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ACORD CERTIFICATE OF LIABILITY INSURANCE <br />DAM(MMIDD/YYYY) <br />`� <br />09/2612018 <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 poiicy(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 endorsemente). <br />PRODUCER <br />CONTACT KlmberN Kelley <br />NAME: Y y <br />Insurance Solutions <br />PNONE <br />TUC No Exl : (949) 348J400 (qIC, No): (949) 348-2373 <br />License g0746539 <br />ADDRESS: 10mK@ins-solutianS.com <br />33302 Valle Rd, Suits 200 <br />San Juan Capistrano CA 92675 <br />INSURER(I) AFFORDING COVERAGE <br />met <br />INSURERA: The Ohio Casualty Insurance Company <br />24074 <br />INSURED _�Q-009r <br />INSURERS: Alimerica Financial Benefit <br />41840 <br />Professional Sports Field Maintenance Inc ^ —oZd J <br />INSURERC : American Fire and Casualty Company <br />24066 <br />wsuaER G : State Comp Ing Fund <br />35076 <br />23 Emerald Gin <br />INSURERE: <br />Laguna Niguel CA 92677 <br />INSURERF: <br />COVERAGES CERTIFICATE NUMRFR: iuAw All <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. NOTWITHSTANDINGANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALLTHE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />LTR <br />TYPE OF INSURANCE <br />NSO <br />imm <br />POLICYNUMBER <br />MMA) EF <br />MMODIYYYY <br />LIMITS <br />COMMERDUIL GENERAL LVIBILT' <br />EACH OCCURRENCE <br />S 1,000,000 <br />CLAIMS -MADE ®OCCUR <br />DAMAGE uKtNitD <br />PREMISES Eapmnence <br />S 100,000 <br />MEDEXP(Anyone on) <br />S 16,000 <br />PERSONALaADVINIURY <br />S 1,000,000 <br />A <br />SKO57465702 <br />10/01/2018 <br />10/01/2019 <br />GEN'LAGGREGATE UMITAPPUES PER: <br />X POLICY ❑ <br />GENERA -AGGREGATE <br />S 2,000,000 <br />JEC07 LOC <br />PRODUCTS-COMP/OPAGG <br />$ 2,000,000 <br />OTHER: <br />S <br />AUTOMOBILE <br />LABILITY <br />COMBINED INGLBLIMI <br />EaaccMent <br />S 11000.000 <br />ANVAUTO <br />BODILY INJURY (Per person) <br />s <br />B <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />AW3A377777 <br />O8/26/2018 <br />08/26/2019 <br />Boo1Ly INJURY (Per ecamn0 <br />S <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />PROPERTY DAMAGE <br />Per=eI9 <br />S <br />Uninsured motorist <br />s 300,000 <br />UMBRELLA UAS <br />OCCUR <br />.....................y.......... <br />EACH OCCURRENCE <br />$ 2000000 <br />AGGREGATE <br />g 2,000,000 <br />C <br />EXCESS UAB <br />CLAIMS -MADE <br />ESA57465702 <br />10/01/12018 <br />10/01/2019 <br />DEO RETENTION $ <br />S <br />WORKERS COMPENSATION <br />PER OTH- <br />W <br />ANDEMPLOYERS' LWBTY YIN <br />STATU TE ER <br />EL EACH ACCIDENT <br />g 1,000,000 <br />D <br />ANY <br />OFFICER/MEMBER EXC UDED?ECUTNE ❑NIA <br />1620478-2018 <br />02/28/2018 <br />02/28/2019 <br />E.L. DISEASE - EAEMPLOYEE <br />S 1,OD0,000 <br />(MendMnry in NH) <br />Ityes, desalt under <br />E.L DISEASE -POLICY UMIT IS <br />1,000,000 <br />DESCRIPTION OF OPERATIONSWoe, <br />DESORPTION OF OPERATIONS I LOCATIONS I VEHICLES PLCORD 101, Addebral Remarks SCkedWe, my Ea aN thed X more space le Ne,ulm n ' <br />V <br />The City of Santa Ana, It's officers, employees, agents, and representative are included as additional insured per the attached . <br />enddr98me <br />5 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 Civic Center Plaza <br />Santa Ana CA 92701 I� <br />CORPORATION. All rights reserved, <br />rwnu eo (eu lolus) The AOORD name and logo are registered marks of ACORD <br />