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CERTIFICATE OF LIABILITY INSURANCE
<br />CATEtMM1Yv)
<br />9sr2s1z6n
<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 pollcy(les) must be endorsed, If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain pollcies 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 />Marsh Risk & Insurance Services
<br />17901 Von Karman Avenue, SURE 1100
<br />(949) 399-5800; License #0437153
<br />Irvine, CA 02614
<br />CONTACT
<br />NAME:
<br />,CN o sty IAC NW:
<br />EMAIL
<br />Attn: NBwpol8each.CedRequest@marsh.mm/F: 212-94a-4323
<br />INSURER(S) AFFORDING COVERAGE NAICAl
<br />INSURER A : Crum & Forster Specialty Insurance Cc 144520
<br />950627�01-01-17-18
<br />INSURED
<br />Placeworks
<br />INSURER 8: Travelers Property Ca$Uslty Company Of America 125674
<br />--
<br />INSURER c____
<br />Dba: The Planning Center
<br />Design Community & Eindso lment
<br />3 MacArthur Place, Suite 1100
<br />INSURER D
<br />INSURER E:
<br />Santa Ana, CA 92707
<br />_
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER: LOS-001721165�15 REVISION NUMBER:9
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
<br />LTR
<br />I TYPE OF INSURANCE
<br />ADOL-
<br />BRi
<br />POLICY NUMBER
<br />POLICY
<br />MMWLI EXP
<br />LIMITS
<br />A
<br />X
<br />I COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE E�X:] OCCUR
<br />X
<br />X
<br />E11111111
<br />1711111117
<br />071012018
<br />EACH OCCURRENCE
<br />$ 5,000,000
<br />DAMAGE TO RE
<br />Ea acwrrance
<br />8 50,000
<br />%CBI
<br />-PREMISES
<br />MED EXP (Any one person)
<br />$ 5,000
<br />& PD Ded. $5,000
<br />PERSONAL &ADV INJURY
<br />$ 6,000,000
<br />AGGREGATE LIMIT APPLIES PER:
<br />POLICY JECOT LOC
<br />GENERALAGGREGATE
<br />$ 5,000,000
<br />GEN'L
<br />%
<br />l
<br />I
<br />i
<br />PRODUCTS -CCMP/OP AGG
<br />$ 5,000,000
<br />OTHER:
<br />I
<br />(
<br />Contractors Pollution
<br />$ 5,000,000
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />I X
<br />I X
<br />RATE37616717CAG
<br />I
<br />I07/0112017
<br />07/01/2018
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />g 1,000,000
<br />X
<br />r
<br />ANY AUTO
<br />AOSVNED SCHEDULED
<br />(
<br />AUTOS AUTOS
<br />NON-OV,MEO
<br />HIRED AUTOS AUTOS
<br />i
<br />l
<br />!
<br />!
<br />BODILY INJURY (Per person)
<br />$
<br />BODILY INJURY (Peraccidene::$
<br />PROPERTY DAMAGE
<br />(Peraccicann
<br />i $
<br />Comic/Col Deductibles — j
<br />s $1,000
<br />R
<br />u
<br />UMBRELLA LIAe
<br />X
<br />'OCCUR
<br />EX6J3287561743
<br />I0710112017
<br />07/012018
<br />EACH OCCURRENCE
<br />$ 4,000,000
<br />%
<br />EXCESS LIAB
<br />CLAIMS -MADE'
<br />(
<br />I
<br />AGGREGATE
<br />$ 4,000,000
<br />DED RETENTION$
<br />S
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y/N
<br />ANY PROPR I ETOWARTNERIEXECUTIVE
<br />OFFICERAMEMSER EXCLUDED? N❑NIA
<br />(Mandatory In NH)
<br />It yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />i
<br />UB7E37616717
<br />0710112017
<br />107101/2018
<br />PER OERT
<br />% TATUTE ER
<br />E.L. EACH ACCIDENT
<br />$ 1,000000
<br />E.L. DISEASE .EA EMPLOYE
<br />$ 1,000,000
<br />E.L. DISEASE - POLICYLIMIT
<br />$ 1,000,000
<br />A
<br />Errors & Dmissions-Claims Made
<br />I
<br />I'EPK118128
<br />07/0112017
<br />07K)U2018 I
<br />Each Claim/Aggregate 5,000,000
<br />Rate Dates: See 2nd Page
<br />i
<br />DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more apace Is required) `f
<br />Re: Operations performed by the named insured for the ceral holder 7
<br />City of Santa Ana, Its officers, agents, employees, and volunteers are included as additional insured where required by written contact with respect 0 General an ahif This Insurance Is pd ary and non-
<br />contributory over any existing Insurance and limited so liability arising oolof the operations of the named insured and where required by wri contract wit t o General Llability. Waive rogation is
<br />applicable where required by written contractwilh respect to General and Auto Llabillty.
<br />City of Santa Ana
<br />20 Civic Center Plaza, M16
<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 />of Marsh Risk & Insurance Services
<br />Rosalynda Martinez
<br />LCKU:7aZKK73eTLiiF1:�\RI, RTT>a
<br />ACORD 25 (2014701) The ACORD name and logo are registered marks of ACORD
<br />
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