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CHATT-1 OP ID: W2
<br />ACOR® CERTIFICATE OF LIABILITY INSURANCE DA0710612017I
<br />�....--" 07tOfi/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(les) 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 />INSURED
<br />& Associates
<br />uL Ste 1010
<br />13417 Ventura Blvd
<br />Sherman Oaks, CA 91423
<br />INSURERS) AFFORDING COVERAGE
<br />Hartford Casualty Insurance Co
<br />Continental Casualty Company
<br />Hartford Fire Insurance Co
<br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<br />29424
<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
<br />TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 15 SUBJECT TO
<br />ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />Finance & Management
<br />TYPE OF INSURANCE R POUCY NUMBER MM [H�) BFF
<br />HLTR ER POLIO
<br />VY MMfDDY X
<br />LIMITS
<br />20 Civic Center Plaza, M-162
<br />GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />A X COMMERCIAL GENERAL 72SBAUVO269 08/01/2016 08/01/2017
<br />UA"Aut1(Eaoccugenc,
<br />$ 300,000
<br />" �LIABILITY
<br />CLAIMS -MADE LK OCCUR
<br />MED EXP (Any one person)
<br />S 10,000
<br />X Deductible $-O-
<br />PERSONAL d ADV INJURY
<br />$ 1,000,000
<br />GENERAL AGGREGATE
<br />$ 2,000,00
<br />I
<br />- COMP/OP AGG
<br />$ 2,000,00
<br />GL AGO REG7JL MIT APPLIES PER: (PRODUCTS
<br />EN'
<br />POLICY PRO- LOC
<br />..
<br />$
<br />AUTOMOBILE LIABILITY
<br />MBINED SINGL LI l"
<br />Ea accident
<br />1,000000
<br />$ r
<br />A ANY AUTO 72SBAUVO269 08/01/2016 08/01/2017
<br />BODILY INJURY (Per person)
<br />$
<br />ALL OWNED SCHEDULED
<br />BODILY INJURY (Per accident)
<br />$
<br />AUTOS AUTOS
<br />X X NON -OWNED
<br />......_
<br />PERRCTA DAM G
<br />$
<br />HIRED AU OS
<br />....... AUTOS
<br />CRE y
<br />$
<br />)( UMBRELLA LIAB X OCCUR
<br />EACH OCCURRENCE
<br />$ 1,000,00
<br />A EXCESS LIAB CLAIMS -MADE 72SBAUV0259 0810112016 08/01/2017
<br />AGGREGATE
<br />$ 1,000,000
<br />DED RETENTION$
<br />$
<br />WORN .—COMPENSATION
<br />WC STATU- OTH-
<br />X
<br />AND EMPLOYERS' LIABILITY I
<br />TORY LI IT _
<br />Y t N
<br />C ANY PRaPfttErORfPARTNERtexEconvs❑IN7A 72WECZ03095 0810112016 08101!2017
<br />EL EACH AEciDENT
<br />$ 1,000,00
<br />OFFICERtMEMBER EXCLUDED?
<br />(Mandatory in NH)
<br />EL.DISEASE-EA EMPLOYE
<br />$ 1,000,00
<br />If yyes, desa10 untler
<br />DFSCRIPTIONOFOPERATIONSbelow
<br />C.L. DISEASE-POLICYUMIT
<br />$ 1,000,000
<br />B Professional EEH114048832 1112112016 11121/2017
<br />Aggregate
<br />2,000,000
<br />Liability
<br />Per Claim
<br />1,000,000
<br />DESCRIPTION OF OPERATIONS t LOCATIONS t VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required)
<br />The City of Santa Ana, it's officers, employees, agents, and representative
<br />are named as additional insured as their interest may appear with respects
<br />to the operations of the named insured.
<br />!'GATICI(,ATF Lint nPP rAM(.r1 I ATIr)N
<br />(E) 1988.2010 ACORU OURPUKA IION. All ngnts reserved,
<br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />CITY OF SANTA ANA
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Finance & Management
<br />AUTHORIZED REPRESENTATIVE
<br />Services Agency
<br />20 Civic Center Plaza, M-162
<br />") jun
<br />Santa Ana, CA 92702
<br />(E) 1988.2010 ACORU OURPUKA IION. All ngnts reserved,
<br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
<br />
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