEASE, E
<br />If yes, tleacdb0 untler
<br />DESCRIPTION OF OPERATIONS belay
<br />EL. DISEASE- POLICY LIMIT $ 1,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES (ACORD 1101, Additional Remarks Schedule, maybe attached If more space is requlredl
<br />The City of Santa Ana, its officers, employees,
<br />agents, and representative are named aagr itional
<br />insured per form CG 20 33 04 13 and CO 20 37 04
<br />13 on the GL policy. Qi
<br />Additional Insured applies per form AC 70 05 03
<br />16 on the Auto policy.��\�
<br />Those usual to the insured's operations.
<br />4
<br />City of Santa Ana
<br />20 Civic Center Plaza - M -23
<br />Santa Ana, CA 92702
<br />W
<br />SHOULD ANY OF THE ABOVE DESCRIBE-6 POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />Ferenc /FR
<br />(c) '1988.2014 ACORD CORPORATION. All rinhts reserved.
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
<br />INSO25 Onl4nn
<br />
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