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Client#:160973 WESTHART ACORDn. CERTIFICATE OF LIABILITY INSURANCE DATE TYPE OF INSURANCE 912012IDOIVVYV) 12 012 017 THIS CERTIFICATE IS ISSUED ASA 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(es) 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 CONTACT NAME: USI Southwest PHONE FA AIC'No, E, : 713 490-4600 A/c No : 713.490.4700 9811 Katy Freeway, Suite 500 E-MAIL Houston,77024 ADDRESS: $ 713 490.46060 0 INSURER(S) AFFORDING COVERAGE NAIC# INSURER A : Gemini Insurance Company 10833 PERSONAL SADVINJURY INSURED INSURER B: sarety National casualty Corp 15105 Town of West Hartford INSURER C: 50 South Main Street INSURER D: West Hartford, CT 06107 $ 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, ILTR TYPE OF INSURANCE 'IN SRL WVDUBR POLICY NUMBER MMIDDIYVYFY MMIDDIYYEXP LIMITS A X COMMERCIAL GENERAL LI ABILITY Fvl X CLAIMS -MADE OCCUR X $250,000 PEM000000605 7/01/2017 07101/201E EACH OCCURRENCE $1 000000 PREMISES Ea occurrrence $ MED EXP (Any one person) $ Retained Limit PERSONAL SADVINJURY $ GENT AGGREGATE LIMIT APPLIES PER: PRO - POLICY 1:1JECT LOC OTHER: GENERAL AGGREGATE $1,000,000 PRODUCTS - COMPIOP AGG $ $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIREDAUTOS AO OOWNED 'e ?e ('Y /y E �A n V� V \�\O,� Eaa aacid.nfi GLE LIMIT $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident)$ PROPERTY DAMAGE Peraccldenl $ $ UMBRELLA LIAB EXCESS LIAS OCCUR CLAIMS -MADE ("' EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN OFFICER/MEMBER EXCLUDED? F_N]NIA (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below SP4057079 $500,000 SIR 710112017 07/0112018 X 2PIUIE I OTH- ER E. L. EACH ACCIDENT $1000000 E. L. DISEASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Effective Date: March 19, 2015 Description: Consultant Agreement- Institute of Museum and Library Services (IMLS) Leadership Grant City of Santa Ana, its officers, employees, agents and representatives are named as additional insured with respects to the General Liability, when required by written contract. City of Santa Ana 20 Civic Center Plaza Santa Ana, CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION_ All rinhts rasaruaH ACORD 25 (2014101) 1 of 1 The ACORD name and logo are registered marks of ACORD #S215098981M21258453 BZLHA