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ACC>R®is CERTIFICATE OF LIABILITY INSURANCE <br />Iii <br />DATE(MM/DDNYYY) <br />11/22/2016 <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 endorsement(s). <br />PRODUCER <br />AndNAME: <br />220 West Company -San Mateo <br />220 West 20th Ave <br />San Mateo CA 94403 <br />CONTACT <br />PHONE 650-573-1111 FAX .650-378-4361 <br />FA <br />E-MAIL <br />ADDRESS <br />INSURERS AFFORDING COVERAGE NAIC IN <br />A <br />INSURERA:Plaza Insurance Company 30945 <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE IT OCCUR <br />INSURED SOUTH -3 <br />INSURER B:LIO d'sofLondon <br />Southwest Trails, Inc. <br />P. O. Box 419 <br />_ <br />INSURER C: Endurance American Specialty 41718 <br />12/1/2017 <br />Gardena CA 90248 <br />INSURER D: <br />INSURER E : <br />INSURER F : <br />COVERAGES CERTIFICATE NUMRFR- 93037440 Rp\/141r\NI MI IMRCD• <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 <br />TYPE OF INSURANCE <br />AUULSUBR <br />INSD <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />MMIDDIYYYY <br />POLICY EXP <br />MMIDD/YVYY <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE IT OCCUR <br />Y <br />PFHR000738301 <br />12/1/2016 <br />12/1/2017 <br />EACH OCCURRENCE $1,000,000 <br />DAMAGE TO RENTED <br />PREMISES Ea occurrence $100,000 <br />MED EXP (Any one person) $5,000 <br />PERSONAL &ADV INJURY $1,000,000 <br />AGGREGATE LIMIT APPLIES PER: <br />PRO - <br />POLICY JECT E LOC <br />GENERAL AGGREGATE $2,000,000 <br />GEN'L <br />X <br />PRODUCTS - COMP/OPAGG $2,000,000 <br />$ <br />OTHER: <br />A <br />AUTOMOBILE <br />LIABILITY <br />PPHR000738301 <br />12/1/2016 <br />12/1/2017 <br />COMBINED SINGLE LIMIT $ <br />Ea accident 1,000,000 <br />ANY AUTO <br />BODILY INJURY (Per person) $ <br />X <br />ALL <br />AUTOS NEO AUTOSULEO <br />BODILY INJURY (Per accident) $ <br />X <br />HIRED AUTOS X NON -OWNED <br />AUTOS <br />PROPERTY DAMAGE <br />Pe,accidentl $ <br />X <br />CA9948 X MCS -90 Endt. <br />IS <br />B <br />X <br />UMBRELLA LIABX <br />OCCUR <br />N <br />N <br />15RENMAI 50005509240900 <br />12/1/2016 <br />12/1/2017 <br />EACH OCCURRENCE $6,000,000 <br />EXCESS LIAB <br />CLAIMS -MADE <br />AGGREGATE_ $6,000,000 <br />DED X RETENTION$0 <br />$ <br />WORKERS COMPENSATION <br />I PER OTH- <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? ❑ <br />N /A <br />STATUTE ER <br />E.L. EACH ACCIDENT $ <br />E.L. DISEASE - EA EMPLOYE $ <br />(Mandatory in Ni <br />If yes, describe under <br />E. L. DISEASE -POLICY LIMIT $ <br />DESCRIPTION OF OPERATIONS below <br />C <br />A <br />Excess Liability <br />Motor Truck Cargo <br />ELD30000097100 <br />PFHR000738301 <br />12/1/2016 <br />12/1/2016 <br />12/1/2017 <br />12/1/2017 <br />EAOC/AGG 3,000,000 <br />Each Occurrence 100,000 <br />Deductible 1,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) <br />Thee City of Santa Ana, it -s officers, employees, agents, and representatives are named as additional <br />insured per attached endorsement form#: <br />CERTIFICATE HOLDER CANCELLATION <br />© 1988.2014 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />City of Santa Ana <br />Attn: Purchasing Department <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 Civic Center Plaza <br />Santa Ana CA 92701 <br />AUTHORIZED REPRESENTATIVE <br />j V <br />© 1988.2014 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD <br />