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ACORO0 CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MM/DDIYYYY)
<br />F2/14/2018
<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 />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 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 />IOA Insurance Services
<br />130 Vantis, Suite 250
<br />Aliso Viejo, CA 92656
<br />CONTPRODUCER
<br />NAME: BettyTran
<br />A/CNto Ext: 949 297-5962 NC No: 949-297-5960
<br />E-MAIL
<br />ADDRESS: betty.tran@ioausa.com
<br />INSURERS AFFORDING COVERAGE NAIC #
<br />PSB0001377
<br />INSURER A: RLI Insurance Company 13056
<br />www.ioausa.com CA License #OE67768
<br />INSURED
<br />D. Woolley & Associates, Inc.;
<br />Harbinger Analytics Group
<br />INSURER B:
<br />INSURER C:
<br />INSURER D:
<br />2832 Walnut Avenue, Suite A
<br />Tustin CA 92780
<br />INSURER E:
<br />INSURER F:
<br />DAMAGETo
<br />PREMISES Ea occurreRENTEDnce $1,000,000
<br />COVERAGES CERTIFICATE NUMBER: 40354562 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.
<br />ILTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />S 6
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM/DD/YY Y
<br />LIMITS
<br />A
<br />/ COMMERCIALGENERALLIABILITY
<br />�/
<br />�/
<br />PSB0001377
<br />2/11/2018
<br />2/11/2019
<br />EACH OCCURRENCE $200 000
<br />CLAIMS -MADE I✓ OCCUR
<br />✓ Prim/NonCon
<br />Scheduled Al Endt
<br />#PPB3130212
<br />Professional Services
<br />DAMAGETo
<br />PREMISES Ea occurreRENTEDnce $1,000,000
<br />MED EXP (Any one person) $10,000
<br />✓ Wvr of Subr
<br />PERSONAL & ADV INJURY $2,000,000
<br />performed by the Insured
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE $ 4,000,000
<br />are Excluded
<br />POLICY PRO-
<br />JECT F�] LOC
<br />PRODUCTS - COMP/OP AGG $4,000,000
<br />$
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />✓
<br />✓
<br />LIABILITY
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />HIRED
<br />AUTOS ONLY ✓ AUTOS ONLDY
<br />✓
<br />✓
<br />PSA0001203
<br />Designated Insured Endt
<br />#CA20481013; Prim/NonCon
<br />and Bikt Wvr of Subr
<br />included on pg 2 of Form
<br />2/11/2018
<br />2/11/2019
<br />EO accident)
<br />.$1,000,000$1,000,000
<br />BODILY INJURY (Per person) $
<br />BODILY INJURY (Per accident) $
<br />PeOr. acEcidenDAMAGE $
<br />$
<br />✓
<br />Prim/NonCon ✓ Wvr of Subr
<br />#PPA3000313
<br />A
<br />UMBRELLA LIAB✓
<br />OCCUR
<br />PSE0001266
<br />2/11/2018
<br />2/11/2019
<br />EACH OCCURRENCE $4000,000
<br />✓
<br />EXCESS LIAR
<br />CLAIMS -MADE
<br />Excludes Professional
<br />Liability
<br />AGGREGATE $4,000,000
<br />I DED I I RETENTION $
<br />$
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />OFF CER/MEMBEREXCLUDED? ECUANYPROPRIETOR/PARTNERITIVE
<br />N / A
<br />,�
<br />PSW0001324
<br />Waiver of Subrogation
<br />Endt #WC0403060484
<br />2/11/2018
<br />2/11/2019�/
<br />ST TUTE ETH
<br />E.L. EACH ACCIDENT $1,000.000
<br />E.L. DISEASE - EA EMPLOYEE $1,000,000
<br />(Mandatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />I
<br />E.L. DISEASE - POLICY LIMIT $1,000,000
<br />A
<br />Professional Liability
<br />RDP0031627
<br />2/11/2018
<br />2/11/2019
<br />$1,000,000 Each Claim
<br />Claims -Made
<br />$2,000,000 Aggregate
<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 an Additional Insured with respect to General Liability (GL) and Automobile Liability but only when required by written contract
<br />with the Insured prior to an occurrence as per Endorsements noted above. GL includes Separation of Insureds and Contractual Liability per limitations
<br />in the BusinessOwners' Coverage form. A Workers' Compensation 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 accqydance with policy provisions.
<br />REVIEWED BY: EUNICE HEREDIA (PG I OF )
<br />[ya:4112Loy G\I=0:C9LR9aC1
<br />City of Santa Ana its officers and employees
<br />20 Civic Center Plaza (M-30)
<br />PO Box 1988
<br />Santa Ana CA 92702
<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 />(AVC) Alicia K. Igram
<br />@ 1988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />40354562 1 2/18-19 GL/AUTO/EXCESS/WC/PL I Cassie Ray 1 2/14/2018 12:31:27 PM (PST) I Page 1 of 5
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