|
a F
<br />ACC_A?L> CERTIFICATE OF LIABILITY INSURANCE DATE iMWD1Y/YYYYI11/30/2016
<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: lit the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed, if SUBROGATION IS WAIVED, Subject to
<br />the terms and conditions ol'the policy, certain policies may require an endorsement. A statement on this ceirtiificate does not confer rights to the
<br />certificate holder In lieu of such endorsement(s).
<br />'OE CT
<br />PRODUCER U11A Jef f Cartwright
<br />PN(916)488-4 1 1 - 702 1 F I AX - 1 1
<br />McClatchy Insurance Agency A-2016-250 pA,HO,C� NQE , Ext); i, WC N01,; 916)4A8- 2336
<br />License #0724020 -MAIL E
<br />ADDRES& 3eff@mcclatchys.ns.com
<br />2410 Fair Oaks Blvd, Suite 140 INSURERIS) AFFORDING COVERAGE NAIC 9
<br />Sacramento CA 95825 INSUAERA:Nonprofits Ins. Alliance of CA 011845
<br />INSURED INSURER 8
<br />Public Safety Training Institute INSURER C
<br />P0 Box 6134 INSURER D
<br />Attn: Lt, Mike Elerick INSURER E
<br />lAuburn CA 95604 JINSURER F
<br />COVERAGES CERTIFICATE NUMBERUCL16113008414 REVISION NUMBER:
<br />THIS IS TO CERTiFY 'P IAT "I 1 9E POILiCIES OF R,41,,3'i,JRANCE I..BtiTED BELOW CfAVE BEEN ISSUED FO Thl INSURED NAMED AVFOVEE FOR Tl(E POLICY PERIOD
<br />INDICATED NOTWITHSTANDING ANY REQUIREMENT. IFRM OR G()NITAPION OF ANY CONTRACT OR OTHER DOCUMENII W1181 RESPE.C7 TO WFilCIH 1HIS
<br />CEPFIFICA1E MAY BE ISSUED OR MAY PIMN. THE INSURANCZ AFFORi ES DED By HC DESCRIBED HEREIN IS SUBJECT 10 ALL I"HE TERMS,
<br />EX(CLIJE,K)NS AND CC)NDIT IONS OMER
<br />F SUCI I POLICIES. LIMITSSHOWNIMAY HAVE BEEN REDUCIED BY PA0 CLAWS.
<br />INSF ADD C SI tR II P I OLII I C I Y EFF POLICY EXP
<br />LTR TYPE OF INSURANCE 'INSp WVD.,. POLICY NUMBER iM.M� OOZY Y.YY) ..�MAk�.D.QfYYYY] . .. ..... ... ... .. . LIMITS
<br />X COMMEPCNAL GENERAL LIABILIITY EAI>' OCCURRENOF' 1, 000, 000
<br />DAMAGE TO REN`11D
<br />A CLAIM&MADE X OCCUR PREMQ'.`,S Ta cncRi rqpcej b. 500, 00O
<br />X I 2016 -31882! -NPO 12/15/2016 12/15/2101'7 m 20,000
<br />��D F�XP (Any one persor�
<br />PERSONAI i AEN INJURY $ 1 000,0001
<br />A',-(�RErATE APPJI15 PFR (I F, N F R A � A f I E (',A I K $
<br />000
<br />X pour,;, 1.010, 1 S - A�,,1C, $ 2, 000-1 000
<br />JECT
<br />0THFR Hired/bor,;wed & NOA $
<br />AUTOMOWLE LIABILITY 70MIi.3INLO SINGI.E I,.IMIT $ 1,, 000', 000
<br />ANY N.JO BODIII Y NJUR� (Pm pf'..rr3rr.1 $
<br />A
<br />All OWNFE) SUI, d 1::: 1! VU9E-D 2 0 16 - 3 18 8 2 12115/2016 12115/2017 BOF)II[YIN,)I�Rv(rl�,,,,,.tccfcic,�nrl S
<br />AL170S AIJ OS
<br />NON -OWNED PROF-R]"Y DAMA6F
<br />X WHED AUTI_'S X 1 NACIS
<br />UMBRELLA LIAB
<br />CIICICIUR EAi.',1 4 CX,CURREN(1,'E $
<br />EXCESS LIAB CLAIMS VADE AGG, RECIA7 E
<br />DED HETFr�'010N$
<br />WORKERS COMPENSATION PER 01 1 -
<br />AND EMPLOYERS' LIABILITY Y ; N %1. SrA 9 ITE ER
<br />ANY PROPMETOR PAR �UNER EXECU rIVE F -- EACH AOCOENI
<br />OFFCER/NIERABER LXCLDED9 NPA
<br />IMandatDry un NHj r 1. DISFASE - EA FMPLOYD:; $
<br />r ye$ C�T)Scrlrxl uIder
<br />1r�S',,RiPTION 01' OPFHA rK)NS b(thyA, $
<br />DESCRIPTION OFOPEIRATIONS! 0.,OCAFJ()N5 rVEHIJOLES IACORO 90t, A(idMonal Rrjmnarks Schodulo, may bo atlachud d more ipace is, roquired)
<br />RE: Public Safety Training. Additional Insured with written contract or agreement,
<br />The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California, 92701; its officers, employees,
<br />agents, and representatives are included as Additional Insured, with respects to General Liability, per
<br />terms and conditions of policy. Additional Insured endorsement attached --CG 20 10 04 13, Insurance is
<br />primary and non-contributory, per attached form--NIAC E61 12 15,
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ATTN: Purchasing Department ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92701, AUTHORIZED REPRESENTATIVE
<br />"elf
<br />0 1988-2014 ACORD CORPORATION. '°,rightsireserved.
<br />ACCIRD 25 (2014/01) TheACORD name and logo are registered marks of ACORD
<br />INS025 (201401? µ,-7
<br />VAGF �/L, PSN`�:�WEJ) VY
<br />
|