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HOLLA-4 OP ID: MB
<br />CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MMIDD
<br />FOR THE POLICY PERIOD
<br />INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />0713012018
<br />_
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />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 WANED, 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 />.�
<br />PRODUCER
<br />Brown & Brown of Florida, Inc.
<br />—60ACTT M18 BDSfl _ —
<br />PHONE— -�� —p--
<br />�AJD �� _813.226.1337 NNPP. 813-226-1313
<br />P. O. Box 173086
<br />Tampa, FL 33672
<br />Tony Leavine
<br />_LLMC
<br />E.MaL ----- - - - -
<br />_Apr +FSs mbush c5bbtam a.com
<br />,_INSURERLSIAFFORDINGCOVERAGENAICN
<br />08101/2019 OAMAGETORX
<br />_.
<br />INsursFRA: SENTRY INSURANCE
<br />INSURFRB Great Northern Insurance
<br />..._._
<br />24988
<br />---' -----
<br />20303
<br />INSURED g
<br />Holland & Knight
<br />LLP ht
<br />Holland&Knight Charitable
<br />------'-----
<br />Foundation, Inc.INsumc:
<br />Federal Insurance Company
<br />_2.0.281
<br />"- ---- --
<br />524 Grand Regency Blvd
<br />INS RERo
<br />Brandon, FL 33510
<br />INSURERE: -
<br />---
<br />IN6URERF:
<br />THIS IS TO CEH'I'VY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED -ABOVE
<br />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
<br />DESCRIBED HEREIN IS SUBJECT TO ALL
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />THE TERMS,
<br />ILTR TYPEOFINSURANCE AtPOLICY EER POLICYEFF
<br />MM
<br />POLICYIXP -
<br />LIMITS
<br />B X COMMERCIAL GENERAL LIABILITYACHOCCURRENCE
<br />„LMMNOM^lY
<br />$
<br />1,000,000
<br />CLqIMS-MADE ® OCCUft1 08101/2018
<br />08101/2019 OAMAGETORX
<br />Insured Contract
<br />,_1Ea44U,n.,l1,000,000
<br />MEDEXPAnrooeoamm §
<br />19999
<br />PERSONAL&ADV INJURY $
<br />1,000,000
<br />GEN'LAGGREGATELIMNAPPLIESPER;GENERALAGGREGATE
<br />PRO -
<br />POLICY LOCPRWUCT6-COMP/OPAGG
<br />§
<br />2,000,000
<br />JECT
<br />S
<br />II1CIeded GA
<br />AUTOMOBILE
<br />LIABILITYCOMBINEDSINGLELIMIT8
<br />1,000000
<br />B
<br />X
<br />ANY AUTO _
<br />-
<br />5
<br />08/01/2018
<br />OS/01 /2019BODILY
<br />INJURY(P rperaon)
<br />$
<br />ALLOWNED- SCHEDULED
<br />D ILY INJURY(Per accident)
<br />$
<br />AUTOS gUT05BO
<br />XHIREDAUTOS
<br />NON.OWNED
<br />X AUTOSPROPERTYDAMAGEX
<br />.
<br />___--
<br />$X
<br />NoOwned Autos
<br />_Lcracriw ti
<br />UMRRELLq LIPB
<br />X
<br />OCCUREACH
<br />OCCURRENCE
<br />$
<br />50,000,00C
<br />EXCE9IBAB
<br />CLAIMSMADE08/01/2018
<br />08/01/2019
<br />AGGREGATE
<br />$
<br />50,000,00DED
<br />RETENTON s
<br />-A
<br />WORImiS COMPENSATIONOTH-
<br />AND EMPLOYERS LIA6eITY YIN
<br />TOTE _ ROFFICER/MEMSER
<br />EXCLUDED2 F
<br />1
<br />08/01/2018
<br />08101/2010
<br />EL EAcIHACCIDENT
<br />$
<br />1,000,000
<br />(MY Mende arylnTNH��rnERIEXECUTIVE—�
<br />EL_OISEASG-EAEMPLQYEi $
<br />1,000,000
<br />_ELDI1000,00B
<br />Personal Property
<br />08!01!2018
<br />08/0112019
<br />Spec Form
<br />144,513,605@
<br />Data Process Equip
<br />08/01/2018
<br />0810112019
<br />Spa Form
<br />21,366,00
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 151, AddlSonal Remarks Schedule, may be attached H more space Is required)
<br />See "Certificate Attachment - Holland &Knight, LLP" attached
<br />g
<br />S1k-,IJn �Z;ttiV
<br />��RT[..Oy.�A�P1.��LU,
<br />CITYSAN
<br />City of Santa Ana
<br />David Cavazos, City Manager
<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 />v rvao-cu IH eTk.unu GVKYUKA I IVN. All rights reserved.
<br />ACORD25(2014/01) The ACORD name and logo are registered marks of ACORD
<br />
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