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A`tCill CERTIFICATE OF LIABILITY INSURANCE
<br />°ATS 1ai2o�rvY'
<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 18 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 10A Insurance Services
<br />130 Vanlis, Suite 250
<br />AIIso Viejo, CA 92656N
<br />NAMEACT Betty Tran
<br />PHONE FAX
<br />949-297-5962(AIC Net: 949.297.5960
<br />batt .tran icausa.com
<br />INSURER(S) AFFORDING COVERAGE NAICY
<br />INSURERA, RLI Insurance Company 13056
<br />www.loausa.com CA License #OE67768
<br />INSURED
<br />D. Woolley&Associates, Inc.;
<br />Harbinger Analytics Group
<br />2832 Walnut Ava IUS, Suite A
<br />Tustin CA 92780
<br />INSURER B:
<br />INSURER C:
<br />--- --
<br />INSURER D:
<br />INSURER E:
<br />INSURER F:
<br />CLAIMS -MADE © OCCUR
<br />Prim/NCroon
<br />COVERAGES CERTIFICATE NUMBER: 3669o201 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 Oil MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLLSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSIR
<br />TYPE Of INSURANCE
<br />A OLSUBR
<br />INSEP
<br />POLICYNUMBER
<br />POLICY EFF
<br />MMIDD/YYYY
<br />PpOLICY EXP
<br />NMIDDIYYYY
<br />LIMITS
<br />COMMERCIAL GENERALLIABILITY
<br />✓
<br />'Wk
<br />t/
<br />PSB0001377
<br />2/11/2017
<br />2/11/2018
<br />EACHOCCURRENCE $ 2,000,000
<br />CLAIMS -MADE © OCCUR
<br />Prim/NCroon
<br />Scheduled 1 End!
<br />2
<br />#PPB Professional
<br />Professional Services
<br />performed by the Insured
<br />are Excluded
<br />PREMISES Ea oaaurmne $ 1,000,000
<br />MED EXP An one ereon $ 10,000
<br />Wvr of Subr
<br />PERSONAL &ADV INJURY It 2,000,000
<br />GEN'L AGGREGATE U MIT APPLIES PER:
<br />POLICY LOC
<br />GENERAL AGGREGATE $ 4,000,000
<br />PRODUCTS-COMP/OP AGO $ 4,000,000
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />LIABILRY✓
<br />ANY AUTO
<br />✓
<br />PSA0001203
<br />Designated Insured Endt
<br />2/11/2017
<br />2/1112018
<br />EOMeIBI INEDISINGLE LIMIT $ 1000,000
<br />BODILY INJURY (Per person) $
<br />✓
<br />OWNED SCHEDULED
<br />AUTos oNLv AUTos
<br />AUTOS ONLY AUTOS ONLY
<br />#CA20481013; Prlm/NonCon
<br />and Blkt Wvr Of Subr
<br />included on pg 2 of Form
<br />BODILY INJURY (P. accident) $
<br />PBOPERk rtl) GE $
<br />$
<br />✓
<br />Prim/NonCon Wvr of Subr
<br />#PPA3000313
<br />A
<br />UMBRELLA LIAR
<br />,/ OCCUR
<br />PSED001256
<br />2/11/2017
<br />2/11/2018
<br />EACH OCCURRENCE s 4.000,000
<br />,/
<br />EXCESS LIAO
<br />CLAIMS -MADE
<br />Excludes Professional
<br />Liability
<br />AGGREGATE S 4,000,000
<br />DED RETENTION
<br />$
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANYPROPRIETOWPARTNEWEXECUT'IVE
<br />OFFICERINIE(Mandato,y In NH)EXGLUOED7 FN
<br />N/A
<br />PSW000'I 324
<br />Walver of Subrogation
<br />Endt#WC0403060484
<br />2/11/2017
<br />2/11/2018STATUTE
<br />ERH
<br />E,L,EACHACOMENT $ 1,000,000
<br />E.L, DISEASE - EA EMPLOYEE $ 1,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE -POLICY LIMIT I $ 1,000,000
<br />A
<br />Professional Llabllity
<br />RDPOO27812
<br />2111/2017
<br />2f11l2018
<br />$1,000,000 Each Claim
<br />Claims -Made
<br />$2,000,000 Aggregate
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks SchedulD, maybe attached If more space is required)
<br />Certificate Holder Is an Additional Insured with respect to General Liability (GL) and Automobile Liability but only when required by wrltten contract
<br />with the Insured prior to an occurrence asper Endorsements noted above- GL Includes Separation of Insureds and Contractual Liability per limitations
<br />In the BuslnessOwners' Coverage form. A Workers' Compensatlon Waiver of Subrogation as noted above Is Included for the person or organization named
<br />In the Schedule that are parties to a contract requiring this Endorsement, provided that contract is executed before the loss. Coverage subject to all
<br />policy terms, conditions, limitations and exclusions. 30 Day Notice of Cancellation/10 Days for Non -Payment In aydance with policy provisions.
<br />REVIEWED BY: EUNICE HEREDIA(PG I OF <)
<br />CERTIFICATE HOLDER CANCELLATION
<br />City
<br />Cit of Santa Ana its officers and employees
<br />20 Center Plaza /M -3U
<br />POBox 1988 )
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCEWITH THE POLICY PROVISIONS.
<br />Santa Ana CA 92702
<br />AUTHORIZED REPRESENTATIVE
<br />(AVC) Alicia K, ]gram
<br />©1988.2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />36690201 1 2/17-1e GWAUM/Excess/we/PL I (AVC) Betty Tran 1 7/14/2019 9:30,46 AM (PDT) I Page v oT 3
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