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AC®RO®
<br />i CERTIFICATE OF LIABILITY INSURANCE
<br />DAT 08128/201BYVY)
<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(les) must have ADDITIONAL INSURED provisions or be endorsed. If
<br />SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this
<br />certificate does not confer rights to the certificate holder In Ileu of such endorsement(s).
<br />PRODUCER
<br />Aon Risk services South, Inc.
<br />Atlanta GA Office
<br />CONTACT
<br />NAME;
<br />PHONE (866) 283-7122 FAX (800) 363-0105
<br />INC. No. Ext): A1C. Ni
<br />3550 Lenox Road NE
<br />Suite 1700
<br />E-MAIL
<br />ADDRESS:
<br />Atlanta GA 30326 USA
<br />047082749
<br />INSURERIS) AFFORDING COVERAGE NAICM
<br />INSURED
<br />INSURERA: Lexington Insurance Company 19437
<br />U. S. Security Associates, Inc.
<br />200 Mansell Court East, Sth Floor
<br />Roswell GA 30076 USA
<br />INSURER B: Liberty Mutual Fire Ins CO 23035
<br />INSURER C: Liberty Insurance Corporation 42404
<br />INSURER D: Lloyd's Syndicate No. 1969 AA1120106
<br />SIR applies per policy ter
<br />INSE:
<br />URER
<br />ions
<br />NSURER F:
<br />MED ENE (Any one person) $10,000
<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. Limits shown are as requested
<br />INSIR
<br />LTR
<br />TYPE OF INSURANCE
<br />/NSD
<br />WVD
<br />POLICY NUMBER
<br />My
<br />My
<br />MMIDDIWW
<br />LIMITS
<br />X COMMERCIAL GENERAL LIABILITY
<br />047082749
<br />U6/UI/ZUI/
<br />Ub/UI/ZUlb
<br />EACH OCCURRENCE $2,000,000
<br />CLAIMS -MADE ❑X OCCUR
<br />SIR applies per policy ter
<br />is & condi
<br />ions
<br />G $500,000
<br />PREMISES Ea occurrence
<br />MED ENE (Any one person) $10,000
<br />PERSONAL &ADV INJURY $2,000,000
<br />GEN'LAGGREGATE LIMIT APPLIES PER:
<br />GENERALAGGREGATE $4,000,000
<br />POLICY ❑ PRO ❑X LOC
<br />JECT
<br />PRODUCTS -CONFIDE AGO Included
<br />OTHER:
<br />Professional Liability Included
<br />B
<br />AUTOMOBILE LIABILITY
<br />AS2-641-443931-057
<br />08/01/201708/01/2018
<br />COMBINED SINGLE LIMIT
<br />Ea accident)81,000,000
<br />BODILY INJURY( Per pemon)
<br />X ANYAUTO
<br />BODILY INJURY (Per accident)
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />HIREDAUTOS NON -OWNED
<br />ONLY AUTOS ON LY
<br />PROPERTY DAMAGE
<br />Per accident
<br />0
<br />X
<br />UMBRELIALIAB X
<br />OCCUR
<br />CSUSA1701997
<br />08/01/2017
<br />08/01/2018
<br />EACH OCCURRENCE $5,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />AGGREGATE $5,000,000
<br />DEO I X
<br />IRETENTION $25,000
<br />o
<br />G
<br />AND
<br />WORKS LIABILITY COMPENSATION ylN
<br />ANYPROPRIETORI PARTNERI EXECUTIVE
<br />OFFICERFMREIE RExauoeov
<br />(Mandatory in NH)
<br />NIA
<br />W7640443931017
<br />A
<br />wC7fi41443931047
<br />MN & WI
<br />08/01/2017
<br />08/01/2017
<br />08/01/2018
<br />08/01/2018
<br />X TATUTE 1TI
<br />S
<br />E.L. EACH ACCIDENT $1,000,000
<br />E.L. DISEASE -EA EMPLOYEE $1,000,000
<br />Mom describe order
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE -POLICY LIMIT 1 $1,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />The City of Santa Ana, its officers, employees, agents, volunteers and representatives are includedOA aditional Insu in
<br />accordance with the policy provisions of the General Liability policy. General Liability policy ced herein i rimary
<br />and Non -Contributory to other insurance available to an Additional Insured, but only in accord'r with the ppoli
<br />provisions. Should General Liability, Automobile Liability and workers' Compensation poli Be car*'H��/��"y�yd b e the
<br />expiration date thereof, the policy provisions will govern how Notice of Cancellation may ell regia I I to Holders
<br />in accordance with the policy provisions of each policy. J -J
<br />CERTIFICATE HOLDER
<br />CANCELLATION r✓Iy�,.G6"\Y
<br />©1988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
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<br />SHOULD ANY OF THE ABOVE DE$ IBED POL CANCELLED BEFORE THE
<br />EXPIRATION DATE THEREOF, NOTICE WILL BE D V RED IN ACCORDANCE WITH THE
<br />POLICY PROVISIONS.
<br />The City of Santa Ana
<br />AUTHORIZED REPRESENTATIVE
<br />20 Civic Center Plaza
<br />Santa Ana CA 92701 USA
<br />Q y/�
<br />✓GdQ�G e�/IbeIICCO elR'.cu'�3 <...J7dGl
<br />©1988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
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