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A�� �® CERTIFICATE OF LIABILITY INSURANCE
<br />12/a/2o17D
<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, 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 />PRODUCER
<br />Arthur J. Gallagher& Co.
<br />Insurance Brokers of CA, Inc. LIC #0726293
<br />1255 Battery Street, Suite 450
<br />CONTACT ..
<br />NAME:
<br />PHONE 415-536-8617 FA 415-536-8627
<br />E-MAIL
<br />S AFFORDING COVERAGE NAICA
<br />San Francisco CA94111SURER
<br />INSURER A:Arilerlcan Fire and Casualty Company 24066
<br />/
<br />INSURED CSGCONS-01
<br />INSURERB:0YPreSS Insurance Company CA 10855
<br />INSURERC:Arch Insurance Company11150
<br />CSG Consultants, Inc.
<br />550 Pilgrim Ddve
<br />Foster City, CA 94404
<br />NSURERD:WestAmerican Insurance Co 44393
<br />CLAIMS -MADE ❑X OCCUR
<br />NSURER E
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: 393444608 REVISION NUMBER:
<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 MIA AVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR
<br />LTR
<br />rypE OF INSURANCEADDLSUBR
<br />INSD
<br />MD
<br />POLICYNUMBER
<br />POLICY EFF
<br />MMIDD/YYYY
<br />POLICY EXP
<br />MMIDDIYYYY
<br />LIMITS
<br />D
<br />X COMMERCIAL GENERALLIABILITY
<br />Y
<br />BKW(18)57695795
<br />12/4/2017
<br />1214/2018
<br />EACH OCCURRENCE $1,000,000
<br />-DAMAPREMISES
<br />CLAIMS -MADE ❑X OCCUR
<br />PREMISES Ea occunence) $500,000
<br />MED EXP (Any one person) $5,000
<br />PERSONAL&ADV INJURY $1,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />GENERALAGGREGATE $2,000,000
<br />POLICY D PRO -
<br />ECT M LOC
<br />PRODUCTS-COMP/OP AGO $2,000,000
<br />$
<br />OTHER:
<br />A
<br />AU)f
<br />BILITY
<br />Y
<br />BAA(18)57695795
<br />12/4/2017
<br />12/4/2018
<br />Ea accident)M $1,000,000
<br />BODILY INJURY (Per person) $
<br />ANYAUTO />
<br />AWNED NLV SCHEDULED AUTOS
<br />BODILY INJURY (Per accident) $
<br />HIRED NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />PROPERTY DAMAGE $
<br />Per accident
<br />A
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />USA(18)57695795
<br />12/4/2017
<br />12/4/2018
<br />EACH OCCURRENCE $5,000,000
<br />AGGREGATE $5,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED X RETENTION $0
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />CSWC821833
<br />12/4/2017
<br />12/4/2018
<br />X PER OTH-
<br />STATUTE ER
<br />ANY
<br />OFFICER/MEMOOR[PARTNEED?ECUTIVE
<br />NIA
<br />E.L. EACH ACCIDENT $1,000,000
<br />E.L.DISEASE-EAEMPLOYE$1,000,000
<br />(Mandatory in NH)
<br />If yes, desuibe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE -POLICY LIMIT $1,000,000
<br />C
<br />Professional Liability
<br />PAAEP0008802
<br />12/4/2017
<br />12/4/2018
<br />Each Claim $5,000,000
<br />retro date: 1/1/1991
<br />Aggregate $5,000,000
<br />Deductible: $50,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS [VEHICLES (ACORD101,AddfiJ I Remarks Schedule, may be attached R more space is recIulmd)
<br />re: consultant agreement for municipal DIaD Ghe scl� ervices made and entered 11/15/16. City of Santa Ana, a charter city and municipal
<br />corporation organized and existing under the Constitution and laws of the State of California, its officers, employees, agents, volunteers and
<br />representatives are included as additional insureds on a Primag—& Non -Cont ._basis on GL & Auto with 30 Day Notice of Cancellation
<br />per attached. 30 Day Notice of Cancellation on Professio a ratb5-i_6-cA ayF deice of Cancellation on WC is not available.
<br />V'4v if W%,kik A- Mk;
<br />\ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City of Santa Ana, Clerk of the City Council THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />20 Civic Center Plaza (M-30) ACCORDANCE WITH THE POLICY PROVISIONS.
<br />PO Box 1988
<br />/ USanta SA Ana CA 92702-1988
<br />AUTHORIZED REPRESENTATIVE
<br />©1988.2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016/03) /'F a ACORD name and logo are registered marks of ACORD
<br />
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