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ACORD® CERTIFICATE OF LIABILITY INSURANCE Dl�z$�2o e ) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAMPCT Chip Francis PHONE (626)396-103$ AIC No: (626)396-1045 EMAILESS,chip@kjains.com Kelley Jiggins and Associates Insurance Brokers PO Box 60310 INSURERS AFFORDING COVERAGE NAIC # INSURERA:Ohio SeOuritV 27082 Pasadena CA 91116-6310 INSURED INSURER B:American Fire 5 Casualty Co 24066 INSURER C: INSURER D: MDG Associates, Inc. INSURER E: 10722 Arrow Route STE 822 INSURER F: Rancho Cucamonga CA 91730 COVERAGES CERTIFICATE NUMBER:2018 2018 GL Auto 5 UMB REVISION NUMBER! THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OFINSURANCE 0 SD B BR AVID POLICY NUMBER POLICY MM/DDN YV POLCYEXP MMIDDNYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 PREMISES fro occurrence) $ 200F000 A CLAIMS MADE EIOCCUR MED EXP (Any one arson $ 15,000 X y BM57179298 7/1/2017 7/1/2018 PERSONAL &ADV INJURY $ 1,000,000 GERL AGGREGATE LIMIT APPLIES PER: POLICY PRO- ❑ LOD `Y JECT GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGO $ 2,000,000 Employee Benefits $ 1,000,000 OTHER: LIABILITY COMBINED SINGLE LIMIT Ea accitlent $ 1,000,000 $ A ANY AUTO AUTOrALL 0ED SCHOEDULED X y BA557179298 7/1/20177/1/2018HIRED NOMOBILE AUTOS X NON -OWNED AUTOS PROPERTY DAMAGE $ Medical a manta $ 5,000 UMBRELLA LIAR EACH OCCURRENCE $ 4,000,000 +,{ HOOCUR AGGREGATE $ 4,000,000 B I EXCESS LIAR CLAIMS -MADE DED I RETENTION$ $ ESM717929B 7/1/2017 7/1/2018 WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? NIA PER OT - STTUTE ER E.L EACH ACCIDENT $ E.L. DISEASE -EA EMPLOYE $ (Mandatory In NH) f yes, describe under E.L. DISEASE- POLICY LIMIT $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) The City of Santa Ana, Its officers, employees, agents and volunteers and named additional insured, but only as respecys the insured's operations as it relates to their signed contract in regards to the CDBG Administration Consluting Services per form CG8810 0413Primay Insurance and Transfer of rights or recovery against others is included in the form. Auto Al CABB10 0113 *30days notice of cancellation except 10 days for non-payment. City of Santa Ana Attn.: Terri Eggers, Community Development 20 Civic Center Plaza Santa Ana, CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Senior Mgmt. Analyst ACCORDANCE WITH THE POLICY PROVISIONS. Agency AUTHORIZED REPRESENTATIVE Jiggins/CHIPi�-- no a CrlRn CrlRPr1RATIr1M All Al hf .em .A ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS026 (201401)