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ACC Rbr CERTIFICATE OF LIABILITY INSURANCEDATE
<br />12107/2017YY)
<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 certtficato does not confer tights to the
<br />PRODUCER
<br />Michael Rodgick(971832A)
<br />196 Technology Dr Ste B
<br />INSURED
<br />SANTA, ANA BUSINESS COUNCIL,
<br />400 E. ATH STREET
<br />Mike
<br />Truck Insurance
<br />21687
<br />Travelers Insurance 1 31194
<br />SANTA ANA CA 92701 INSURER P:
<br />COT/rRAGPS r:PRTiPII^.ATP NI IMRPR, RPVLCInN NIIRAPPR•
<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$i£T ._.,RANO-PO V ODGY R
<br />LTR TYPE OF INSURANCE I AOUCYNUMBER ! MMlDwyYYY DDA'YYY I LIMITS
<br />GENERAL LIABILITY
<br />AUTHORIZED REPRESENTATIVE
<br />SANTA ANA CA 92701
<br />CC
<br />EACH OCCURRENCE 5 11000 600
<br />(X COMMERCIAL GENERAL LIABILITY '
<br />1 I
<br />_
<br />!–DAMAG TO RENTED
<br />i PREMISES rEn 4cc,.,y�reAc9)_.,_f g
<br />t_��_,rr I
<br />j CLAIMS MAGE L/_j OCCUR I }
<br />j
<br />.1000000 _
<br />MED EXP fAn�ane Porson) S 10,000
<br />B _ _ Y N 605503396
<br />12/07/2017
<br />( 1 210 712 01 8
<br />I PERSONAL&ADV INJURY_ S 1,000,000
<br />_
<br />GENERAL AGGREGATE $ 2_000 000_
<br />OENL AGGREGATE LIMIT APPLIES PER: t
<br />PRODUCTS-COMPIOPAGG S %000000
<br />POLICY PRO• LRC
<br />S
<br />AUTOMOBILE LIABILITY
<br />COMBINED SINGLE LIMIT I
<br />E9._ _ n 1,000,000
<br />ANY AUTO
<br />BODILY INJURY ]Por pwmN is
<br />_
<br />¢--I ALL OWNEDSCHEDULED
<br />AUTOS I AUTOS 605503300
<br />12/07/2017
<br />12/07/2016
<br />BODILY INJURY IPccld
<br />ernonl) S
<br />NON OWNED AUTOS j
<br />HIREDAUTOB
<br />].._� !
<br />-fT20PERTY DAMAGE _PS
<br />Per acatlgntl� .._J.__..
<br />UMBRELLA LWB
<br />_ I ;OCCUR
<br />i
<br />EACH OCCURRENCE IS
<br />I EXCESS LIAD p I
<br />CLAIMS -MADE] !
<br />_.._...._ ..._. .. .—I _._, ...
<br />I AGGREGATE §
<br />_j_ -
<br />_j
<br />T._ .,._
<br />fCEO ! 1 RETENTIONS
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS'DAeiLITY
<br />'
<br />i
<br />!
<br />x- WC $1 ATU OTH-I
<br />i JoRy LIMl79! 1S8y.
<br />YIN]
<br />ANY PROPRIETORIRARTNERIEXE44TOVE (NfA ] 9061364
<br />D I!OFFICERIMEMBER EXOlUDED9
<br />�j
<br />,1$f10/2017312/'i
<br />0/20'1$
<br />_
<br />EL EACH ACCIDENT is 1,000,000
<br />- -
<br />11MandatorylnNH'
<br />DISEASE -CA EMPLOYEE;$ 1,000.000
<br />if yyee, dosWbenndar _
<br />]DESCRIPTIONOP OPERATIONS bnlew j
<br />hEI ---------� ,.. .__ _..
<br />EL DISEASE -POLICY LIMITS 1,000,000
<br />Fidelity Bond(
<br />(12110!2018
<br />5,000 51R $900,000
<br />E D&O 106032611
<br />12/10/2017
<br />1,000 SIR $1,000,000
<br />. EPL I
<br />I
<br />1,000 SIR $1,000,000
<br />DESCRIPTION OF OPERATIONS ILOCATIONSl VEHICLES (Attach ACORD IE1, AddlBonal Ramarke Schedulo, It mom spaco is mgalmd)
<br />400 E. 4TH STREET, SANTA ANA, CA 92701
<br />CITY OF SANTA ANA, ITS OFFICERS, AGENTS, EMPLOYEES AND VOLUNTEERS ARE NAMED AS ADDITIONAL INSUREDS FOR GENERAL LIABILITY
<br />PURPOSES. COVERAGE IS PRIMARY AND NON-CONTRIBUTORY, WITH THIRTY (30) DAYS NOTICE OF CANCELLATION, EXCEPT 10 DAYS FOR
<br />NONPAYMENT OF PREMIUMS
<br />r.FRTIPIr ATP Ani rYPR r`.Ame"PI I ATInRI
<br />ACORD 25 (2010105) ©1988.2010 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />CITY OF SANTA ANA
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />20 CIVIC CENTER PLZ
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />SANTA ANA CA 92701
<br />ACORD 25 (2010105) ©1988.2010 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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