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�— <br />CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MM/DD/YYYY) <br />03/20/2018 <br />1 <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 have ADDITIONAL INSURED provisions or be endorsed. If <br />SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this <br />certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />Aon Risk Insurance Services west, Inc. <br />LOS Angeles CA Office <br />707 Wilshire Boulevard <br />Suite 2600 <br />CONTACT <br />NAME: <br />PHONE(866) 283-7122 FAX (800) 363-0105 <br />(AJC. No. Ext): (A/C. No.): <br />E-MAIL <br />ADDRESS: <br />INSURER(S) AFFORDING COVERAGE NAIC # <br />LOS Angeles CA 90017-0460 USA <br />INSURED <br />INSURER A: Travelers Property Cas CO Of America 25674 <br />wi l l dan Financial Services <br />27368 Via Industria <br />INSURER B: Lexington Insurance Company 19437 <br />INSURER C: <br />suite 200 <br />Temecula, CA 92590 USA <br />INSURER D: <br />INSURER E: <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 570070486210 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. Limits shown are as requested <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />INSD <br />SUBR <br />WVD <br />POLICY NUMBER <br />(MWDDQ= <br />IMM1DDIYYYY1LIMITS <br />A <br />X COMMERCIAL GENERAL LIABILITY <br />PbJUIJJbb586TIL17 <br />EACH OCCURRENCE $1,000,000 <br />CLAIMS -MADE X❑OCCUR <br />DAMAGEOR N $1,000,000 <br />PREMISES Ea occurrence) <br />MED EXP (Any one person) S15,000 <br />X Employee Benefits Liability <br />X Contractual Liability Included <br />PERSONAL 8 ADV INJURY S1,000,000 <br />GEML AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE $2,000,006 <br />X POLICY PRO ❑ LOC <br />JECT <br />PRODUCTS-COMP/OP AGG $2,000,000 <br />OTHER: <br />A <br />AUTOMOBILELIABILRY <br />P -810 -7j365332 -TIL -17 <br />11/09/201711/09/2018 <br />COMBINED SINGLE LIMIT $1,000,000 <br />Ea accident <br />BODILY INJURY ( Per person) <br />X ANYAUTO <br />BODILY INJURY (Per accident) <br />OWNED SCHEDULED <br />AUTOS ONLYAUTOS <br />HIRENON-OWNED <br />PROPERTYDAMAGE <br />ONLY AUTOS ONLY <br />Per accident) <br />UMBRELLALIA6 <br />EACH OCCURRENCE <br />AGGREGATE <br />EXCESS LIAB <br />HOCCUR <br />CLAIMS -MADE <br />DED I RETENTION <br />A <br />WORKERS COMPENSATION AND <br />PJUB9355881917 <br />1:70-912017 <br />11 09/2018 <br />X PER STATUTE I OTH- <br />ER <br />EMPLOYERS' LIABILITY YIN <br />E.L EACH ACCIDENT $1,000,000 <br />ANY PROPRIETOR/ PARTNER I EXECUTIVE <br />N <br />OFFICER/MEMBER EXCLUDED? <br />❑ <br />NIA <br />E.L. DISEASE -EA EMPLOYEE $1,000,000 <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE -POLICY LIMIT $1,000,000 <br />B <br />Archit&Eng Prof <br />028174912 <br />11/09/2017111/09/2018 <br />Aggregate $2,000,000 <br />SIR applies per policy terns <br />& condiions <br />Per Claim $1,000,000 <br />SIR $250,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) <br />RE: User Fee Study; Prop 218 Sanitation Review. <br />The City of Santa Ana, its officers, employees, agents and representatives are included as Additional Insured in accordance <br />with the policy provisions of the General Liability policy. The General Liability policy evidenced herein is Primary and <br />Non -Contributory to other insurance available to an Additional Insured, but only in accordance with the policy's provisions. <br />Should General Liability, Automobile Liability and workers' Compensation policy be cancelled before the expiration date <br />thereof, the policy provisions will govern how notice of cancellation may be delivered to c rtificate holders in accordance <br />with the policy provisions. <br />REVIEWED BY: EUNICE HEREDIA (PG I OF ) <br />Ll <br />O <br />N <br />m <br />O <br />0 <br />O <br />r <br />U) <br />O <br />Z <br />m <br />R <br />V <br />d <br />U <br />CERTIFICATE HOLDER CANCELLATION Qq: <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE <br />POLICY PROVISIONS. <br />City Of Santa Ana AUTHORIZED REPRESENTATIVE <br />Finance and Management Services Agency <br />Purchasing Division L%� �s <br />20 Civic Center Plaza _-} <br />Santa Ana CA 92701 USA �i <br />©1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />