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<br />LEGAL -3 OR ME US
<br />CERTIFICATE OF LIABILITY INSURANCE DArE(MM,DDNYYY)
<br />IN,`" 09!1912017
<br />THIS CERTIFICATE 1S 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 WAIVEb, 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 endorsementis).
<br />INSURED
<br />Mesa Insurance Services
<br />Hview Parkway #401
<br />CA 92071
<br />2101 North Tustin Avenue INSURER C.
<br />Santa Ana, CA 92706 =INSURER
<br />COVERAGE
<br />rnvFRAr PA CERTIFICATE_ NUMBER: 1 REVISION NUMBER -
<br />6605
<br />THIS IS To CER1"IFY 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,
<br />THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE
<br />TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INsft' DOL U
<br />POLOYEFP POLICY EXP
<br />LTR( TYPE OF INSURANCE INSD WVD
<br />POLICY NUMBER MMIOOIYYYY ffMMiRW_Y_WY11 LIMITS
<br />EMPLOYEES AND VOLUNTEERS
<br />A S X1 COMMERCIAL GENERAL LIABILITY
<br />I EACH I;OCURRENCE L5
<br />1,000,0{}
<br />J CLAIMS MADE � OCCUR X
<br />DADA T
<br />MUP2133.01 0710112017 6770112015 P11
<br />REMISES Ea orcanence) s
<br />1,000,00
<br />{
<br />7 P Omy r
<br />MED EXP {AnY enep on) if_
<br />10,00
<br />!PERSONAL&ADVINJURY $
<br />1,000,00
<br />GENT AGGREGA1 E LIMIT APPLIES PER:
<br />j GENERAL AGGREGATE 5
<br />2,000,00
<br />POLICY X
<br />I JEC LOC
<br />PRODUCTS -COMPIO_P ADD 5
<br />2,000,06
<br />OTHER:
<br />I S
<br />AUTOMOBILE LIABILITY
<br />COMBINED
<br />COMBINED SINGLE LIMIT
<br />Ea B §
<br />1,000,000
<br />A ANY
<br />_
<br />WUP2133-09 07/0112017 O710i/2018 BODILY INJURY (Perpersan) 9
<br />AUTOS Eq SCHEDULED
<br />I BODILY INJURY (Per Idanl) $
<br />---
<br />AUTOS AUTOS
<br />_X,{NON-OWNED `
<br />X HIRED AL1T05
<br />�,
<br />i Pe�accaen DAMAGE $
<br />t)
<br />(AUTOS
<br />},' UMEs<RLI.LA LIAe IX OCCUR
<br />1 EACH OCCURRENCE $
<br />2,000,06
<br />LF EXCESS {aAe GUAM,...
<br />HUU2134.01 0770112017 0710112018; AGGREGATE �,5
<br />2,000,00
<br />4 DED' h RETENTIONS 10.000,
<br />S (5
<br />1wORKERS00MPICNSATGN j
<br />' X PER
<br />i `ERT {
<br />_
<br />ANP EMPLOYERS' LIABILITY YIN E
<br />B ANVPROPMETOUPARTNERIEXECUTIVE
<br />❑(N/A
<br />I—
<br />IWC201700015159 09/0112017 0910112018 EL. EACHACCIDENT S
<br />'I---
<br />_
<br />1,000,00
<br />OFFICER44EMBER EXCLUDED?
<br />(MandatorylnNl¶ j
<br />1 EL. DGEASE-EAEMPLOYEEI S
<br />1,000,000
<br />DES'_Re5ddllkllndBr
<br />DES�RIPIJON OF OPERATIONS below
<br />EL. DISEASE -POLICY LIMIT �S
<br />1,000,000
<br />A Sexual Ahuso and
<br />_
<br />(HUP2133.01 07/0112017 0710112018 Per Polls:
<br />2,000,000
<br />Molestation Liab
<br />I
<br />1HUP2133.01 iPer FRED
<br />1,000,00
<br />DEsORIP PON OF OPERATIONS I LOCATIONS I VEHICLES (ACORO 101, Addltiomi Remarks Schedule, maybe attached It more space is required(
<br />RE: OPERATIONS OF THE NAMED INSURED AS CERTIFICATE HOLDERS INTEREST MAY
<br />(1
<br />APPEAR SUBJECT TO POLICY TERMS, CONDITIONS AND EXCLUSIONS. CERTIFICATE f{r`
<br />HOLDER IS INCLUDED AS ADDITIONAL INSURED
<br />PER FORM MGL 1242 03 14 ATTACHED.
<br />cERTIPICATP 4101_DER CANCELLATION
<br />SANTAA2
<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 />CITY OF SANTA ANA
<br />ITS OFFICERS, AGENTS, AND
<br />AUTHORIZED REPRESENTATIVE
<br />EMPLOYEES AND VOLUNTEERS
<br />20 CIVIC CENTER PLAZA
<br />(SANTA ANA, CA 92701
<br />O 1988-2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
<br />
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