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URBAPUT-01 AGREEN AC>R"e �..r-.---, CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 12/29/2016 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 certiflcste does not confer rights to the certificate holder in lieu of such ondorsement s . PRODUCER Brown & Brown of New York Inc. BOO Westchester Avenue, N411 Rya Brook, NY 10573 CONTACT PHONE 914 337-1639c No; 914) 337-1596 t 6 AIL ADDRESS: certificates When .com )NSURER B AFFORWNe COVERAGE MAIC q iNsuReRALlborty Surplus Insurance Corp10725 INSURED INSURER a $ INSURER 0: ..,......., PREMISEa(Ea occurrence Urban Futures, Inc. .............._,........._..�............_....__.._ INSURER 0: MED EXt+ Arryare wr) 17821 E. 17th Street Tustin, CA 82780 INSURER E: INSURER P ; 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 HATH 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. ILTR TYPE OP INSURANCED Awt 9= POLICYNUMSER MM ODY P MMIopIYY LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS MADE ❑ OCCUR.._.,..........�,.. EACH OCCURRENCE $ PREMISEa(Ea occurrence $ MED EXt+ Arryare wr) s PERSONAL &ADV INJURY $ LIMN r APPLIES PER: POLICY L-�_7 jER& 0 LOC GENERAL AGGREGATE $ GEMLAGGRE(G�ATE PRODUCTS-COMPiOP AGO $ $ OTHER: AUTOMOBILE LIAsi TY - EOMBIINNEED ZINGLH LIMI S-"®-ASV-ry BODILY INJURY (Par person) IS ANY AUTO AUTOS�ED SCHEDULED NON-0WNEO HIRED AUTOS AUTOS BODILY INJURY (par xtoideM) S FR D E Per accident UM13RELLA LIAa OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED RETENTION _ WORKERS COMPENSATION AND EMPLOYERS! LIABILITY YIN ANY PROPRIETORIPARTNERlEXECUTIVE OPFICERIMEMSER EXCLUDED? Cl (Mandatory In NH) ff yes, er DESCRIPTION OF OPERATIONS below NIA P T - STAT_ ER ��"--- E.L. EACH ACCIDENT S� E.L. DISEASE - EA EMPLOYEE It E.L. DISEASE -POLICY LIMIT $ X EOSNASET3N00i 1212312016 1212312011 Each 2050,00 A E&O1Cyber Liability EOSNABET3NO01 1212312D16 12!2$12017 Retention Each Claim DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addinenal Remarks Schedule, nifty be attached if more space is required) City of Santa Ana is listed as an Additional Insured under the Errors & Omissions Liability policy. Waiver of Subrogatlon Is Included. CERTIFICATE HOLDER CANCELLATION (01988.201& ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD �Z__r1� go-. ��ev C�7��c v ��% SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Teresa Ramirez ACCORDANCE WITH THE POLICY PROVISIONS, 20 Civic Center Plana AUTHORIZED REPRESENTATIVE Santa Ana, CA 92701 (01988.201& ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD �Z__r1� go-. ��ev C�7��c v ��%