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<br />CERTIFICATE OF LIABILITY INSURANCE
<br />121112017
<br />DATE(MMIDDIYYYY)
<br />6f 6/l/2017
<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 />ADDL
<br />fN D
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject 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 lieu of such endorsement(s).
<br />POLICY NUMBER
<br />PRODUCER LOCkton Insurance Brokers, LLC
<br />CA License #OF15767A1C
<br />Three Elmbarcadero Center, Suite 600
<br />San Francisco CA 94111
<br />(415)568-4000
<br />NAME:
<br />LIMITS
<br />FAX
<br />No, Ext): A1C, Nos :
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAdMS-MADE191 OCCUR
<br />EMAIL
<br />ADDRESS:
<br />N
<br />INSURER /AFFORDIN C VERAGE
<br />NAIL#
<br />INSURER A : National Fire Insurance Co of I laill'ord
<br />20478
<br />INSURED Active Network LLC "s 2
<br />1394474 17 North TX 5201 Harwood St., Suite 2500 M1 1
<br />Dabs
<br />INSURER B The Continental Insurance Company 'n
<br />35289
<br />INSURER C : Lloyd's of London
<br />38253
<br />Company
<br />wSUR R D : Columbia Casuals Com an !
<br />31127
<br />INSURER E:- Illinois National Insurance Company
<br />23817
<br />INSURER
<br />IncludedGENT
<br />lrranvcr's r100rlcrrrA'171=KIHAA01= v REVISION NUMBER: 7tJ4�'S.'S1iAA
<br />r947G:J .kjotoo ......_-
<br />'I+UVCV
<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 />S
<br />TYPE OF INSURANCE
<br />ADDL
<br />fN D
<br />SLIBR
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MMIDD/
<br />POLICY EXP
<br />IMMIDDlYYYY
<br />LIMITS
<br />A
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAdMS-MADE191 OCCUR
<br />Y
<br />N
<br />6016940273
<br />6/1/2017
<br />9/1/2013
<br />EACH OCCURRENCE 1,000,000
<br />PREMISES RENTED occurrence)1,0'00,000
<br />MED EXP An one erson 15,0'0'0
<br />I lost I i a©r Liab
<br />PERSONAL & ADV INJURY $' 1,000,000
<br />IncludedGENT
<br />GENERAL AGGREGATE S 2,000,000
<br />AGGREGATE LIMIT APPLIES PER"
<br />PRODUCTS - COMPIOP AGG $ 2,000,000
<br />POLICY O PRO -ECT D, LOC
<br />$
<br />OTHER
<br />A
<br />AUTOMOBILE LIABILITY
<br />N
<br />N
<br />601604'0230
<br />6/1/2017
<br />9/l/2013
<br />EaaaB�doDtSINGLELIMIT $ 11000,000
<br />BODILY INJURY (Per person) $ .r'�X'X i�X X X
<br />X ANY AUTO
<br />AUTOS ONLY AUTHEDULED
<br />OS
<br />HIRED D NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />X Collip $500 X Coll $500
<br />INJURY(Per accident $]]{,5�..
<br />XX
<br />�ROPEERdTYDAMAGE $ X`S x i
<br />$ xxxxxXX
<br />H
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />N
<br />1'sl
<br />6016940287
<br />6/l/2017
<br />9/112013
<br />EACH OCCURRENCE $, 25,000,000'
<br />AGGREGATE $ 25,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED RETENTION$
<br />$ xxxx.�ix
<br />B
<br />COMPENSATION
<br />AND EMPLOY
<br />AN PROPRI ®ERS' LIABILITY YIN
<br />ANY PROPRIETORlPARTNERdE>tECUT'IVE
<br />ER EXCLUDE E ®
<br />(Mandatory in NH)
<br />N (A
<br />N
<br />60169'4'0256 ACS)
<br />601 6940`42 CA,
<br />y S )1
<br />6./1/2017
<br />61'1/2017
<br />9/1/201$
<br />91112013
<br />sTATDTE CER
<br />Xyy
<br />000
<br />E.L. EACH ACCIDENT $ 1,000,000
<br />n nn�l1
<br />E.L. DISEASE. EA EMPLOYEE 1,000 000
<br />E . DISEASE - POLICY LIMIT 1,000,000
<br />If yea. describe under
<br />DESCRIPTION OF OPERATIONS below
<br />C
<br />1)
<br />L,
<br />Crime
<br />PrimaryTechE&O/C0er
<br />XS'reuh Ec°�O/Cy�bcr
<br />N
<br />N
<br />SPRDR1700925 crime
<br />7)65711631;&C7
<br />02-330-25-49
<br />6111201 7
<br />12/112.016
<br />1211/2,016
<br />9/112013
<br />1211/2017
<br />1211/2017
<br />55,000,000 Limit
<br />$5,000_,000
<br />$5,000,000
<br />J"
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule„ may be attached if more space is required �
<br />City of Santa Arra, its officers, agents and employees are. included as additional insured as respects General Liability as required t it en contract or
<br />agreement. Coverage is primary and non-contributory. See attacbed separation of insured's clause - form 480-02-2000, a
<br />y.J YYY
<br />:��,~y •iM1 �V
<br />UERTIFIGAT E h1U'LUEK L MlvvcLLn rvr+ uW r .- & ,,,,.
<br />i.
<br />SHOULD ANY OF THE ABOVE DESCRIBEDw-OLICIES BE CANCELLED BEFORE
<br />THE EXPIRA'TION'S DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />12901238 AUTHORIZED REPRESENTATIVE
<br />City of Santa Ana, its officers
<br />agents and employees
<br />Attention: Silvia Cuevas
<br />26 Civic Center Plaza
<br />Santa Ana CA 92701
<br />Arman ?r ran1rtnAt @19 8-2015 ACOR CORPORATI . All rights reserved
<br />The ACORD name and logo are registered marks of ACORD
<br />
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