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CSR® CERTIFICATE OF LIABILITY INSURANCE
<br />DATE tMM1DDdYYYY)
<br />' 4/2016
<br />11 14,
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CEITIFICATE 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 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 />Edgewood Partners Insurance Center
<br />License No. OB29370
<br />P.Q. Box 13847
<br />CONTACT Kim.. Coleman Berger
<br />NAME.
<br />PHONE FAX ---_.._
<br />JJQ rxt� 6-576-1534 916583-7619
<br />E-MAIL Kim Coleman Berger@epicbrokrurs.com
<br />.ADDRESS.:. __. —_
<br />Sacramento CA 95853
<br />INSURER(S) AFFORDING COVERAGE NAIL #
<br />INSURER A: Hartford Insurance of Midwest .37478
<br />INSURED DKSASSOC
<br />INSURER B Hartford CasualtyInsuranceCorn apy 29424
<br />DIES Associates
<br />INSURER C :Llo ds of London 85202
<br />1970 Broadway, Suite 740
<br />Oakland CA 94612
<br />INSURER D :Hartford Aooident & Indemnity Compa 22357
<br />CLAIIMS-MADE � OCCUR
<br />PD.d
<br />INSURER E:
<br />INSURER F:
<br />COVERAGES CERTIFICATE NmBEll 371073280 RFVI'SION 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 MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />/NSR
<br />''.. LTR
<br />TYPE OF INSURANCE
<br />Ai7D
<br />BNSD
<br />B
<br />WVD
<br />'..... POLICY NUMBER.
<br />POLICY EFF
<br />MMIDDfYYYY
<br />POLICY EXP
<br />MMPDDMYYY
<br />_. ... _
<br />LIMITS
<br />A
<br />X
<br />COMMIERCIALGENERAL LIABILITY
<br />157UUNVJ5164
<br />5/112016
<br />5/112017
<br />EACH OCCURRENCE $1,000,000...
<br />CLAIIMS-MADE � OCCUR
<br />PD.d
<br />._......_
<br />DAMAGE TO RENTED
<br />PREMISES Ea occurrence) $300,000
<br />X
<br />.._...._...__.-..
<br />MED EXP /Any one person) $10,000__
<br />$5,000
<br />PERSONAL & ADV INJURY $1.,000,000
<br />'L AGC3REGATE LIMIT APPLIES PER
<br />GENERAL AGGREGATE $2,000,000
<br />GEN
<br />......
<br />POLICY X
<br />[ ECT a LOC
<br />... .........._.
<br />PRODUCTS - COMPlflP AGO $2 000,000
<br />._....... m $
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />57UUNVJ5164
<br />5/1/2016
<br />5/1/2017
<br />COMBINEDIN LE LIMIT$
<br />1,000,000
<br />BODILY INJURY (Per person) $
<br />AUTO
<br />IXANY
<br />OWNED SCHEDULED
<br />ALL AUTOS AUTOS
<br />O
<br />NON -OWNED
<br />HIRED AUTOS X AUTOS
<br />BODILY INJURY (Per accident) $
<br />PROPERTY DAMAGE
<br />Per accident $
<br />$
<br />No Owned Ault
<br />B
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />57XHUVJ3516
<br />5(1/2016
<br />511/2017
<br />EACH OCCURRENCE $2,000,000
<br />AGGREGATE $2,000,000
<br />EXCESS LIAB
<br />CLAIMS-MiADE
<br />DED IX RETENTION$$10,000
<br />$
<br />D
<br />YVORKFRS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANY PROPRIETORIPARTNER/EXECUTIVE
<br />57WEGE0049
<br />511/2016
<br />5/112017PER
<br />OTH-
<br />X STATUTE ER
<br />.
<br />E.L. EACH ACCIDENT $1,000,000
<br />OFFICERIMEMBER EXCLUDED?
<br />NIA
<br />__.._.__._... _
<br />E.L. DISEASE - EA. EMPLOYE $1,000„000
<br />IMandatory in NH)
<br />If yes, describe ander
<br />DESCRIPTION OF OPERATIONS below
<br />E.L,DISEASE -POUCYLIMIT $1,0100,000
<br />C Errors & Omissions BN300650K 5/1/2016 5111'2017 PerClaiiTs $1,000,000
<br />Claims Made Aggregate $3,0700,000
<br />Retro Date; 511711979 Deductible $50,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addito-onal Remarks Schedule, may be attached if more space is required)
<br />Re: Santa Ana Metro East Innovative Parking Strategies. Additional Insured: The City of Santa Arra, its
<br />officers, agents, employees and representatives. When required by written contract, Additional Insured
<br />status with primary coverage applies to General Liability and Automobile Liability, Waiver of
<br />Subrogation applies to General Liability, Automobile Liability, and Workers` Compensation and 30 ]lay
<br />Notice of Cancellation applies to General Liability, all per the att Chad endorsements.
<br />CERTIFICATE HOLDER CANCELLATION I
<br />U 1988.20114 ACORD CORPORATION. All, rights reserved.
<br />ACORD 25 (2014101) 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 />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />Attn: Purchasing Dept,
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza
<br />Santa Ana CA 92701
<br />'.. AUTHORIZED REPRESENTATIVE
<br />U 1988.20114 ACORD CORPORATION. All, rights reserved.
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
<br />
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