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Ate`" CERTIFICATE OF LIABILITY INSURANCE 12(MM/DDNYYY)ATE `64. 0511112017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER,. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. It SUBROGATION IS WAIVED subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER.. CONTACT NAME: Automatic Data Processing Insurance Agency, Inc. iAJ�No, Ext): FAX No): 1 Adp Boulevard ADDARILESS: Roseland, NJ 07068 THIS IS TO CERTIFY THAT THE, POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIM'S. INSR ..... ......... ............. LTR TYPE OF INSURANCE -ADDL SUBRI _ POLICY EFF I POLICY EXP ....... __. INSD WVD POLICY NUMBER JMMIDDNYYYJ [MMIDDfYYYY)LIMITS __ . COMMERCIAL GENERAL. LIABILITY.EACH OCCURRENCE..... .. DAMAGE. TO RENTED I CLAIMS -MADE OCCUR ..... ! ! PREMISES (Ea occurrence) is _ MED EXP (Anyone person) is ....... -.� PERSONAL &.ADV INJURY GFN"L AGGREGATE LIMIT APPLIES PER: AGGREGATE $ POLICY PRO- LOC JECT r{ PRODUCTS L'4�C✓ '� ;� ODUGYS- GOMPlOPAGO $ _ I OTHER - r� V AUTOMOBILE LIABILITY j l e N , OOM&NED SINGLE LIMIT $ ANY AUTO IEa accident) _'�" '�Ai'°" BODILY INJURY (Per person) $ ALL OS SCHEDULED Autos AUTOS . NON tta�,,� ...... �,fC `41 BODILY INJURY (Per $ �"Irw`"�I ( ? -OWNED HIRED AUTOS , AUTOS ^r,'�"'`` PI2QPFRTY 5AMAGE 4 }'°' (Per accident) 40 ... .... $ � I$ i UMBRELLA LIAR i OCCUR EACH OCCURRENCE i $ EXCESS LIAR CLAMS -MADE.. _.. AGGREGATE 5 DFD RETENTION $ ,....... ........ ....----......... $ WORKERS COMPENSATIONx PER OTH- AND EMPLOYERS' LIABILITY YIN ER. A aFFICEROIM BERIEXCLUa�aa EcuTIVE �, NIA N BLWC811574 05101/2017 05/01/2018 . E.L EACH ACCIDENT $ 1,000,000 -. (Mandatary in NHI ',. ET_ DISEASE - EA EMPLOYEE-.. S 1,600,000 If yes, describe... under ..__............. ........_ _ DESCRIPTION OF OPERATIONS below '... F L. DISEASE - POLICY LIMIT S 1,�000,000 DESCRIPTION OF OPERATIONS I LOCATIONS !VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) UtK 1, Ik-IC A It NULII CANCELLATION City of Santa Ana Parks, Recreation & Community Attn: Services Agency 1825 W. Civic Center Santa Ana, CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY (PROVISIONS. AUTHORIZED REPRESENTATIVE, _4 .,...,,-4 -) k— , Pn r"r"MRpnpaTIr3N All rinhtc racarr.rari ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD