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Lip
<br />m CERTIFICATE OF LIABILITY INSURANCE
<br />'�
<br />DATSQ018YW)
<br />OM3/28/2018
<br />0
<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 lieu of such endorsement(s).
<br />PRODUCER
<br />Aon Risk services South, Inc.
<br />Atlanta GA office
<br />NAME
<br />PHONE (g66) 283-7122 FAX (800) 363-0105
<br />(PJC. No. Ext): AIC. Nc.:
<br />3550 Lenox Road NE
<br />Suite 1700
<br />EMAIL
<br />ADDRESS:
<br />Atlanta GA 30326 USA
<br />SIR applies
<br />pP per policy terns
<br />INSURER(S) AFFORDING COVERAGE NAICe
<br />INSURED
<br />INSURERA: Lexington Insurance Company 19437
<br />U. S. Security Associates, Inc. ,,AA �,r�I
<br />200 Mansell Court East, 5th Floor
<br />Roswell CnA. 30076 USA
<br />INSURER B: Liberty Mutual Fire Ins CO 23035
<br />INSURER C: Liberty Insurance Corporation 42404
<br />INSURERD: Lloyd's syndicate No. 1969 AA1120106
<br />INSURER E:
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: 570070599105
<br />REVISION NrIMRER-
<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 />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />AUDI
<br />?NSD
<br />BUSH
<br />WVD
<br />POLICY NUMBER
<br />MMIDDIYYYY
<br />MMIDD/YNNY
<br />LIMITS
<br />A
<br />X COMMERCIALGENERALLIABRJTY
<br />CIAIMS-MADE ❑X OCCUR
<br />SIR applies
<br />pP per policy terns
<br />& condi
<br />ions
<br />EACH OCCURRENCE $2,000,000
<br />$500,000
<br />PREMISES Ea occurrence
<br />MED EXP (Any one Person) $10,000
<br />PERSONAL a ADV INJURY $2,000,000
<br />GENT, AGGREGATE LIMIT APPLIES PER:
<br />GENERALAGGREGATE $4,000,000
<br />POLICY ❑PET X❑LOC
<br />PRODUCTS-COMPIOPAGGIncluded
<br />OTHER:
<br />Professional Liability included
<br />B
<br />AUTOMOBILE LIABILITY
<br />AS2-641-443931-057
<br />08/01/2017
<br />08/01/2018
<br />COMBINED SINGLE LIMIT
<br />Eaacdaent $1,000,000
<br />BODILY INJURY (Per Person)
<br />X ANYAUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />HIREDAUTOS NON -OWNED
<br />ONLY AUTOS ONLY
<br />BODILY INJURY (Per ardent)
<br />PROPERTY DAMAGE
<br />PeremiUenl
<br />D
<br />X
<br />UMBRELLALIA13
<br />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 %
<br />RETENTION 425,000
<br />C
<br />D
<br />WORKERS COMPENSATION AND
<br />EMPLOYERS' LIABILITY YIN
<br />ANY PROPRIETOR I PARTNER/EXECUTIVE
<br />OFFICEWMEMBER EXCLUDED?
<br />(Mandatory in NH)
<br />Ifyes,descbbe under
<br />DE SCRIPTION OF OPERATIONS below
<br />N/A
<br />wA764D443931017
<br />ADS
<br />w0641443931047
<br />MN & wI
<br />0910112017
<br />08/01/2017
<br />08/01/2018
<br />08/01/2018
<br />1 PER OTH-
<br />X STATUTE
<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 />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space R reuai )
<br />The City of Santa Ana, its officers, employees, agents, volunteers and representativea.ISVe included as tional Insured in
<br />accordance with the policy provisions of the General Liability policy. General Li ty pylicy evid ed herein is Primary
<br />and Non -Contributory to other insurance available to an Additional Insured, b1y� in, rdance h the policy's
<br />provisions. Should General Liability, Automobile Liability and workers' Comp Ms i poylc�lks elled before the
<br />expiration date thereof, the policy provisions will govern how Notice of Cance1111111atiyj\\\\\be i to Certificate Holders
<br />in accordance with the policy provisions of each policy. CL✓.`/ Qv�
<br />CERTIFICATE HOLDER CANCELLATION 00'"(`Cji'
<br />©1988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
<br />O
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<br />SHOULD ANY THE ABOVO�6SCRIBED POLICIES BE CANCELLED BEFORE THE
<br />EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED 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 />JQ41 aJLlcY6 e/sN�fmY_D �✓f2a
<br />©1988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
<br />O
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