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DATE IMM/DO/TlYYI
<br />_ CERTIFICATE OF LIABILITY INSURANCE 12/20/2017
<br />TEAS 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, EXTE,VD OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />THIS CERTIFICATE OF INSURANCE DOES NOT CONST17U'TE A CONTRACTBETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE
<br />L 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 WAIVED, subject to the
<br />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 />PRODUCER CA LIC #OD28784
<br />CONTACT Linda Hetherington
<br />Orion Risk Management Insurance Services Inc
<br />PHONE 949.608.4920 FAx 949.263 8860
<br />1800 Quail St Suite 110
<br />MAIL Ihetherington@Orion risk, corn
<br />INSURER(S) AFFORDING COVERAGE
<br />NAICN
<br />INewport Beach, CA 92660
<br />INSURER A; Liberty Mutual Fire Insurance
<br />TB2661066115027
<br />_^! _
<br />INSURED
<br />INSURER a:
<br />DAMAGES RENTED
<br />PREMISESaNTED ce $1,000,00
<br />Shea Homes Limited Partnership
<br />655 Brea Canyon Road
<br />Walnut, CA 91789
<br />NsuREac:
<br />NsuRER D;
<br />INSURER E:
<br />PERSONAL&AOVINJURY $3,000,00
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: 17-18 WJF Shea Std REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY
<br />PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT
<br />TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS
<br />SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />msR
<br />LTO
<br />TYPE OF INSURANCE
<br />ADDL
<br />INCH
<br />BUSH
<br />WYG
<br />POLICY NUMBER
<br />POLICY EFF
<br />MMIDD(YYYY
<br />POLICY EXP
<br />MMIDDIYYYY
<br />LIMITS
<br />A
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS.MADF X( OCCUR
<br />TB2661066115027
<br />08/01/2017
<br />08/01/2018
<br />EACH OCCURRENCE $3,000,00
<br />DAMAGES RENTED
<br />PREMISESaNTED ce $1,000,00
<br />MED EXP �An o Exclude
<br />PERSONAL&AOVINJURY $3,000,00
<br />$`6,00D OD
<br />GENERAL AGGREGATE W
<br />GENERAL AGGREGATE LIMIT APPLIES PER:
<br />RO
<br />POLICY 0 .IPECT 0 LOC
<br />PRODUCTS-0OMFLOP AGO $6,000,001))
<br />OTHER
<br />AUTOMODILE
<br />LIARILRY
<br />AS2661066115017
<br />08/01/2017
<br />08/01/2018
<br />CONecNa O191NGLE LIMIT $2,000,00
<br />ANY AUTO
<br />SGDILYINJURY(PB„pe,a..)
<br />A
<br />1x
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />BOOILYINJURYIParaccvN.Q
<br />NON -OWNED
<br />HIRED AUTOS AUTOS
<br />—
<br />PROPERTY DAMAGE
<br />Per occltlenl
<br />i
<br />UMBRELLA LDD
<br />OCCUR
<br />EACH OCCURRENCE
<br />E%CE99IJA.
<br />CUIMS.MAUE
<br />AGGREGATE
<br />QDED aErervTloN'r
<br />A
<br />WORKERS COMPENSATION
<br />AMIDEMPLOYERS LIABILITY YIN
<br />oFFlcewMelmeFalxc�oo oXEcunve
<br />(MantleWryin NH)
<br />Il yec, Jeswbe antler
<br />MIA
<br />INA266D066115C37
<br />08/0'1/2017
<br />08/01I2018
<br />PER OTH
<br />X STATUTE ER
<br />E.L. EALH ACCIDENT
<br />$1,000,00
<br />E.L. DISEASE -EA EMPLOYEE $1,000,00
<br />DESCRIPTION OF OPERATIONS Ilial.
<br />_T
<br />E.L DISEASE -POLICY LIYf $1,000,004
<br />DESCRIPTION OF OPERATIONS I LOCATIONS' VEHICLES IACONO 101, Addltloncl Remarks Schedule, may do aHached home fpece Ie,mmlrotll
<br />Re: Encroachment permit - As respects general liability: City of Santa Ana, its offixers, employees, agents, volunteers and
<br />respresentatives are included as additional insured per terms of the attached endorsements. This insurtance is primary and
<br />any insurance of the additional insureds is non-contributory. 30 days notice of cancellation except 10 days for non-payment
<br />per attached endorsement.
<br />I V'
<br />CERTIFICATE HOLDER_ QACIX
<br />City Of Santa Ana • M3 t,-~ C/y' �l nl (�,L'?
<br />�SHOU6b ANY -OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
<br />{ J wJ
<br />20 CIVIC Center Plaza=
<br />EXPIRATION S�,T,�„THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH
<br />__'THE1FrSC1E�PROVISIDNS.
<br />Santa Ana, CA 92701
<br />AUTHORIZED REPRESENTATIVE
<br />Trisha Engelhart
<br />©'1988-2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
<br />
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