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GATE (MWDD/YYYY)
<br />�'� +CERTIFICATE OF LIABILITY' INSURANICE
<br />4/21f2017
<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 CONTACT Brooke Steiner
<br />NAME:
<br />Chanson -Wilson Insurance PHONE FAX
<br />(7.$5I537-1600 ......... IAIC,No).('85)537-1657
<br />..............
<br />555 Poyntz Avenue, Suite 205 AdgxESS:bsteinerpcharlsonwilsnn.com
<br />P.O. Box 1989 INSURER($L AFFORDING COVERAGE .. N'AICff
<br />Manhattan KS 66505-1989 wsURERA Chubb Group of Ins. Companies
<br />INSURED INSURER B
<br />Ci.v:i cPlus , Inc . - INSURER C ;
<br />i
<br />302 S. 4th Street, Suite 500 INSURER
<br />Manhattan KS 66502 1 INSURER : I I
<br />COVERAGES CFRTIFICATF Nt1MRFR-2016-2017 CivicPlus REVISION NUMRER
<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
<br />ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT
<br />TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE (INSURANCE AFFORDED
<br />BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN
<br />REDUCED BY PAID CLAIMS.
<br />iNSR TYPE OF INSURANCE ADDL SUBR
<br />LTR INSD WVO POLICY NUMBER
<br />POLICY EFF I POLICY EXP I LIMITS
<br />MMIDBIYYYY MMIDBFYYYY
<br />XCOMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE $ I
<br />2,000,000
<br />'.,..„ CLAIMS -MADE X OCCUR ',.
<br />DAMAA
<br />j PPRREMISES(OEaENTED occurrrenrs) $
<br />2,000,000...
<br />i ac blanket contractual X 3602-53-12
<br />5/17/2016 5/17/201I MED EXP (Any one person) $
<br />10,000
<br />la.abilit*
<br />PERSONALS,ADVdNJURY $
<br />1,000,000,.
<br />GENT AGGREGATE LIMIT APPLIES PER: '..... ''....
<br />,. GENERAL AGGREGATE $
<br />2,000,000
<br />X POLICY PE © F -1 ' LOC
<br />PRODUCTS - COMPIOP AGG $
<br />2,000,000
<br />OTHER. '..
<br />Information & Network Tech $
<br />3 , 000 , 000
<br />AUTOMOBILE LIABILITY ',.
<br />,_........_
<br />COMBINED SINGLE LIMIT $
<br />'_...LFa accrc1w ta.. _
<br />1,000,000
<br />A
<br />X ANY AUTO
<br />BODILY INJURY (Per person) $
<br />.....
<br />... —..
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS (16) 7358-87-9.2
<br />5/17/2016 5/17/2017 BODILY INJURY (Peraceident) $
<br />.. ..
<br />NON -OWNED
<br />PROPERTY DAMAGE $
<br />HIRED AUTOSaccident)
<br />_ AUTOS
<br />(Per accident)
<br />.... ...
<br />Terrcnsm $
<br />X UMBRELLA LIAR OCCUR '.......
<br />EACH OCCU
<br />A
<br />EXCESS ILIAB CLAIMS -MADE,.
<br />.... _.
<br />I
<br />AGGREGATE $
<br />........
<br />-
<br />DED 1RETENTION$ 7989-4.9-14
<br />.. .__... .......
<br />5/17/2016 5/17/2017 1
<br />.. ..... ......
<br />WORKERS COMPENSATION
<br />PER OTH
<br />AND EMPLOYERS' LIIABULITY YIN
<br />STATUTE . EIz
<br />I
<br />IANY PROPRIETORfPARTNERfEXECUTIVE
<br />NIA...
<br />E L EACH ACCIDENT $
<br />... 1
<br />1 000 00(}
<br />r
<br />OFFICERIMEMBEREXCLUDED?
<br />(Mandatary in NH) (17) 7174-92-49
<br />5/17/2016 5/1..7/2017 E.L.ISEASE - EA EMPLOYEE $
<br />1, 000, 000...
<br />If yes, describe under
<br />_. , _
<br />...
<br />DESCRIPTION OF OPERATIONS below
<br />E_L DISEASE - POLICY LIMIT $
<br />1,000,000
<br />A
<br />i
<br />I Directors 6 Officers 8242-9361
<br />5/17/2016 5/17/2017 Aggregate Limit
<br />$1,000,000
<br />Cyber Liability 3602..-53-12
<br />5/17/2016 5/17/2017 Aggregate Limit
<br />$3,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATION'S I VEHICLES (ACORD 1.01, Additional Remarks. Schedule, may be attached If more space is required)
<br />The City of Santa Ana, its officers, employees, agents,
<br />volunteers and representatives are named as
<br />additional insureds with regard to liability & defense
<br />of suitsarising from tZerationsd
<br />uses
<br />',performed by or on behalf of the named insured.A1
<br />SHOULD ANY OF THE A E DESr
<br />POLICIES BE CANCELLED BEFORE
<br />City of Santa Ana THE EXPIRATION THEROTICE: WILL BE DELIVERED IN
<br />20 Civic Center Plaza ACCORDANCE WITH THE POLICY ONS.
<br />Santa Ana, CA 92701
<br />AUTHORIZED REPRESENTATIVE fn
<br />B L' o o k e S t €, i n e L' / TAIL �"' ',,•'k '" '" '1' ,,•+$-'-- -'��' 4.., +d..:.�F,,,„�.
<br />1988-2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
<br />I N50251901Ani t
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