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ACC:>Rbr CERTIFICATE OF LIABILITY INSURANCE
<br />`-+"'w
<br />DATE (MMIDDM Y)
<br />11 /15/2016
<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: 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 />certificate holder in lieu of such endorsements .
<br />PRODUCER
<br />Dealey, Renton &Associates
<br />DRA License 0020739
<br />199 S Los Robles Ave Ste 540
<br />CONTACT Marie Swaney
<br />ME
<br />PHONE626-844-3070 FAX
<br />Ext),
<br />No)
<br />EWa_afe
<br />-MAILAdC
<br />. mswaney@dealeyrenton.com
<br />Pasadena CA 91101
<br />INSURERS AFFORDING COVERAGE NAIC #
<br />INSURER A:American Automobile Ins. Co. 21849
<br />X COMMERCIAL GENERAL LIABILITY
<br />INSURED URBANCROS
<br />INSURERB:Travelers Casualty & Surety Co. Anne 31194
<br />Urban Crossroads, Inc.
<br />41 Corporate Park, Suite 300
<br />Irvine, CA 92606
<br />INSURERC:Valley Fore Insurance Company 20508
<br />INSURERD:Continental Insurance Company 35289
<br />INSURER E: National Fire Insurance Cc of Hartf 20478
<br />949 660-1994
<br />INSURER F :
<br />COVERAGES CERTIFICATE NHMRFR- 187052544 Iacvrc!OM Ml mento.
<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 ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />ILTR
<br />TYPE OF INSURANCE
<br />NSD
<br />WVD
<br />POLICY NUMBER
<br />MMLIDIY`IVYYEFF
<br />MOLDYVYY
<br />LIMITS
<br />C
<br />X COMMERCIAL GENERAL LIABILITY
<br />Y
<br />Y
<br />6021297176
<br />11/1/2016
<br />11/1/2017
<br />EACHOCCURRENCE $2,000,000
<br />CLAIMS -MADE X OCCUR
<br />D MAGE TO RENT D
<br />PREMISES Ea occurrence $1,000,000
<br />MED EXP (Any one person) $10,000
<br />X Qontractual L'ale
<br />X XCU Included
<br />PERSONAL &ADV INJURY $2,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />GENERALAGGREGATE $4,000,000
<br />POLICY PES
<br />LOC
<br />PRODUCTS - COMP/OP ADD $4,000,000
<br />$
<br />OTHER:
<br />E
<br />AUTOMOBILE
<br />LIABILITY
<br />Y
<br />Y
<br />6020089431
<br />11/1/2016
<br />11/1/2017
<br />EOaccident N LE $1,000,000
<br />X
<br />ANYAUTO
<br />BODILY INJURY (Per person) $
<br />ALL OWNED SCHEDULED
<br />BODILY INJURY (Per accident) $
<br />-PROPERTY—DAMAGE
<br />AUTOS AUTOS
<br />X
<br />HIRED AUTOS X NONOAUTOS
<br />$
<br />Per accident
<br />(Per
<br />$
<br />D
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />Y
<br />Y
<br />6020089476
<br />11/1/2016
<br />11/1/2017
<br />EACH OCCURRENCE $2,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />AGGREGATE $2,000,000
<br />DED X I RETENTION$0
<br />$
<br />A
<br />WORKERS COMPENSATION
<br />WZP81036544
<br />11/1/2016
<br />11/1/2017PER
<br />X 0TH-
<br />ANDEMPLOYERS'LIABILITY YIN
<br />STATUTE ER
<br />E.L EACH ACCIDENT $1,000,000
<br />ANY PROPRIETORIPARTNEWEXECUTIVE
<br />OFFICERIMEMBER EXCLUDEDP
<br />NIA
<br />EL.DISEASE-EA EMPLOYEE $1,000,000
<br />(Mandatory in NH)
<br />If yes, describe under
<br />E.L. DISEASE -POLICY LIMIT $1,000,000
<br />DESCRIPTION OF OPERATIONS below
<br />B
<br />Professional Liability
<br />105517955
<br />11/1/2016
<br />11/1/2017
<br />$1,000,000 Per Claim
<br />Claims Made Form
<br />$2,000,000 Annual Aggregate
<br />DESCRIPTION OF OPERATIONS / LOCATIONS IVEH ICLES (AC ORD 101, Additional Remarks Schedule, may be attached If more space is required)
<br />General Liability excludes claims arising out of the performance of professional services. Umbrella
<br />policy is a follow -form to underlying General/Auto/Employers Liability Policies.
<br />RE: All operations of the named insured -- City of Santa Ana, its officers, employees, agents, and
<br />representatives are named as additional insured as respects general and auto liability for claims
<br />arising from the operations of the named insured as required per written contract or agreement.
<br />Coverage afforded the additional insured is primary and non-contributory as respects to general
<br />See Attached...
<br />CERTIFICATE HOLDER �� CANCELLATIO 30 ay NOCM 0 Day for NonPay of Prem
<br />@ 1988.2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
<br />City Of Santa Ana, its Officers, employees, agents, and
<br />representatives
<br />Attn: Purchasing Division
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza
<br />AUTHORIZED REPRESENTATIVE
<br />Santa Ana CA 92701
<br />@ 1988.2014 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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