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CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MM/DD/YYYY)
<br />AODL
<br />INSD
<br />12/28/2016
<br />THIS
<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(ies) must have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subjoct to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder in Ileu of such endorsement(s).
<br />PRODUCER Spectrum Risk Management
<br />p 9
<br />CONTACT
<br />NAME; Account Mana er
<br />74 Discovery
<br />Irvine, CA 92618
<br />PHONE FAX
<br />_iA/C ext): 949-756-5730 A( c_Nol; 949-_756-5740
<br />IL
<br />ADDRESS: Off] COOS peCtrU in risk. coin
<br />$ 1,000,000
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC 8
<br />✓
<br />INSURER A: Navigators Specialty Insurance Co
<br />36056__
<br />www.spectrumrisk,com OC77485
<br />INSURED
<br />TSCM Corporation
<br />INsuggR_s__ American States Insurance Company
<br />19704
<br />04
<br />---
<br />)NSURERC: National Union Fire Insurance Co, of Plltsburgh,PA
<br />—
<br />_ 19446
<br />TSCM Corporation Of Arizona
<br />Pa ano Investment Group, LLC
<br />wsuRERD: cypress Insurance Co.
<br />-- ._..
<br />17 171 Jamestown Lane
<br />Huntington Beach CA 92647
<br />INSURER E:
<br />- --- -
<br />-- -
<br />INSURER F
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICYF,/] PRC LOC
<br />=WWAMazoilCl�11yTACYftl \t•awrtayy�
<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 />INSR
<br />LTR TYPE OF INSURANCE
<br />AODL
<br />INSD
<br />SU©R
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM/DD/YYYY
<br />POLICY EXP--
<br />MM/DD/YYYY
<br />LIMITS
<br />A �/
<br />I
<br />COMMERCIAL GENERAL LIABILITY
<br />1
<br />CLAIMS-MADE OCCUR
<br />LA17CGLO195681C
<br />i'111/2017
<br />{
<br />'1/1/2018
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />DAMAGETO RENTED—
<br />_PREMISES L occurroncpJ__—
<br />$ 100,000
<br />-...............-_--.......... _
<br />✓
<br />Deductible- $2500
<br />MED EXP (Any one person)_
<br />$ 5,000
<br />Contractual Liability
<br />PERSONAL SADV INJURY
<br />'1,000,000
<br />✓
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICYF,/] PRC LOC
<br />_
<br />GENERAL AGGREGATE
<br />_$
<br />$ 2,000,000
<br />PRODUCTS -COMP/OP AGG
<br />--
<br />$ 2,000,000
<br />—
<br />$ ----— -
<br />OTHER:
<br />ii
<br />AUTOMOBILE
<br />LIABILITY
<br />!,
<br />!
<br />01-CI-II69920-10
<br />1('1!2017
<br />1/1/2018
<br />COM cc1d DSINGLELIMIT
<br />Ea accident
<br />$
<br />1,000,000
<br />PODILY INJURY (Per person)
<br />$
<br />✓
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />BODILY INJURY Per accident
<br />( )
<br />$
<br />AUTOS ONLY AUTOS ONLY
<br />PROPERTY DAMAGE
<br />IPar--
<br />ac cldenQ_.__
<br />--
<br />$
<br />$
<br />✓
<br />Dedcutible-0 I
<br />C
<br />,/
<br />UMBRELLALIAB ✓ OCCUR
<br />BE 066322235
<br />1/1/2017
<br />1/1/2018
<br />EACH OCCURRENCE
<br />$ 5,000 000
<br />EXCESS LIAR CLAIMS MADE
<br />AGGREGATE
<br />$ 5,000,000
<br />$
<br />DED RETENTION$0
<br />D
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y / N
<br />ANYPROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICER/MEMBER EXCLUDED?
<br />IN/A1
<br />I
<br />I
<br />TSWC706736
<br />7/1/2016
<br />i
<br />7/1/2017
<br />i.-✓ STATUTE. _ .OTRH-
<br />E.L. EACH ACCIDENT
<br />—
<br />$ 'I ,000,000
<br />(Mandatory In NH)
<br />If yes, describe under
<br />E.L. DISEASE - EA EMPLOYEE
<br />--- ------
<br />$ 1 000 000
<br />---'------'-----
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 1,000,000
<br />DESCRIPTION OF OPERATIONS below
<br />�
<br />I
<br />DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
<br />Re; Parking lot sweeping services.
<br />The City its officers, agents, employees are named additional Insureds with resepect to the general liability and auto liability per the attached
<br />blanket carrier form,
<br />., _. - _.-_-. -.-
<br />t VIEW €1 B 6 UN&s E HEREDIA (P.
<br />V 1111 V— I 1-1—IN
<br />The City of Santa Ana
<br />Community Development Agency
<br />20 Civic Center Plaza M-25
<br />Santa Ana CA 92701
<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 />AUTHORIZED REPRESENTATIVE
<br />Jim Waterhouse
<br />U 1988-2015 ACORD CORPORATION. All rights reserved,
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />33500652 1 Ginnie 1 2017 All 1.1—s 1 Ginnie Bustz-ante 112128/2016 12:12:25 P14 (NDT) I Nqn 1 er 9
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