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A hY CERTIFICATE OF LIABILITY INSURANCE
<br />dMMID
<br />DATE O6/292017 /2017 IVYYY)
<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 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 />Marsh Risk & Insurance Services
<br />17901 Van Korman Avenue, Suite 1100
<br />CONTACT
<br />NAME:
<br />PHONE FAX
<br />UNIC No EX), L No
<br />(949) 399-5800; License 90437153
<br />Irvine, CA 92614
<br />EMAIL
<br />ADDRESS________
<br />__-
<br />Attn: NewportBeach.CerfRequest@marsh,coni 212-948-4323
<br />INSURER(S) AFFORDING COVERAGE
<br />HAD It
<br />INSURER A: Crum & Forster Specialty Insurance Cc
<br />44520
<br />980627-01-01-17-18
<br />INSURED
<br />Placeworks
<br />INSURER B : Travelers Property Casualty Company Of America
<br />25674
<br />INSURER C
<br />Dbal The Planning Center
<br />INSURER D
<br />Design Community & Enviornment
<br />3 MacArthur Place, Suite 1100
<br />--- - --------
<br />---
<br />Santa Ana, CA 02707
<br />INSURER E i
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: LOS-001721165-15 REVISION NUMBER:9
<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 />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />IN D
<br />SUBR
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MMIDDIYYYV
<br />POLICY E%P
<br />MMIDDIYI'YV LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL[ IABILITY
<br />X
<br />X
<br />EPK118128
<br />1111112117
<br />07/0112018 EACH OCCURRENCE
<br />5 5,000,000
<br />CLAIMS -MADE OCCUR
<br />PREM eoocc ErDence
<br />$ 50,000
<br />X
<br />$ 5,000
<br />BI & PD Dad. $5,000
<br />MED EXP (Any one person)
<br />_
<br />$ 5,OOQ000
<br />PERSONAL & ADV INJURY
<br />AGGREGATE LIMIT APPLI ESPER,
<br />$ 5,000,000
<br />GEHL
<br />GENERALAGGREGATE
<br />X
<br />POLICY ElPRO-ECT ❑ LOG
<br />:
<br />PRODUCTS-COMP/OPAGG
<br />$ 5,000,000
<br />$ 5,000,000
<br />OTHER:
<br />��I
<br />Contractors PO ut10n
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />X
<br />X
<br />BA7E37616717CAG
<br />107/01/2017
<br />07/01/2018
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$ 1,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />X
<br />ANY AUTO
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />INJURY (Per accident)
<br />$
<br />PRDAOILV
<br />PROPERTY DAMAGE
<br />Peraccident
<br />$
<br />NON -OWNED
<br />HIRED AUTOS AUTOS
<br />_.
<br />ComplColl Deductibles
<br />$ $1,000
<br />B
<br />UMBRELLA LIAR
<br />X
<br />OCCUR
<br />EX6J3287561743
<br />07/01/2017
<br />07/0112018
<br />EACH OCCURRENCE
<br />$ 4,000,000
<br />$ 4,000,000
<br />X
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />AGGREGATE
<br />DED RETENTION$
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y
<br />ANY PROPRIETORIPARTNERIEXECUTIVE NIN ❑NIAI
<br />OFFICER/MEMBER EXCLUDED?
<br />(Mandatorym NH)
<br />U07E37616717
<br />07/01/2017
<br />07/01/2018
<br />X PER OTH-
<br />STATUTE ER
<br />_
<br />E.L. EACH ACCIDENT
<br />is 1,000,000
<br />E.L. DISEASE - EA EMPLOYEE
<br />is 1,000,000
<br />f yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />I
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 1,000,000
<br />A
<br />Errors & Omissions -Claims Made
<br />EPKIl BI28
<br />1711111117
<br />17111/2018
<br />Each Claim/Aggregate 5,000,000
<br />Paths Dates'. See 2nd Page
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) ,1
<br />Re: Operations performed by the named insured for the certificate holder V 7 °
<br />City of Santa Ana, its officers, agents, employees, and volunteers are included as additional insured where required by written contract with respect to General an ability, This insurance is pri ary and non-
<br />contributory over any existing insurance and limited to liability arising out of the operations of the named insured and where required by written contract wile e t o General Liability. Waive rogation is
<br />applicable where required by written contract with respect to General and Auto Liability.
<br />CERTIFICATE HOLDER CANCELLATION s00i cep C.PIr
<br />City of Santa Ana
<br />owj—
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />20 Civic Center Plaza, M-35
<br />THE EXPIRATION DATE THEREOF, .NOTICE WILL BE DELIVERED IN
<br />Santa Ana, CA 92701
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />of Marsh Risk & Insurance Services
<br />Rosalynda Martinez„
<br />ACORD 25 (2014101)
<br />@ 1988-2014 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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