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ALORb®
<br />CERTIFICATE ®Ir LIABILITY INSURANCEDATE(MM/D
<br />'YY).
<br />2/9/2017
<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 CON'T'RACT BETWEEN THE ISSUING INSURER(% AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder Ts an ADDITIONAL INSURED, the polioy(las) must have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and condidOns of the policy, certain policies may require an endorsement, A Statamont on
<br />this Certificate does not confer rights to the certificate holder In lieu of aueh endorsement(s).
<br />PRbtlUCER
<br />Arthur J. Gallagher& Co.BONE
<br />Insurance Brokers of CA, Inc. LIC #0726293
<br />505 N Brand Blvd, Sults 600
<br />Glendale CA 91203
<br />NAME: T Mel Cha
<br />_
<br />"818-630-2300
<br />698.539-2300 ,818-539.2301
<br />E•M IL .Mel ohan(ajg.eam
<br />INSURERS ARPORBING COVERAGE NATO #
<br />INSURBRA:Berkley National Insurance Company 38911
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS•MAOE � OCCUR
<br />INSURED INTEHOU-03
<br />uNsumn SINEW York Marine And General Insuran 16608
<br />Interval House
<br />P.Q. Box 3356
<br />Seal Beach, CA 90740
<br />INSURER O:
<br />INSURERD:
<br />INSURER E'
<br />X Sexual Abuse Lle
<br />COVERAGES CERTIFICATE NUMBER= 558997154 IcritlIRIAN NI Ia,1RICM.
<br />71115 IS TO CERTIFY THAT THE POLICIES OP INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE POR 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 DESORIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />ILTP
<br />TYPE OP INSURANCE—-......
<br />ADDL
<br />Man
<br />SUER
<br />wvu
<br />POLICY NU
<br />C
<br />0
<br />1011/2016
<br />49LID EXP
<br />LIMITS
<br />A
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS•MAOE � OCCUR
<br />Y
<br />HHS8525826.10
<br />10/112017
<br />EACH OCCURRENCE ,_$1,000,000
<br />A B'RENTEar.. "�'
<br />REM1993 (Ea urrnae $100 000
<br />X Sexual Abuse Lle
<br />MEDEXPfAnytlnapmeon $A,000
<br />X 1
<br />PERSONAL&AbVINJURY $1000,000
<br />GEN -1. AGGREGATE LIMIT APPLIES PER:
<br />X POLICY ❑ IE"" FI LOC
<br />GENERAL AGGREGATE $8,000,000
<br />PRODUCT&-OOMPICPAGG $3,00D,000
<br />I Professlonol Llab $1MMISMM
<br />OTHER
<br />AUTOMOBILE
<br />LIABILITY
<br />GPIABINED SINGLE UKT$
<br />Ea aca'da 1
<br />ANY AUTO
<br />BODILY INJURY (Par poreon) S
<br />S E
<br />I TUTU 090NLY AUU1, 5wULNLgDp
<br />AUTOS ONLY A11T08 tlNLY
<br />BODILY INJURY (Per accident) $
<br />Per accldont dA S
<br />A
<br />UMBRELLA LIAR
<br />X -OCCUR
<br />HHN 9565362.10
<br />1011/2016
<br />10/1/2017
<br />EAOHOCCURRENCR 32,000,000
<br />X
<br />EXCESS LIAR
<br />CLAIMS -MADE
<br />AGGREGATE $2,QQQ,000
<br />ORD X RETENTION$0
<br />Sexual misconduct $Inolvoed
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS'LIABILITY YIN
<br />ANY PROPRIETORIPARTNE8MXRGUTIVE ❑N/A
<br />OFFICRR/MEMEER EXCLUOFD7
<br />(Mandatory In NH)
<br />r es dooeri sunder
<br />WG?.01700008079
<br />211/2017
<br />2/112018
<br />X PTA E ETH
<br />R.L. EACH AOCIOENT 01000000
<br />E.L. DISEASE -EA EMPLOYE` $1,OQtl,000
<br />E.L. DISEASE -POLICY OMIT $1,000,000
<br />ESERIPTI N OF OPERATIONS below
<br />A
<br />A
<br />A
<br />Property CoVerage
<br />Crime -Theft
<br />Forgery & Alteration
<br />HHS8526626-10
<br />HH38620626.10
<br />HIdS8628028.1a
<br />10/1/2016
<br />10/1/2010
<br />1011/2016
<br />1011/2017
<br />10/1/2017
<br />101112017
<br />Limii:$4,339,200 Deducible:$I,000
<br />Limit:300,000 Ded:$1,000
<br />IImIk$BQQ,QOQ Ded$1000
<br />DESOnipTIONOFOPCRATIONS/LOCATIONS/VEHICLES (ACOR0101, Additional nammha Schedule, may be attached It more space Is required)
<br />Policy: Cyybar Liability,
<br />Policy#: ET1280674 ,ketro Qate:711/2016
<br />Term:7/1/2016 to 7/1/2017
<br />Limit/Aggregate; 1,000,000 Retentlon:$5,000
<br />City Santa Ana, Its ottGore, agents employees and volunteers are named additional insured with
<br />A y
<br />See Attached...o
<br />City of Santa Ana Community Development Agency (M-26)
<br />Administrative Services Divialon
<br />Attn: Terri Eggers
<br />20 Civic Center Plaza, M-26
<br />Santa Ana CA 52701
<br />USA
<br />ACORD 25 (2016/03)
<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 RE
<br />RQV.4,bra01,
<br />ACORD
<br />The ACORD name and logo are registered marks of ACORD
<br />rights
<br />
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