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<br />CERTIFICATE OF LIABILITY INSURANCE
<br />DATE IMMIDINYY,Y'
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.
<br />412812017
<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($),AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the poiicy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsements .
<br />PRODUCER License 1110757776 I CONTACT Jordan BartleBan
<br />NAME:
<br />HUB International Insurance Services Inc. I (AHK c. E UL (951) 779.8575 Ti FPN>g(951 231.2572
<br />3390 University Ave., Ste 300 EFiAi
<br />Riverside, CA 92501 `SAD@ Ss. cai.cpu(c hubinternatlonal.eom _
<br />INSURERt51 AFFORDlNO COVERAGE Nmci
<br />INSURER A: Sentinel Insurance Company. Ltd. 11000
<br />......._...._ ^_,��
<br />INSURED INSURER B : Hartford Accident and indemnity Comcany;22357
<br />Westbound Communications, Inc. INSURER c: Axis insurance Company 37273
<br />625 The City Dr., Ste 480 INSURER D:
<br />Orange, CA 92868
<br />INSVRER E: ._.._
<br />INSURER F:
<br />1.VDAtl CC I•Col.,PATC MIIRMPIT0. RFVISUNJ M1IMHFC.
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSRt ADDL!SUeA
<br />TYPE OF INSURANCE -
<br />POUCY NUMBER
<br />7 POLICYEFP
<br />k POGuffin ' i iiMn3
<br />A X COMMERCIAL GENERAL LIAHRITY (
<br />,CAMS -LADE OCCUR X'
<br />1
<br />X 172SBAIB4627
<br />0516ti1201T
<br />05+461281$;
<br />! EACH OCCURRENCE S 2,000,000
<br />^...
<br />DAMMGE TO RENTED i 1,000,000
<br />MED EXPiAnY onacersPni S 10,000
<br />PERSONAL&ACV WJURY ii 2,000'000
<br />.....
<br />I
<br />1 N'L AGGREGATE LIMIT APPLIES PER.
<br />POLICY PERE 7:1LOC
<br />—1I
<br />GENERAL AGGREGATE S4.000.000
<br />PRODUCTS - COMPIOPA 4,000,000
<br />If nt
<br />A AUTOMOBILE LIABILITY
<br />I
<br />3ASULEO
<br />AUTOS ONLY TO
<br />X NY AUTO i I
<br />X AUTqINED "M
<br />AU
<br />,
<br />BA051061201710510612018,
<br />�
<br />COMBINED SINGLE LIMIT $ 2,000,000
<br />I
<br />~URv Eab nili
<br />otaccRdwent ccTS
<br />TY
<br />�Pe—S
<br />A
<br />r�
<br />UMBRELU tlAB II—X OCCUR
<br />i BXCESSLAe i CLAIMS -MADE
<br />I
<br />�ZSBAI84627
<br />!
<br />( 0510612017 051061201$
<br />€ACHOCCURRENCE i 2,000,000
<br />rE 2,000,000
<br />IIs
<br />. DED X R,,eNT�Ns 14,000
<br />B IW"ERS COMPENSATION
<br />AMC EMPLOYERS' LIABILITY
<br />ANY PROPRIEYOWARTNEREXECUTNE YIN
<br />%FFICER Fir n REXCLUDED? y ��
<br />Mmtla[
<br />I
<br />NtA
<br />'7jWE1.`t-R3783 109t28t201610912872017,
<br />X ;PER DTH.
<br />�
<br />E.t'cACH ACCIDENT S 1.000.000
<br />1.0 AID
<br />E.L DISEASE EA EMPLOYEES
<br />E.L. DISEASE:POLICY LIMIT 1,000,000
<br />If. ns. 10 rba under
<br />DESCRIPTION OF OPERATIONS bel
<br />C !Professional Liab
<br />MCN000234351601 0912512016 0912512017
<br />!Per Claim 3,000,000
<br />CRetention: $10,000
<br />I
<br />I
<br />I
<br />'MCN000234351601 09/2512018 09/2512017
<br />I
<br />Aggregate 3,000,000
<br />DESCRIPTION OF OPERATIONS' LOCATIONS I VEHICLES (ACORD 101. Atldibonal Remmka Schedule. may b,I atW.h.d if mesas ace ie reeuirad)
<br />The City of Santa Ana, it's officers, employees, agents, volunteers and representatives are Additional !Insured in regards to General Liability per form
<br />IH 12001185 which includes 30 Day Notice of Cancellation. Primary 8 Non -Contributory wording and Waiver of Subrogation coverages apply to the General
<br />Liability policy when required by written contract per the attached endorsement SS0008 04105 Ings. 16.17 of 24).
<br />City of Santa Ana
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92701
<br />4IFF11iTiPTAIIt1
<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
<br />1988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORO name and logo are registered marks of ACORD
<br />!r 5;
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