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,ter I0 CERTIFICATE F LIABILITY INSURANCEDATE IMMIDDIYYYY)
<br />1211612a19
<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(les) crust have ADDITIONAL INSURED provisions or he 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 endorsement(s).
<br />PRODUCER. CONTACT Sue Lusic
<br />NAME:
<br />Cornerstone Specialty Insurance Services, Inc. PgHa t Ext : (714) 731-7700 AIX (714) 731-7750
<br />14252 Culver Drive, A299 E-MAILrxccc
<br />suecarnerstonespecoalty.com
<br />n na
<br />INSURER(S) AFFORDING COVERAGE.
<br />NAIL #
<br />Irvine
<br />CA 92604
<br />INSURER A :
<br />Travelers Property Casualty Co
<br />25674
<br />INSURED
<br />INSURER B :
<br />Travelers Indemnity Cc of Conn
<br />25682'.
<br />C BELOW, INC.
<br />INSURER C :
<br />Continental Casualty Company
<br />20443
<br />14280 Euclid Avenue
<br />INSURER D
<br />INSUREER E
<br />China
<br />CA 91710
<br />INSURER F
<br />COVERAGES
<br />CERTIFICATE NUMBER: 19120 COVERAGES
<br />REVISION NUMBERf
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMELY ABOVE FOR THE POLICY PERIOD
<br />INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITIiON OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAYBE 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 />INSR
<br />LTR
<br />TYPE OF INSURANCE ,
<br />INSD
<br />',�. WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />IMMIDDIYYYY
<br />POLICY EXP
<br />MMIDDIYYYY
<br />LIMITS
<br />X',,,
<br />COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 2,000,000
<br />CLAIMS -MADE. ® OCCUR
<br />5AMAGE75RENTED
<br />PREMISES lEa occurrence
<br />1,000,000
<br />X
<br />MED EXP (Any one perzon)
<br />$ 10,000'
<br />ADDTL INSRDIP 8r NC
<br />X
<br />13LNKT WVR OF SUBRO
<br />PERSONAL &ADv INJURY
<br />q 2,000,000
<br />A
<br />Y
<br />Y
<br />680-5H559891
<br />12M812019
<br />12/18/2020
<br />GEN'LAGGREGATE .LIMIITAPPLI!E.SPER:
<br />GENERALAGGREGATE
<br />$ 4,000,000
<br />POLICY ® NECPRO-
<br />POLICY F7LOC
<br />PROIDUCTS- COMPICPAGG
<br />$ 4,000,000..
<br />$
<br />OTHER:
<br />AUTOMOBILE
<br />LIABILITY
<br />CBINEDSINGLELIMIT
<br />EOMa aooudumf
<br />y 1,000,000
<br />BODILY INJURY (Per person)
<br />S
<br />ANY AUTO
<br />B
<br />OWNED SCHEDULED
<br />AU70S ONLY AUTOS
<br />Y
<br />Y
<br />BA-7D687122
<br />12118/2019
<br />12/18/2020
<br />BODILY I NJURY C Per accident)
<br />$
<br />PROPERTY DAMAGE
<br />Per aecudenl
<br />y
<br />HIRED NON -OWNED
<br />AU70S ONLY AUTOS ONLY
<br />S
<br />X
<br />UMBRELLA LIAB
<br />XOCCUR
<br />EACH OCCURRENCE
<br />E 10,000,000
<br />A
<br />EXCESS LIAR
<br />GLAIM,9,-MADE
<br />Y
<br />Y
<br />CUP 4181T634
<br />1218/2019
<br />'12118/2020
<br />AGGREGATE
<br />$
<br />X
<br />DED ''.. I RETENTION $ 0
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS" LIABILITY Y f NI1,Qaa,aa0
<br />ANY PROPRIETORYPARTNE.PJEXECUrIVE
<br />OFFICERWEMBER EXCLUDED?
<br />(Mandatory in NH)
<br />N/A.
<br />Y
<br />XJIUB8J675252
<br />1211812Q19
<br />12/18/202Q
<br />X1 SPT.4TUTP ?TH-
<br />E.L. EACH ACCIDENT
<br />E.L. DISEASE - EA EMPLOYEE
<br />1,naa,aQa
<br />$
<br />If yes., describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />1,aQa,aaa -
<br />$
<br />C
<br />Professional Liability
<br />Claims Made
<br />MCH288306745
<br />12118/2019
<br />12/18/2020
<br />Each Claim
<br />Annual Aggregate
<br />$2,000,000
<br />$2,000.000
<br />DESCRIPTION OF OPERATIONS J LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule„ may be attached if more space is required)
<br />City of Santa Ana, its officers, employees, agents, volunteers and representatives are Additional Insured for Generai Liability but only if required by written
<br />contract with the Named Insured prior to an occurrence and as per attached endorsement. Coverage is subject to all policy terms and conditions. *30 days
<br />notice of cancellation, except for 10 days notice for non-payment of premium. For Professional Liability, the aggregate limit is the total insurance for all
<br />covered claims reported Within the policy period.
<br />F-.VJEWED & APPROVED
<br />y RiS ANAC1IWMPNT iVISI0N
<br />City of Santa Ana
<br />20 Civic Center Plazaftft
<br />Santa Ana
<br />CA 92701
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATIONDATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />@ 1988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
<br />
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