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•�CERTIFICATE OF LIABILITY INSURANCE DATE (M611041YYYY) <br />b/7/201Cr <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 INSURERS�, AUTHORIZED <br />'PRESENTATIVE OR PRODUCER, FIND THE CERTIFICATE HOLDER, <br />IMPORTANT, if the cortIfIcate holder Is an ADDITIONAL INSURED, the pollcy(les) mLlat be endorsed, If SUBROGATION I5 WAIVED, sul jeotto <br />the terms and conditions of the policy, certain polfclesmay rdqulre ed ,endorsement. A staielnent on this certificate does not gonfor rights to the <br />certificate holder In Ilcu of such endorsemsnl(s , <br />PRCDDIlCER D T 'ami arsen <br />NAME: <br />Mutual, Insurance Agency :(626)793-9595 FAX <br />CA License # 057.4081 RppA"- lament:@mutualineagcy°.eom <br />__�....._._._._._._— _ <br />30 IL Marengo Ave Irasurt -RLS) A "FDRc1HQ c0V9PA ae NAlc n <br />Pasadena CA .01101 insuREr€A,Chi2 Castialt Tns Ca 24071 <br />iNBUR@D €ttstlREReitlhio 9ecurit. Ids Co ___ 24.082 <br />MDD Associates, Inc.. iNsuRERccAme.rican Fire and Casualty -Co 24066 <br />1:0.722 Arrow Route, Suite 822 <br />Rancher <br />CA 91.73 <br />COVERAGES CERTIFICATE NUMBERs2016-2017 GL; Atit o, ZxCsREVESIsOfii N.URII.BEFd <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO '64E INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER 60GOME=NT WITH RESPECT' TO WHICH THIS <br />CERTIFICATE" MAY ESE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS. SUBJECT TO Atk THE TERMS, <br />E=XCLUSIONS AND CONDITIONS OF SUGH POLICIES. LIMITS SHOW. N FAA' HAVE B EN REOUCED BY PAID CLAIMS. <br />I�BIR <br />TYPE Of INSURANCE <br />Apo <br />IM <br />SBR <br />WV6 <br />POLICl`N 6E <br />pDLICYEFF <br />MM DD <br />POLICY EXP <br />Llhir#$ <br />A <br />K CgMh[ERGIAL:GI NERAL LIABILITY <br />CLAIh15-tviRDE� ®GCi1Ft <br />EACH OCCURRENCE- <br />$ ;L, 000, 000 <br />D AME To Nr <br />P Qecu enc <br />� � � 200,000 <br />MRO EXP An onoperson) <br />$ 25,060 <br />i{ <br />8 01757179296 <br />7/1/203.6 <br />7/1/20 7 <br />PE€tSONAL ADYINJURi <br />$ 1r00dn0t}p <br />©EN'i. <br />AG.GREOATE LIM T APR LJFS KII <br />POLICY PriO- .LOC <br />JECT <br />C�ENERAC LtGGFiEdAI E - <br />pi20DUOT$-COr,4F/OPAGG <br />— _ <br />$ 2,000,000 <br />;$ 2,000;000 <br />$ __.-.._........_.._.,. <br />AUTR&SOE}iLE <br />LIABILITY <br />MBIN..�01! €NGLE L MCr <br />$ 11000,000 <br />X <br />ANY AUTO <br />Ail.OWNED AUTOiuLtti <br />AUTOS AUTOS <br />� <br />HAsi757179299 <br />7/.1/2016 <br />7.3,/2017 <br />1` <br />BODILY KJORY (F 9r ptruv)n) <br />ROPILY (Per <br />I ) <br />$ <br />ASWN3 <br />PROPERTY <br />Pea <br />Waior of Colliston <br />500 <br />UMBRELLA LtAB X OCCUR <br />'t. <br />ACR OGCUR <br />g 4.000, 000 <br />EXC SS LEMS <br />- <br />A430REOAT@ <br />S A..[i€1(5.iiffF[- <br />X I I EIAM7179.29 <br />LIABILITY Y"fit <br />PARTNERIEXECUTIVE <br />EXCLUDED? F H f A <br />7/1/2016 1 7/1/2417 <br />E.L: EACH ACCl004 5 <br />E.L. DISEASE - EA EMPLOYE $ <br />pE3gRi1>TiON of OPERATIONS 1 LOCATIONS f YE}iiCCES (ACORn 101, Addllfonal Remarks $chedul&,. may be altached it more space is requir@d) <br />The City of Santa Ana, its officers, employees, argentd and volunteers are named Additional: insured, but: <br />only as respects the Insureds. Operationo as it relat=es to their Signed Contraot in regards to the CI�HG <br />Administration Gansulting Services per Farm CC8610. att',aCt ad- Primary Inauranee and Transfer of Rights of. <br />Recovery Against Others is included per Form CGRO10 attached. <br />CERTIFICATE HOLDER rAN( PI I ATIflhi <br />SHOULD ANY OF THE ABOVE DESCRIBED POLIGIES BE. CA€'iCELLED BEFORE <br />City Of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />CEamarmunit y DeVBIO ament Agency ACCORDANCE WITH THE POLICY PROVISIONS. <br />Aims 'Perri Eggera, Seni6r Mgrmt. Analyst <br />20 Civic Center Plaza AVDibRIZEDRCPRa4CI1TAT[VI. <br />i"raTtta FillEl..r %'A 92701 <br />X-IG%Ii1dY'd WCiciLCFri/TLLs <br />41981 -2014 ACO€ D CORPORATION. All rights reserved. <br />AGORD 25 (201410.1) The ACORD name and logo are. registered marks a4:ACORD <br />INS025 pori4o€) <br />