ORGANIZATIONAL QUALITY ASSOCIATES - 2016

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e<7 MAK L CERTIFICATE OF LIABILITY INSURANCE 8001 DAT9(MMIDD/YYYY) 1 9/12/2016 THIS CERTIFICATEIS 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(les) must have ADDITIONAL INSURED provisions or 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). PR 0 CER WEAVER BROS INS ASSOCS INC/PHS CONTACT NAME: PHONE, E.p. (866) 467-8730 iwc, Nof. (888) 443-6112 630405 P: (866) 467-8730 F: (888) 443-6112 E-MAILADDRESS: PO BOX 29611 INSURERS) AFFORDING COVERAGE NAIC# CHARLOTTE NC 28229 INSURER A. Hartford Casualty Ins Co 29024 INSURED INSURER a: US Liability Insurance Co. 25895 INSURER c CLAIMS -MADE OCCUR ORGANIZATIONAL QUALITY ASSOCIATES INC. INSURER 2802 MOORINGS WAY SE INSURER E: SOUTHPORT NO 28461 INSURER r: COVERAGES CERTIFICATE NUMBER: 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 TYPE OF INSURANCE ADDL SUITS POLTCYNUMRRR POLICYGPF MM/DD POLICYCXP LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1, 000, 000 CLAIMS -MADE OCCUR PREMIES(RENTED 5300 000 PREMISES R NTED nce) / MED ESP (Any ons parson) $10, 000 A X General Lia17 42 SBA BW3781 01/21/2016 01/21/2017 PERSONAL &ADV INJURY 51, 000, 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE 52, 000, 000 POLICY❑ PRO -O LOC JECT PRODUCTS -COMPIOP AGE $2, 000, 000 OTHER. $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1 000 000 (Ea accident) / / BODILY INJURY (Per pardon) $ ANYAUTO A OWNED ASCHEDULED AUTOS ONLY UTOS 42 313A BW3781 01/21/2016 01/21/2017 BODILY INJURY (Per accident) $ PROPERTY DAMAGE 5 (Per accident) X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY 5 X UMBRELLA LIAR X OCCUR EACH OCCURRENCE t2,000,000 A EXCESS LIAB CLAIMS -MADE 42 SBA BW3781 01/21/2016 01/21/2017 AGGREGATE s2,000,000 UED X RETENTION$ 10, 0 0 1 $ WORKERS C'OMPENSd/ION dNDSUPLOYRRTIJAMEITY PER OTH- STATUTE ER E L. EACH ACCI DENT ANY PROPRI ETORIPARTNERIEXECUTIVE YIN OFFICERIMEMBER EXCLUDED? (Mandefery IN NH) ❑ WA E.L, DISEASE -EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E. L. DISEASE -POLICY LIMIT $ S Professional Liab SPI011433J 07/19/2016 07/19/2017 $1,000,000/$3,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Those usual to the Insured's Operations. CERTIFICATE HOLDER CANCELLATION ©1988-2015 ACORD CORPORATION. All rights r s i' d. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD A, SEP 2 0 201 7 oilt- -70 t7 BY: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED City of Santa Ana BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Attn.: Purchasing Department AUTHORIZED REPRESENTATIVE 20 CIVIC CENTER PLZ SANTA ANA, CA 92701.L91 i ©1988-2015 ACORD CORPORATION. All rights r s i' d. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD A, SEP 2 0 201 7 oilt- -70 t7 BY: