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'`®II ®® CERTIFICATE OF LIABILITY INSURANCE <br />­DATE4/13/2017 <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 <br />CONTACT <br />NAME: Tina Cowie <br />Cornerstone Specialty Insurance Services, Inc. <br />14252 Culver Drive, A299 <br />PHONE x (719) 731-7700 aC Nob: ('!19)]31 -]]BO <br />EMAIL tina@cornerstones ecialt com <br />ADD ESB: P Y <br />INSURERS AFFORDING COVERAGE NAIC # <br />INSURER A:Travelers Property Casualty Cc 25674 <br />Irvine CA 92604 <br />INSURED <br />INSURER B:Travelers Casualty & Surety Co. of 19046 <br />INSURERC: <br />HAYER CONSULTANTS, INC. <br />4067 Hardwick St. <br />INSURER O: <br />INBURERE: <br />PNB 250 <br />Lakewood CA 90712 <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER -16/17 COVERAGES REVISION NIIMRFR- <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 />HTR <br />R <br />rypE OF INSURANCE <br />ADDLSUBR <br />POLICY NUMBER <br />POLICY EFF <br />IMMl <br />POLICY EXP <br />fMMl <br />LIMITS <br />A <br />X COMMERCIAL GENERAL LI ABILITY1,000,000 <br />CLAIMS -MADE TOCCUR <br />EACH OCCURRENCE $ <br />DAMAGETO-RENTED 300,000 <br />PREMISES Ea occurrence $ <br />MED EXP (Any one person) $ 5,000 <br />X ADDTL INSURED/PRIMARY <br />X <br />680-22731,506 <br />6/13/2016 <br />6/13/2017 <br />X BLNXT WVR OF SUBRO <br />PERSONAL& ADV INJURY $ 1,000,000 <br />AS REQUIRED BY WRITTEN <br />GENLAGGREGATE LIMITAPPLIES PER: <br />POLICY [X] JECT [_] LOC <br />GENERAL AGGREGATE $ 2,000,000 <br />CONTRACT <br />CONTRACTUAL LIM INC1,D <br />PRODUCTS - COMP/OP AGG $ 2,000,000 <br />$ <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT $ INCLUDED <br />Ea accident <br />BODILY INJURY (Per person) $ <br />AI <br />AUTO <br />AUTOS ALL OWNED AUTOS <br />680-2273L506 <br />6/13/2016 <br />6/13/2017 <br />BODILY INJURY (Pereccldent) $ <br />X <br />HIRED AUTOS X NON -OWNED <br />AUTOS <br />PROPERTY DAMAGE $ <br />Per accident <br />$ <br />X <br />UMBRELLA LIM <br />X <br />OCCUR <br />EACH OCCURRENCE $ 2,000,000 <br />AGGREGATE $ 21000,000 <br />A <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED X RETENTION 0 <br />$ <br />CUP -6536Y635 <br />6/13/2016 <br />6/13/2017 <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y/N <br />ANY PROPRIETOWPARTNEWEXECUTIVEE.L. <br />OFFICERNEMBER EXCLUDED? F-1 <br />NIA <br />IPER OTH- <br />STATUTE ER <br />EACH ACCIDENT $ <br />E . DISEASE - EA EMPLOYE $ <br />IMandatory in NH) <br />If yes, describe under <br />E.L. DISEASE - POLICY LIMIT $ <br />DESCRIPTION OF OPERATIONS below <br />B <br />Professional Liability <br />106639088 <br />12/1/2016 <br />12/1/2017 <br />Each Claim $2,000,000 <br />Claims Made <br />Annual Aggregate $2,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) <br />The City of Santa Ana, it's officers, employees, agents, and representative are Additional Insured for <br />General Liability but only if required by written contract with the Named Insured prior to an occurrence <br />and as per attached endorsement. Coverage is subject to all policy terms and conditions. *30 days notice <br />of cancellation, except for 10 days notice for non-payment of premium. For Professional Liability <br />coverage, the aggregate limit is the total insurance available for all covered claims reported within the <br />policy period. <br />City of Santa Ana <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 <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 REPRESENTATIVE <br />ina Cowie/SGL <br />CORPORATION. All ritlhte reserved_ <br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD <br />INS025 on1 an1l <br />