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ACC>RD CERTIFICATE OF LIABILITY INSURANCE ik.� DATE(MMIDDNYYY) 5/31/2018 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(les) 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 endorsements . PRODUCER AM _aONTADT Chip Francis PHONE (626)396-1035 FAX o:(62tl)396-1045 Kelley Jiggins and Associates Insurance Brokers i 21AIL chPPt°i k ains.com ADDRESS: PO BOX 60310 INSURERS AFFORDING COVERAGE HAIG0 Pasadena CA 91116-6310 - INSURERA:Weet American Insurance Com an 44393 INSURED INSURERB:OhiO Security 27082 INSUR,RC:A0lerican Fire & Casualt CO 24066 MDG Associates, Inc. INSURER D: 10722 Arrow Route STE 822 INSURER,: Rancho Cucamonga CA 91730 INSURER F: .....................�... 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, INSR L.POLICY TYPE OF INSURANCE DL im. UBR NUMBER POUCYEFF PO I UCYEKP LIMITS A $ COMMERCIAL GENERAL LIABILITY CLAMS -MADE OCCUR EACH OCCURRENCE $ 11000,000 DAMAGETO ENTEO ISE E ccu $ 200, 000 MED EXP An one Person X DEN57179298 7/1/2019 7/1/2019 $ 15,000 PERSONAL &ADV INJURY $ 11000,000 GENLAGGREGATELIMITAPPLIE8 X PER: POLICY O PRO- ❑ JECT LOC GENERAL AGGREGATE $ 2,000.000 PRODUCTS-COMP/OP AGO $ 2,000,000 Employee Banefila $ 11000,000 OTHER: AUTO MOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 11000.000 B X ANY AUTO OWNEDALL AO UTOSCHEDULED AUTOSX HIRED AUTOS X NON -OWNED AUTO$Us BA357179298 7/1/2018 7/1/2019 BODILY INJURY (Par person) $ X BODILY INJURY (Per acciden0 $ PPROPCF"DAMAGE $ Madlcal osmares $ 5,000 UMBRELLA UAB X OCCUR EACH OCCURRENCE $ 4, 000 000 X GGREGATE 8 4,000,000 C EXCESS UAe CLAIMS -MADE DED 1 1 RETENTION $ RSA57179298 7/1/2D18 7/1/2019 WORKERS COMPENSATION ANDEMPLOYERS-LIABILITY YIN ANY PROPRIETOMPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatmy In NH) If yes, describe under NIA PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT I $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addldonal Remarks Schedule, may be attached Nmore 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 CA8810 0113 ^ tQk , •30days notice of cancellation except 10 days for non-payment. Cab\ City of Santa Ana Attn.: Terri Eggers, Senior Mgmt. Analyst Community Development Agency 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 ACCORDANCE WITH THE POLICY PROVISIONS. Jiggins/CHIP i`-- 9)'1988.2014 ACORO CORPORATION All A..H.� . ._.ea 2 ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401)