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OP ID: YC <br />,d►�oRO CERTIFICATE OF LIABILITY INSURANCE <br />D03/23/201ATE YY) <br />0312312018 <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 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 lieu of such endorsement(s). <br />PRODUCER <br />Narver Insurance <br />641 W. Las Tunas Drive <br />CONTACT <br />NAME: June Samarin <br />PHONE FAX <br />A/C No Ext:626-943-2237 (A/C No): 686-299-1010 <br />E-MAIL ADDRESS: jsamarin@narver.com <br />PO Box 1509 <br />San Gabriel, CA91778-1509 <br />WESLEY HAMPTON HOUSE <br />PRODUCER LIEBE-1 <br />CUSTOMER ID#: <br />INSURER(S) AFFORDING COVERAGE <br />NAIC # <br />INSURED Liebert Cassidy Whitmore <br />INSURERA: Sentinel Insurance Company <br />11000 <br />6033 W. Century Blvd. <br />Los Angeles, CA 90046 <br />INSURERB: Federal Insurance <br />20281 <br />INSURER C: Aspen Specialty Insurance <br />10717 <br />INSURERD: Lloyds of London <br />16792 <br />INSURER E : <br />INSURER F : <br />COVERAGES CERTIFICATE NUMBER: 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 />INSR <br />LTR <br />OF INSURANCE <br />ADDLTYPE <br />INSR <br />WVDSUBI <br />POLICY NUMBER <br />POLICY EFF <br />MM DDIYYYY <br />POLICY EXP <br />MMIDDIYYYY <br />LIMITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ 2,000,000 <br />A <br />X COMMERCIAL GENERAL LIABILITY <br />X <br />72SBAAK0318 <br />12/14/2017 <br />12/14/2018 <br />PREMI ESESS ( RENTEDEa <br />PREMIoccurrence <br />$ 1,000,000 <br />CLAIMS-MADE � OCCUR <br />MED EXP (Any one person) <br />$ 10,000 <br />PERSONAL & ADV INJURY <br />$ 2,000,000 <br />GENERAL AGGREGATE <br />$ 4,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS- COMP/OP AGG <br />$ 4,000,000 <br />X POLICY PRO LOC <br />$ <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />$ 2 OOO,OOO <br />ANYAUTO <br />BODILY INJURY (Per person) <br />$ <br />ALL OWNED AUTOS <br />BODILY INJURY (Per accident) <br />$ <br />A <br />SCHEDULED AUTOS <br />HIRED AUTOS <br />72SBAAK0318 <br />12/14/2017 <br />12/14/2018 <br />PROPERTY DAMAGE <br />(PER ACCIDENT) <br />$ <br />X <br />X <br />$ <br />A <br />NON-OWNEDAUTOS <br />72SBAAK0318 <br />12/14/2017 <br />12/14/2018 <br />$ <br />X <br />UMBRELLA LIAB <br />X <br />OCCUR <br />EACH OCCURRENCE <br />$ 2,000,000 <br />AGGREGATE <br />$ 2,000,000 <br />A <br />EXCESS LIAB <br />CLAIMS -MADE <br />72SBAAK0318 <br />12/14/2017 <br />12/14/2018 <br />DEDUCTIBLE <br />$ <br />X <br />$ <br />RETENTION $ 10,000 <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANY PROPRIETOR/PARTNER/EXECUTIVE Y 1 N <br />OFFICER/MEMBER EXCLUDED? ❑ <br />(Mandatory in NH) <br />NIA <br />7175-05-95 <br />04/01/2018 <br />04/01/2019 <br />X WC STATU- OTH- <br />TORY LIMITS ER <br />E.L. EACH ACCIDENT <br />$ 1,000,000 <br />E.L. DISEASE - EA EMPLOYEE <br />$ 1,000,000 <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below:::: <br />E.L. DISEASE- POLICY LIMIT <br />$ 1,000,000 <br />C <br />Professional Liab. <br />LRA9AF817 & XPL409238 <br />12/10/2017 <br />12/10/2018 <br />Per Claim 5,000,000 <br />D <br />Cyber Liability <br />WN 146910 <br />12/06/2017 <br />12/06/2018 <br />Per Claim 3,000,000 <br />DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) <br />Certificate Holder is named as an Additional Insured in regards to attached <br />General Liability Form SS 00 08 04 05, per written contract or agreement. <br />CERTIFICATE HOLDER CANCELLATION <br />CITYSAA <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 />ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 Civic Center Plaza <br />P.O. Box 1988 <br />AUTHORIZED REPRESENTATIVE <br />Santa Ana, CA 92702 <br />©1988-2009 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD <br />