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CERTIFICATE OF LIABILITY INSURANCE DATE2016 /YYYY) 11/10/201 1 / 10/2016 THIS CERTIFICATE IS 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(ies) must 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). PRODUCER Woodruff -Sawyer & CO. 50 California Street, Floor 12 San Francisco CA 94111 CONTACT __NAME: PHONE FAX PM Ext 4) 15 391 2141 _ - Ac Ne)415-989-9923 E EDD LE INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Chubb Custom Insurance Company 38989 11/1/2017 INSURED AMERLOG-01 INSURER B: INSURER C: Cabco Yellow, Inc. dba John Wayne Airport Yellow Cab Service 901 Amanecer, Suite Suite 260 _ INSURER D ----------- INSURER E: San Clemente CA 92673 INSURER F: COVFRAGFS CFRTIFICATF NIIMRFR• 953996672 RFVICInM MI11111l 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 I — LTR TYPE OF INSURANCE ADDLUBR INSD WVD ----- POLICY EFF POLICY NUMBER MM/DD/YYYY POLICY EXP MMIDD/YYYY -- LIMITS A X COMMERCIAL GENERAL LIABILITY .J CLAIMS -MADE lxl OCCUR Y 79965269 11/1/2016 11/1/2017 EACH OCCURRENCE -15ATvfAG`E fo lNrl t .....m PREMISES (-Eta„pvcurrancQ),,, $1,000,000 1QQ_000, MED EXP (Any one person) _ _.______ $5,000 __........__....._.—..._,_.....-.._.._.__... PERSONAL & ADV INJURY $1,00_0,000 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 GEM) X POLICY JECT- L_ LOC PRODUCTS - COMP/OP AGO _ $2,000,000 -- — - $ OTHER: AUTOMOBILE LIABILITY COMBINED G MIT Ea accident) __ $ BODILY INJURY (Per person) $ ANY AUTO ALLOWN EDSCHEDULED AUTOS -- -- --_..-....--------.._.._...-_...---- BODILY INJURY (Per accident) -- $ NON -OWNED HIRED ALL OS AUTOS (Per avoidant) _ , $ $ UMBRELLA LAB HCLAIMS-MADE OCCUR EACH OCCURRENCE_ $ AGGREGATE $ EXCESS LIAB DED RETENTION$ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? NIA A PER OTH- —_-. STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE - $ (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT - $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Santa Ana, its agents, officers, employees and volunteers are included as additional insured as required by written contract. REVIEWED BY: EUNICE HEREDIA (PG OF } CERTIFICATE HOLDER CANCELLATION O 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 Civic Center Plaza ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 1988 Santa Ana CA 92702 AUTHORIZED REPRESENTATIVE dF O 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD