PUBLIC AGENCY RETIREMENT SERVICES (PARS) -2016

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ACC?R& CERTIFICATE OF LIABILITY INSURAN'CE' FTE (M12_'D/2017D/YYYY) 1 51 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(es) 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 CONTACT NAME: Warner Pacific Insurance PHONE FAX DAMAGE TO RENTED (AIC, No, Ext): (AID, No): 32110 Agoura Rd E-MAIL ADDRESS: MED EXP (Any one person) INSURERS) AFFORDING COVERAGE NAIC to W I estlake Village CA 91 1 361 INSURER A:Employers Assurance Company 25402 INSURED INSURER B PHASE II SYSTEMS INC, DBA; PARS INSURER C 4350 VON KAPRM AVE INSURER D SUITE 100 INSURER E ,INEWPORT BEACH CA 92660 1 INSURER F: K1K§1'1;41:fA1M 21 TILT1 L24 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 Abu suBR POLICY EFF POLICY EXP LTH TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDD)YYYY) (MMIDDIYYYYI LIMITS JCOMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE OCCUR DAMAGE TO RENTED 'PREMISES (Ea occurrence), MED EXP (Any one person) $ . . . . .. ............. ............ ....... PERSONAL & ADV INJURY $ . . ............. . ... .... . .. . GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRO- POLICY JECT LOC PRODUCTS - CCMPIOP AGG . ...... .. . ... . .. $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accciept) ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED I ; AUTOS AUTOS BODILY INJURY (Per accident) $ i NON -OWNED PROPERTY DAMAGE $ HI RED AUTOS AUTOS (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXC ESS LIAB CLAIMS-MADE'...AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION x PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER,,, .. ........... ,ANY PROPRIETOR/PARTNENEXECUTIVE NiA E.L. EACi I ACCIDENT $ 1 000,000 OFFICER/MEMBER EXCLUDED? i (Mandatory in NH) N SMC002110615 4/1/2017 4/1/2018 E.L. DISEASE EA EMPLOYEE $ 1,000,000 If yes. describe under DESCRIPTION OF OPERATIONS betow E.L. DISEASE POLICY LIMIT $ 1, 000, OOG DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required) TEN DAYS NOTICE OF CANCELLATION FOR NON—PAYMENT. City of Santa Ana Attn: Executive Director of Personnel Se 20 Civic Center Plaza, M-24 Santa Ana, CA 92701 L,LLLA I IUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE @ 1988.2014 ACORE)/60RPORATION, All riGhts reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401)