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ACORL> CERTIFICATE OF LIABILITY INSURANCE
<br />DATE tMMIDDM vI
<br />O9f2eJ2017
<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 Ileu of such endorsement(s).
<br />PRODUCER
<br />CONTACT Kimberely Kelley
<br />NAME
<br />Insurance Solutions
<br />HONN Ext: (949)348-7400 (949)348-2373
<br />INC.License
<br />#0746539
<br />E-MAIL K[mK@ins-solutions.com
<br />ADDRESS:
<br />33302 Valle Rd, Suite 200
<br />. A F
<br />INSUREFUER(SIAPFORBINGCOVERAGE
<br />-
<br />NAIC#
<br />_
<br />INSURERA:: The Ohio Casualty Insurance Company
<br />24074
<br />San Juan Capistrano CA 92675
<br />INSURED --,D017-
<br />INSURERa_Allmerica Financial Benefit
<br />41840
<br />Professional Sports Field Maintenance lnc i
<br />INSURERC; American Fire and Casualty Company
<br />24066
<br />23 Emerald Gin
<br />INSURER D: State Comp Ins Fund
<br />36070
<br />INSURER E:
<br />Laguna Niguel CA 92077
<br />INSURER F:
<br />_
<br />COVERAGES CERTIFICATE NLIMRF_R- 17-18 All REVISION NLIMRFR.
<br />THIS IS TO CERTIFY THATTHE 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAYBE 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 />LTR
<br />TYPE OF INSURANCE
<br />SD
<br />MD
<br />POUCYNUMSER
<br />MMIDDIYYEYYY
<br />MMIo��
<br />LIMITS
<br />MERCIAL GENERAL LIABILITY
<br />CI -AIMS -MADE OCCUR
<br />T
<br />EACH OCCURRENCE
<br />s 1.000,000
<br />PREMISES Ea gccurrencej,,,,_
<br />S 500,000
<br />MED EXP(Any p. Peraph)
<br />5 15,000
<br />I
<br />PERSONAL&ADV INJURY
<br />S 1.000,000
<br />A
<br />BKO57465702
<br />10/0112017
<br />10101/2018)
<br />AGGREGATE LIM IT APPLIES PER:
<br />POLICY ❑ jECT E LOC
<br />GENERALAGGREGATE
<br />a 2.000,000
<br />GEN'L
<br />X
<br />PRODUCTS COMPIOPAGG
<br />S 2,000,000
<br />$
<br />OTHER:
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />S 1,000,000
<br />BODILY INJURY (Per perscnl
<br />5
<br />X
<br />ANYAUTO
<br />B
<br />OWNED SCHEDULED
<br />AUTOSONLY AVTOS
<br />HIRED NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />AW3A377777
<br />08/26/2017
<br />08/26/2018
<br />BODILY INJURY (Pera¢idenq
<br />3
<br />PROPERTY DAMAGE
<br />Peracdtlerc
<br />5
<br />Uninsured motorist
<br />5 300,000
<br />X
<br />UMBRELLA UAa
<br />X
<br />OCCUR
<br />9ZF66 U"E """"
<br />EACH OCCURREVNCE
<br />S 2,000,000
<br />C
<br />EXCESS LIAR
<br />11
<br />CLAIMS MADE
<br />ESA57465702
<br />10/0U2017
<br />10/01/2018
<br />'AGGREGATE
<br />5 2000,QQo
<br />BED
<br />RETENTION S
<br />-
<br />S
<br />O
<br />WORKERS COMPENSATION
<br />AND EMPLDYERS'LIASILNY
<br />ANY PROPRIETORIP.ARTNEWEXECUTIVE Y/N
<br />OFFICERIMEMBER EXCLUDED? ❑
<br />(MzodafmYln NH)
<br />If yes, deecdbe under
<br />DESCRIPTION OF OPERATIONS below
<br />N/A
<br />1620476-2017
<br />02/26/2017
<br />02/26/2018
<br />PER OTH
<br />X STATUTE ER
<br />Eh. EACH ACCIDENT
<br />$ 1,000,000
<br />EL, DISEASE -a EMPLOYEE
<br />a 1,000,000
<br />E,L DISEASE - POLICY LIMIT
<br />$ i,000,000
<br />DESCRIPTION OF OPERATIONS! LOCATIONS l VEHICLES (ADORp tef, Atldibonal Rmnarks &cM1ednlP, may ba attached if more space Is req�u r�
<br />The City of Santa Ana, it's officers, employees, agents, and representative are Included as additional insured per t�h�sc:had an rsemmee I
<br />City of Santa Ana
<br />20 Civic Center Plaza
<br />Santa Ana
<br />CA 92701
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />T14E EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />©1988-2015 ACORD CORPORATION. All rlchts reserved.
<br />ACORD 25 (2016I03) The ACORD name and logo are registered marks of ACORD
<br />
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