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AC(C>Ra CERTIFICATE OF LIABILITY INSURANCE
<br />liii.i
<br />DATE(MMIODeYYYY)
<br />1 711812017
<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(ies) must have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsoment(s).
<br />PRODUCER Tech Serve Alliance Services Corp.
<br />1420 King Street; Suite 610
<br />VA 22314
<br />CONTACT
<br />PHONE FAX
<br />BXt1' 703-997,4271 AD Nm• 7o703.997,7727Alexandria,
<br />EMAIL
<br />ADDRESS
<br />INSURERS AFFORDING COVERAGE
<br />NAIC#
<br />INSURER A: Star Insurance Company
<br />18023
<br />WWwAschservealliane&Drg
<br />INSURED
<br />The Comdyn Group, Inc.
<br />569 Rustic Hills Dr
<br />INSURERS: ProCentury Insurance Company
<br />21903
<br />INSURERc.
<br />INSURER D: National Specialty Insurance Com an
<br />22608
<br />Simi Valley CA 93065
<br />INSURER E:.
<br />INSURER F
<br />COVERAGES CERTIFICATE NUMBER: nR79a9R1 RFVIRION NIIMRFR•
<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 CONTRACTOR 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 />ILTR
<br />TYPE OF INSURANCE
<br />A D
<br />i
<br />SUER
<br />wen
<br />pOLICV NUMBER
<br />POLICY EFF
<br />POLICY EXP
<br />MMIDDIYYYY
<br />LIMITS
<br />D
<br />�/ COMMERCIAL GENERAL LIABILITY
<br />CLAIMSMADE �OCCUR
<br />✓
<br />NDA0791984
<br />6/15/2017
<br />6/15/2018
<br />EACH OCCURRENCE s 1,000,000
<br />DAMA-ETO
<br />PREMISES(5aoMuMence S 1,000,000
<br />MED EXP An'ane arson $ 10,000
<br />PERSONAL A ADV INJURY S 1,000,000
<br />GENT AGGREGATE LIMIT APPLIES PER:
<br />✓ POLICY E jEa L] LOU
<br />GENERAL AGGREGATE s 2,000,000
<br />PRObUCTS- COMPIOP AGG $ 2,000,000
<br />$
<br />OTHER:
<br />D
<br />AUTOMOBILE
<br />LIABILITY
<br />✓
<br />NDB0791984
<br />6/15/2017
<br />6/15/2018
<br />COMBINED SINGLE l'M[-r�' e Ei $ 1,000 a00
<br />BODILY INJURY (Per person) $
<br />AUTO
<br />PANY
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />BODILY INJURY per accident $
<br />I )
<br />HIRED NON -OWNED
<br />AUTOS ONLY ✓ AUTOS ONLY
<br />PROPERTYDAMAGE
<br />Per accident $
<br />D
<br />UMBRELLA LIAB ,/
<br />OCCUR
<br />✓
<br />NDC0791984
<br />6/15/2017
<br />6/15/2018
<br />EACH OCCURRENCE $ 10000, 00
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />$ 1,000,000
<br />DED I ✓ I REfENTIONS10,000
<br />_AGGREGATE
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANYPROPRIETOR/PARTNERIEXECUTIVE
<br />OFFICERIMEMBER EXCLUDED'
<br />NIA
<br />WC0791984
<br />6/15/2017
<br />6/15/2018
<br />PSTEARTITi H.
<br />E.L. EACH ACCIDENT $ 1,000,000
<br />EL.DISEASE - EA EMPLOYEE $ 1,000,000
<br />(Mandatory in NH)
<br />If Yes, describe under'
<br />OESCRIPTION OF OPERATIONS below
<br />E.L, DISEASE -POLICY LIMIT 1 $ 1,000,000
<br />D
<br />A
<br />E&O/Professional Liab
<br />Crime- 3rd Party Sianket
<br />✓
<br />NDA0791984
<br />CR0791984
<br />6/15/2017
<br />6/15/2017
<br />6/15/2018
<br />6/15/2018
<br />$1,000,000 Ea Claiml$1,000,000 Aggregate
<br />$100,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS/ VEHICLES (ACORD 701, Additional Remarks $chednie, may bo attached if more space Is required)
<br />City of Santa Ana, its Officers, Agents and Employees are Additional Insured as respects to General Liability
<br />per attached CG2010 1093 Additional Insured Endorsement. Should any of the above described policies be cancelled or reduced before the expiration
<br />date thereof, the Issuing insurer and/or agent will endeavor to mail 30 days written notice the the Certificate Holder, but failure to do so shall
<br />Impose no obligation or liability of any kind upon the Insurer, its agents or representatives.
<br />-) I 19,)
<br />CERTIFICATE HOLDER CANCELLATION
<br />Client
<br />City of Santa Ana,
<br />SHOULD ANY OF TI IS ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />Its Officers, Agents, and Employees
<br />THE EXPIRATION DATE THEREOF, NOTICE
<br />WILL BE DELIVERED IN
<br />20 Civic Center Plaza
<br />ACCORDANCE WITH THE POLICY PROVISIONS,
<br />Santa Ana CA 92702
<br />AUTHORIZED REPRESENTATIVE
<br />Mark B. Roberts
<br />©1988.2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
<br />16729281 1 COmdyn Eae 17-1$ Approval C3rtifieaeo I dill Norton 1 7/16/2017 2:12039 PN (EUT) I Page 1 of 2
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