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PARAG-3 OP ID: CM
<br />'4 J?" CERTIFICATE OF LIABILITY INSURANCE
<br />DATE/05/20Y
<br />09/05/207
<br />F 17
<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 />The Dougherty Company, Inc.
<br />P.O. Box 7277
<br />Long Beach, CA 90807
<br />Richard Lindgren
<br />CONTACT
<br />NAME:
<br />PHONE 562-424-1621 F""X
<br />A/C No Ext): (ac No): 562-490-0432
<br />E'MA—ADDRESS: sylvia@doughertyins.com
<br />GENERAL LIABILITY
<br />INSURER(S) AFFORDING COVERAGE NAIC #
<br />INSURER A: Hartford Insurance Company 29424
<br />INSURED Paragon Partners Ltd.
<br />5660 Katella Avenue, Suite 100
<br />INSURER B: Lloyds of London '..AA112
<br />EACH OCCURRENCE $ 1,000,00
<br />Cypress, CA 90630
<br />INSURER C:
<br />INSURER D.
<br />INSURER E:
<br />01/01/2017
<br />INSURER F:
<br />REMISETO-R '
<br />S Ea ccurrencel $ 300,00
<br />COVERAGES CERTIFICATE NUMBER: 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 />IOU
<br />LTR
<br />TYPE OF INSURANCE
<br />INSR
<br />WVDJ B
<br />POLICY NUMBER
<br />MM DDNYYY
<br />MM/DDIYYYY
<br />LIMITS
<br />GENERAL LIABILITY
<br />EACH OCCURRENCE $ 1,000,00
<br />A
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE OCCUR
<br />X
<br />72UUNPR1964
<br />01/01/2017
<br />01/01/2018PREMISE
<br />REMISETO-R '
<br />S Ea ccurrencel $ 300,00
<br />MED EXP (Any one person) $ 10,00
<br />PERSONAL & ADV INJURY $ 1,000,00
<br />X Contractual
<br />Deductible -0-
<br />GENERAL AGGREGATE $ 2,000,00
<br />GE_N'L AGGREGATE LIMIT APPLIES PER:
<br />PRODUCTS - COMP/OP AGG $ 2,000,00
<br />X POLICYJECT I PRO- LOC
<br />$
<br />AUTOMOBILE LIABILITY
<br />COMBINED SINGLE LIMIT 1,000,00
<br />Ea accident $
<br />BODILY INJURY (Per person) $
<br />A
<br />ANY AUTO
<br />X
<br />72UUNPR1964
<br />01/01/2017
<br />01/01/2018
<br />ALL OWNED SCHEDULED
<br />'. AUTOS AUTOS
<br />BODILY INJURY (Per accident) $
<br />X 'HIRED AUTOS X NON -OWNED
<br />AUTOS
<br />PROPERTY DAMAGE $
<br />PER ACCIDENT
<br />Deductible: $ nil
<br />X No Owned Autos
<br />X UMBRELLA LIABX
<br />OCCUR
<br />EACH OCCURRENCE $ 10,000,00
<br />AGGREGATE $ 10,000,00
<br />A
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />72RHUPR2423
<br />01/01/2017
<br />01/01/2018
<br />'. DED X RETENTION$ 10,000
<br />$
<br />A
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETOR/PARTNER/EXECUTIVEY/N
<br />OFFICER/MEMBER EXCLUDED? y
<br />(Mandatory in NH)
<br />N / A
<br />72WENG6914 -ALL STATES
<br />EMPLR'S LIAB &STOP GAP
<br />01/01/2017
<br />01/01/2017
<br />01/01/2018
<br />01/01/2018
<br />X WC STATU- OTH-
<br />TORY LIMITS ER
<br />E.L. EACH ACCIDENT $ 1,000,00
<br />E.L. DISEASE - EA EMPLOYE $ 1,000,00
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT $ 1,000,00
<br />B
<br />Real Estate
<br />MPL102807417
<br />05/22/2017
<br />05/22/2018
<br />Claim: 2,000,000
<br />Errors & Omissions
<br />CLMS MADE: $151K RETENTION
<br />Aggregate 2,000,00
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required)
<br />Re: Agreement No. A-2017-229. The City of Santa Ana, its officers,
<br />employees, agents, volunteers and representatives are named as Additional
<br />Insured for Auto and General Liability as respects operations of the Named
<br />Insured. Coverage is primary and non-contributory. Endorsements attached.
<br />30 days prior written notice of cancellation applies.
<br />REVIEWED BY: EUNICE HEREDIA (PG 1 F*
<br />,,r-mIIria,HIc nvLuctc
<br />SANTAA2
<br />City of Santa Ana
<br />Public Works Agency, M-36
<br />Attn: Leticia Lopez
<br />20 Civic Center Plaza
<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 />Ad
<br />©1988-2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
<br />
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