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---1 MAGEL-1
<br />14C7o/e" CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
<br />04/30/2018
<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 endorsement(s).
<br />PRODUCER 262-478-1000 CONTACT Diane Larson
<br />NAME:
<br />Bruce Gendelman Co., Inc. PHONE 262-478-1000 FAX262-478-1001
<br />Suite 101 (A/C, No, Ext): (A/c, No):
<br />500 W Brown Deer Rd dlarson@gendelman.com
<br />E-MAIL @g - - - - - _
<br />Milwaukee, WI 53217 ADDRESS: _ _ _ I -
<br />_ _
<br />r'nX1CDA1_CC /`00TI01^ATC \11111I1DCD.
<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 />INSU RER A: Phoenix Insurance Co
<br />25623
<br />INSURED Magellan Advisors, LLC
<br />TYPE OF INSURANCE
<br />_
<br />INSURER B: Travelers Indemnity Company
<br />25658
<br />Mr.John Honker
<br />45
<br />450 Alton Road #1402
<br />POLICY EFF
<br />INSURER C : Travelers Indemnity of America
<br />25666
<br />Miami Beach, FL 33139
<br />X I COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE FV7 OCCUR
<br />INSURER D: Lloyd's of London
<br />16608K446321
<br />04/12/2018
<br />.. Llovd's NAIC# AA1122000
<br />EACH OCCURRENCE $ 2,000,000
<br />r'nX1CDA1_CC /`00TI01^ATC \11111I1DCD.
<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 />TYPE OF INSURANCE
<br />ADDL
<br />SUBR
<br />POLICY NUMBER
<br />POLICY EFF
<br />POLICY EXP
<br />LIMITS
<br />A
<br />X I COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE FV7 OCCUR
<br />Y
<br />16608K446321
<br />04/12/2018
<br />04/12/2019
<br />EACH OCCURRENCE $ 2,000,000
<br />DAMAGE TO o TEDence $ 300'000
<br />MED EXP (Any oneperson) $ 5,000
<br />PERSONAL & ADV INJURY $ 2,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />X POLICY a j� LOC
<br />GENERAL AGGREGATE $ 4,000,000
<br />PRODUCTS - COMP/OP AGG $ 410001000
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT 2,000,000
<br />Ea accident $
<br />BODILY INJURY Perperson) $
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTNOpSW
<br />16608K446321
<br />04/12/2018
<br />04/12/2019
<br />BODILY INJURY Per accident $
<br />Pe�eccldent DAMAGE $
<br />X
<br />p
<br />AUTOS ONLY X AUOTOS ONtY
<br />B
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />EACH OCCURRENCE $ 1,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />Y
<br />CUP81<473520
<br />04/12/2018
<br />04/12/2019
<br />AGGREGATE $ 1,000,000
<br />DED X RETENTION $ 5,000
<br />C
<br />WORKERS COMPENSATIONX
<br />AND EMPLOYERS' LIABILITY Y / N
<br />ANY PROPRIETOR/PARTNER/EXECU I IVE
<br />OFFICER/MEMBER EXCLUDED?
<br />(Mandatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />N / A
<br />U68K601189
<br />04/12/2018
<br />04/12/2019
<br />PER OTH-
<br />STATUTE ER
<br />E.L. EACH ACCIDENT $ 1,000,000
<br />E.L. DISEASE - EA EMPLOYEE $ 1,000,000
<br />E.L. DISEASE - POLICY LIMIT 1'000'000
<br />D
<br />PROFESSIONAL LIAB
<br />B0621PMAGE000818
<br />04/12/2018
<br />04/12/2019
<br />EA CLAIM 2,000,000
<br />$25,000 DEDUCTIBLE
<br />I:
<br />AGGREGATE 2,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />Project Description: A-2018-029 and RFP No. 17-111
<br />See additional pages for additional insured and primary / non-contributory
<br />coverages.
<br />REVIEWED BY: EUNICE HEREDIA (PG' OF C -
<br />CITSA03
<br />City of Santa Ana
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92701
<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 />— buta- 9eV414&"_.
<br />ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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