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CERTIFICATE OF LIABILITY INSURANCE (MMomrv) 107/2112017DATE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER WBA InsurancePHONE 13304 Philadelphia Street Ste 200 Whittier CA 90601 CONTACT Maria Fredendall , 662 789.5704 FAX No, (562) 789-5804 E-MAIL License #OD79617 INSURIERal AFFORDING COVERAGE NAIC H wsURERA: Philadelphia Indemnity Ins Company INSURED Kingdom Causes dba: City Net PO Box 90243 Long Beach CA 90809 INSURER B: Hiscox Insurance Company Inc. INSURERC: INSURER D, INSURER E: -INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR 118. TYPE OF INSURANCE AOOL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $2,000,000 A X COMMERCIAL GENERAL LIABILITY DAMAGE TaESORENTED $100,000 CLAIMS -MADE %OCCUR Y PHPK1576201 01/11/2017 01/11/2018 MED EXP (Any one erson $5,000 PERSONAL & ADV INJURY s2,000,000 GENERAL AGGREGATE $4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGO $4,000,000 X POLICY PRO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 A ANYAUTO BODILY INJURY (Per person) $ ALL OWNED AUTOOULED Y PHPK1576201 01/11/2017 01111/2018 BODILY INJURY (Per accident) $ X NON'WNED HIRED AUTOS X AUTOS PROPERTY DAMAGE $ UMBRELLA LAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED I I RETENTION $ WORKERS COMPENSATION WC STATU- 171 AND EMPLOYERS' LIABILITY Y I NDRY, ER ANY PROPRIETORIPARTNERIEXECUTIVEE E.L, EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? LJ NIA IManUatory in NH) E.L. DISEASE - EA EMPLOYE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ A Professional Liability Y PHPK1576201 01/11/2017 01/11/2018 $1Mil Each Incident $2Mil Aggre. B Privacy Liability Y MPL1841282.16 10/19/2016 10/19/2017 $1,000,000 Limit DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) The City of Santa Ana, its officers, employees, agents, volunteers & representatives are named additional insured with respects to the operations of the named insured per the attached CG20261185 endorsement. Such insurance is primary and non-contributory. CERTIFICATE HOLDER CANCELLATION City of Santa Ana 20 Civic Center Plaza SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE <> ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD