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<br />CERTIFICATE OF LIABILITY INSURANCE
<br />6/30/2017
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
<br />NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
<br />BELOW.
<br />POLICIES
<br />THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN
<br />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 have ADDITIONAL INSURED
<br />provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement.
<br />A statement on
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsement s
<br />PRODUCER
<br />Earl Bacon Agency, Inc.
<br />.
<br />NA MECONTACT Bobb Bacon/Nanc Klucher
<br />PHONE
<br />.850-878-2121 FAX Ne.850-878-2128
<br />P.O. Box 12039
<br />Tallahassee FL 32317
<br />AdQE
<br />E-MAIL . bbacon@earlbacon.com/nkluch@earlbacon.com
<br />INSURER SI AFFORDING COVERAGE NAIC#
<br />Y-
<br />Y
<br />INSURER A: Con}Inen}al Casual} Compan 20443
<br />INSURED MGTOF-1
<br />MGT of America, LLC
<br />INSURERS:Valle Forge Insurance Co. 20508
<br />INSURERC:Trans ortation Ins. Co. 20494
<br />MGT of America Consulting, LLC
<br />INSURER D:TravelersCas.&Suret Co.ofAmer. 31194
<br />3800 Esplanade Way, Ste 210
<br />Tallahassee FL 32311
<br />INSURERE:American Cas.Co.of Readin , PA 20427
<br />INSURER F
<br />COVERAGES CERTIFICATE NUMBE 703708752
<br />•
<br />THIS IS TO CERTIFY THAT THE POLICIES INSURANCE LISRTED BELOW HAVE REVISION NUMBER:
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, BEEN ISSUED TLi THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />UI REMENT, TERM OR CONDITION OF ANY CONTRACT
<br />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
<br />TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED
<br />INSR BY PAID CLAIMS,
<br />LTR
<br />TYPE OF INSURANCE
<br />INSD
<br />MIND
<br />POLICYNUMBER
<br />POLICY EFF
<br />MMIDOrvYYV
<br />POLICY EXP
<br />MMIDO/YYYY
<br />LIMITS
<br />E
<br />X COMMERCIAL GENERAL LIABILITY
<br />Y-
<br />Y
<br />5095130327
<br />7/1/2017
<br />7/1/2018
<br />EACH OCCURRENCE $1,000,000
<br />CLAIMS-MADEX❑ OCCUR
<br />AMA TO N T D
<br />X A -XV Rating
<br />PREMISES Es occurce $300,000
<br />ren
<br />MED EXP (Any one person) $15,000
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER',
<br />PERSONAL&ADVINJURY $1,000,000
<br />GENERAL AGGREGATE $2,000,000
<br />X
<br />POLICY E PRO- [_
<br />AGG $2,000,000
<br />LOC
<br />JECTPRODUCTS-COMP/OP
<br />OTHER:
<br />Deductible $None
<br />E
<br />AUTOMOBILE
<br />LIABILITY
<br />Y
<br />Y
<br />2093563501
<br />7/1/2017
<br />7/1/2018
<br />Ea accident $1,000,000 $1,000,000
<br />ANYAUTO
<br />BODILY INJURY (Per person) $
<br />OWNED SCHEDULED
<br />X
<br />AUTOS ONLY AUTOS
<br />NON -OWNED
<br />BODILY INJURY (Per accident) $
<br />AUTOS ONLY X AUTOS ONLY
<br />PR REPLY DAMAGE
<br />X
<br />A -XV Rating
<br />Per accident $
<br />Deductible $None
<br />A
<br />X
<br />UMBRELL4 LIAB X OCCUR
<br />2093563496
<br />7/1/2017
<br />7/1/2018
<br />X
<br />EXCESS LIAB CLAIMS -MADE
<br />EACH OCCURRENCE $5,000,000
<br />X
<br />AGGREGATE $5,000,000
<br />DED RETENTION 10,000
<br />$
<br />X ORTH-
<br />B
<br />C
<br />WORKERS COMPENSATIONy
<br />AND EMPLOYERS' LIABILITY
<br />3011086712-AII OtheY
<br />7/1/2017
<br />7/1/2018
<br />YIN
<br />ANVPROPRIETDRIPARTNER/EXECUTIVE
<br />3011066788 CA
<br />7/1/2617
<br />7/1/2018
<br />STATUTE
<br />E. L EACHACCIDENT $500,000
<br />OFFICER/MEMBER EXCLUDED? ❑MIA
<br />(Moreov ry In NH)
<br />E.L. DISEASE - EA EMPLOYEE $500,000
<br />lyes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E. L. DISEASE-POLOYLIMIT $500,000
<br />D
<br />Professional Liability (E&O)
<br />N
<br />Clad
<br />Claims --Made Form
<br />N
<br />105636880
<br />7/1/2017
<br />7/1/201B
<br />Each Claim 2,500,000
<br />7/5/95 Retro Date/A++XV
<br />Aggregate 5,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more is
<br />space required)
<br />Umbrella: A -XV Rating. Alf Other Workers' Comp & CA Workers' Comp: U
<br />A -XV Rating.
<br />CA - Workers' Comp Employers Liability Limits:
<br />$1,000,000 Each Accident REVIEWE6_1)" �•
<br />$1,000,000 Disease Policy Limit
<br />By Margaret Mercer at 5:44 pm, t31, 2017<
<br />$1,000,000 Disease Each Employee
<br />Cyber Liability: Continental Casualty Company -Limits of Liability $1,000,000/$1,000,000 Retention $10,000 Reto Date
<br />Made Effective 3/30/17 - 3/30/2018 3/30/2017 -Claims
<br />CERTIFICATE HOLDER ......._... _._..
<br />City of Santa Ana
<br />20 Civic Center Plaza (M-30)
<br />P.O. Box 1988
<br />Santa Ana CA 92702-1988
<br />ACORD 25 (2016/03)
<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 />b
<br />©1988-2015 AC(
<br />The ACORD name and logo are registered marks of ACORD
<br />All rights reserved.
<br />
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