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acoRa®CERTIFICATE OF LIABILITY INSURANCE
<br />��
<br />PATE (M I
<br />6/26/2/2 01717
<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 Ileu of such ondorsement(s).
<br />PRODUCER
<br />ISU Insurance Services - Centinel Agency, LLC
<br />250 Executive Park Blvd
<br />CONTACT Fernando Rivas
<br />AME: _
<br />PHONE (415)657-2000 2002
<br />. fisc No Ials)6n-
<br />C,
<br />-MALL Fernando@iouca.com
<br />_AQQRESSt.,
<br />INSURER(S)AFFORDINGCOVERAGE NAICN
<br />Suite 4800
<br />INSURER A:SCottadale Insurance Company
<br />San Francisco _ CA 94134
<br />INSURED
<br />California Barricade Rentals Inc r
<br />INSURER BAmerican_ Fire and Casualty Company
<br />INSURERCNational Union Fire Ins Cc of
<br />1550 E Saint Gertrude Place
<br />INSURERD:State Compensation Ins_ Fund
<br />INSURERE_Hi SCCx Insurance CCmpan}^ Inc
<br />$ 100, 000
<br />INSURBRF:Xinsale Insurance Com an
<br />Santa Ana CA 92705
<br />COVERAGES CERTIFICATE NUMBER:17-18 GL,WC,BA,XS,E&O,PL REVISION NUMBER:
<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 />IN
<br />OF INSURANCE
<br />DL
<br />SUER
<br />POLICY NUMBER
<br />MOLIICY IEFF
<br />POLICYTYPE
<br />MMIUDV EXP
<br />LIMITS
<br />A
<br />X `C`OVMERCIALGENERALLIASIUTV
<br />�,-1 CLAIMS -MAGE 51 OCCUR
<br />EACH OCCURRENCE
<br />$ 11000,000
<br />DMA ETO RENTED
<br />PREMISES (Ea occurrence
<br />$ 100, 000
<br />MED UP (Anyone person)
<br />_
<br />$ Excluded
<br />X
<br />BCB0036349
<br />7/1/2017
<br />7/1/2D1S
<br />PERSONAL& ADV INJURY
<br />$ 11000,000
<br />GENERAL AGGREGATE_
<br />$ 2,000,000
<br />GENT AGGREGATE LIMIT APPLIES PER:
<br />X POLICY L—]PRO-JECT [__] LOC
<br />PRODUCTS - COMP/OP AGG
<br />$ 21000,000
<br />Employee Benefits
<br />$ 11000,000
<br />OTHER:
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />Ee accident
<br />$ 1,000,000
<br />BODILY INJURY (Par person)
<br />$
<br />B
<br />X
<br />ANY AUTO
<br />ALL OWN50 rr-]� SCHEDULED
<br />AUTOS I AUTOS
<br />X
<br />HAA (1a) 50 05 63 03
<br />7/1/2017
<br />7/1/2018
<br />BODILY INJURY Por accident
<br />( )
<br />$
<br />W -OWNED
<br />HIRED AUTOS X NOP
<br />PROPERTY DAMAGE
<br />e ac ent
<br />$
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 5,000 000
<br />AGGREGATE
<br />$ 51000,000
<br />fY•
<br />g
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DEO J I RETENTIONS
<br />BE 065409561
<br />7/1/2017
<br />7/1/2018
<br />$
<br />D
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANY PFRIMEMTORlEXCLUDRIEXECUTIVE
<br />(Mandator, In ER EXCLUDED?
<br />dtoryin NH)and
<br />If
<br />DESCRIPTION
<br />DESCRIPTION OF OPERATIONS below
<br />OF O
<br />NtA;
<br />j
<br />9063608-17
<br />I
<br />7/1/2017
<br />7/1/2018
<br />X PER �OTH-
<br />E.L EACH ACCIDENT
<br />E.L. pIBEASE - EA EMPLOYEE
<br />$OFFIC_ 1,000,000
<br />j'$ 1,000,000
<br />(EL. DISEASE -POLICY LIMIT
<br />T w
<br />$ 1,000,000
<br />E
<br />Professional Liability
<br />(
<br />MPL1863490.16
<br />12/1/2016
<br />12/1/2017
<br />Each Claim $1,000,000
<br />F
<br />Pollution Liability
<br />0100052798-0
<br />7/1/20]]
<br />7/1/2018
<br />Each Pollution Condition- $1,000,000
<br />DESCRIPTION OF OPERATIONS LOCATIONS IVEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)``M1M1''Pj
<br />The City of Santa Ana, its officers, employees, agents, and representative a,{'.®\�Aded as additi
<br />insured per form CG 20 33 04 13 and CG 20 37 04 13 on the GL policy.Al
<br />t lam% Cj
<br />Additional Insured applies per form CA 88 10 01 13 on the Auto policy. eg'\ QPJa
<br />Those usual to the insured -is operations.
<br />G Jf�
<br />City of Santa Ana
<br />20 Civic Center Plaza - M-23
<br />Santa Ana, CA 92702
<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 />Ferenc/FR
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
<br />INS025 r?D14nn
<br />All richts
<br />
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