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CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MOQ�OD OYYY) <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) 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 endorsement(s). <br />PRODUCER <br />Aon Risk Services Northeast, Inc. <br />Ann Risk Services Northeast, Inc. <br />CONTACT <br />PHONE g6fi-283-]122 FAX 800-363-0105 <br />P1C. No. Exg: AIC. No.: <br />NY NY Office <br />199 Water Street <br />E-MAIL <br />ADDRESS: <br />New York NY 10038-3551 USA <br />CGL2008089 <br />0101201701/01 <br />EACH OCCURRENCE $2,000,000 <br />INSURER(S) AFFORDING COVERAGE <br />NAICM <br />INSURED <br />INSURERA: Hartford underwriters Insurance Company <br />30104 <br />Bureau Veritas North America, Inc. <br />1665 Scenic Avenue, Ste. 200 <br />costa Mesa CA 92626 USA <br />INSURERS: Hartford Fire Insurance Co. <br />19682 <br />INSURERC: AllianZ Global PI Us Insurance Co. <br />35300 <br />INSURER D: Twin City Fire Insurance Company <br />29459 <br />PREMISES Ea occunence <br />INSURER E: Trumbull Insurance Company <br />27120 <br />INSURERF: sentinel Insurance Company, Ltd <br />11000 <br />COVERAGES CERTIFICATE NUMBER: 570066126752 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 re uested <br />MSR <br />TYPE OF INSURANCE <br />ADS <br />SUB <br />POLICY NUMBER <br />POLICY EFF <br />MMIDDMW <br />POLICY EXP LIMITS <br />DD <br />C <br />X COMMERCIAL GENERAL LIABILITY <br />CGL2008089 <br />0101201701/01 <br />EACH OCCURRENCE $2,000,000 <br />CLAIMS -MAGE ❑X OCCUR <br />DAMAG $1,000,000 <br />PREMISES Ea occunence <br />MED EXP (Any one person) $10,000 <br />PERSONAL &ADV INJURY $2,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE $2,000,000 <br />PRO X <br />X <br />POLICY JECT LOC <br />PRODUCTS - COMP/OP AGG $2,000,000 <br />OTHER: <br />B <br />AUTO MOBILE LIABILITY <br />10 AS 541202 <br />01/01/2017 <br />01/01/2018 COMBINED SINGLE LIMIT <br />$2,000,000 <br />ADS <br />Ea accident <br />A <br />X ANY AUTO <br />10 AS 541203 <br />01/01/2017 <br />01/01/2018 BODILY INJURY( Per person) <br />OWNED SCHEDULED <br />HI <br />BODILY INJURY(Peraccidenq <br />AUTOS ONLY AUTOS <br />HIRED AUTOS NON -OWNED <br />PROPERTY DAMAGE <br />ONLY AUTOS ONLY <br />Par accitlenl <br />UMBRELLA LIAR <br />OCCUR <br />EACH OCCURRENCE <br />EXCESS LIAR <br />CLAIMS -MADE <br />AGGREGATE <br />DED RETENTION <br />E <br />WORKERS COMPENSATION AND <br />IOWNS41200 <br />01/01/2017 <br />01/01/2018PER OTH- <br />x <br />EMPLOYERS'LIABILITY YIN <br />AOS <br />STATUTE <br />H <br />ANY PROPRIETOR I PARTNER I EXECUTIVE <br />OFFICERIMEMBER EXCLUDED? N <br />NIA <br />10WN$4120D <br />D1/01/2D17 <br />E L. EACH ACCIDENT $1,000,000 <br />D1/D1/2D1$ <br />(Mandatory in NH) <br />AK ID IL NJ NY <br />E. L. DISEASE -EA EMPLOYEE $1,000,000 <br />Ifca, describe under <br />DESCRIPTION OF OPERATIONS below <br />E. L. DISEASEPOLICYLIMIT $1,000,000 <br />C <br />Archit&Eng Prof <br />PPL2008139 <br />01/01/2017 <br />01/01/2018 Each Claim $1,000,000 <br />SIR applies per policy ter <br />his & condi <br />ions Aggregate $1,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) <br />certificate Holder is included as Additional Insured in accordance with the policy provisions of the Business Auto Coverage & <br />General Liability Coverage policy. <br />A waiver of Subrogation is granted in favor of Certificate Holder in accordance with the policy provisions of the Business AUt <br />Coverage, General Liability Coverage & Workers Compensation - casualty policy. <br />CERTIFICATE HOLDER <br />CANCELLATION <br />-ms`s <br />©1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 26 (2016103) The ACORD name and logo are registered marks of ACORD <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 />Ik <br />P'^� <br />s <br />POLICY PROVISIONS. <br />+�'r <br />City Of Santa Ana <br />20 Civic Center Plaza' <br />AUTHORIZED REPRESENTATIVE <br />Attn: City Clerk <br />Sant <br />Santa Ana CA 92701 USA <br />©1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 26 (2016103) The ACORD name and logo are registered marks of ACORD <br />