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<br />144coR,a CERTIFICATE OF LIABILITY INSURANCE
<br />D07/18ATE /2017Y)
<br />07/18/2017
<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 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 />Wortley/Poole Professional,Ltd
<br />1 Penn Center
<br />1617 JFK Boulevard, Suite 880
<br />Philadelphia, PA 19103
<br />Paul J. Lucci
<br />CONTACT
<br />Paul Lucci
<br />PHONE FAx
<br />A/c No Exl): 215-564-6971 A/C No): 215-564-6975
<br />EMAIL lucci^wortle oole.com
<br />V yp
<br />PRODUCERp
<br />CUSTOMER,,,: CLRDEA
<br />INSURER(S) AFFORDING COVERAGE NAIC #
<br />_
<br />INSURED CLR Design, Inc
<br />INSURER A: Charter Oak Fire Ins. Co. 25615
<br />833 Chestnut Street,Suite 1000
<br />Philadelphia, PA 19107
<br />INSURER B:Travelers Indemnity Co. 2565$
<br />INSURER C : Travelers Indemnity Co.
<br />25674
<br />INSURER D ; XL Specialty Insurance Company
<br />37885
<br />_ _
<br />INSURER E :
<br />_
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER: 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 MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />ILPOLICY
<br />TR
<br />TYPE OF INSURANCE
<br />INSIR ADDL
<br />SUER
<br />POLICY NUMBER
<br />EFF
<br />MMIDD/YYY
<br />POLICY EXP
<br />MM/DD/YYYY
<br />LIMITS
<br />GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 1,000,00
<br />A
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS-MADE 1*1 OCCUR
<br />X
<br />680-2J979064
<br />07/11/2017
<br />07/11/2018
<br />DAMAGE TO PREMISES RENT occurrence)
<br />$ 1,000,00
<br />MED EXP (Any one person)
<br />$ 10,00
<br />PERSONAL & ADV INJURY
<br />$ 1,000,00
<br />_
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />PRODUCTS - COMP/OP A_GG
<br />$ 2,000,00
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICY JE� LOC
<br />$
<br />AUTOMOBILE LIABILITY
<br />COMBINED SINGLE LIMIT
<br />(Ea accident)
<br />$ 1'000,0D0
<br />ANY AUTO
<br />BODILY INJURY (Per person)
<br />-
<br />$
<br />ALL OWNED AUTOS
<br />BODILY INJURY (Per accident)
<br />$
<br />B
<br />''. SCHEDULED AUTOS
<br />X' HIRED AUTOS
<br />BA-27281_15A
<br />07/11/2017
<br />07/11/2018
<br />PROPERTY DAMAGE
<br />(PERACCIDENT)
<br />$
<br />X NON -OWNED AUTOS
<br />$
<br />$
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 5,000,00
<br />AGGREGATE
<br />$ 5,000,000
<br />B
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />CUP-6T36Y412
<br />07/11l2017
<br />07/11/2018
<br />DEDUCTIBLE
<br />$
<br />$
<br />RETENTION $
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE Y I N
<br />OFFICER/MEMBER EXCLUDED? ❑
<br />N / A
<br />UB7302Y24A
<br />07/11/2017
<br />07/11/2018
<br />X WCSTATU- OTH-
<br />TORY LIMITS ER
<br />_
<br />E.L. EACH ACCIDENT
<br />_
<br />$ 1,000,00
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,00
<br />(Mandatory in NH)
<br />IF yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 1,000,00
<br />D
<br />Professional
<br />DPR9915991
<br />07/11/2017
<br />07/11/2018
<br />Ea Claim 2,000,000
<br />i ;";lity
<br />. ,,Ly
<br />(
<br />.._ A
<br />Milli /1yy 2,UUu,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
<br />RE: Agreement # A-2016-377
<br />R VIkWECb G�° (�. _ EUNi'4 E WiLfELIA (PGY OF
<br />% r-m I iriwAi r- nvl-ucrc
<br />SANTA-3
<br />City of Santa Ana
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92702-1988
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />© 1988-2009 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD
<br />
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