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A O® <br />CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MM OD YYYY) <br />5116/2018 <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(ies) must have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />Assurance Agency, Ltd. <br />One Century Centre <br />1750 E. Golf Road <br />NAMEACT Terrance Threatt <br />PHONE 312 625-5569 Fnc No: 847 440-9126 <br />EMAIL <br />ADDREss: tthreattaassuranceagency.com <br />INSURERS AFFORDING COVERAGE NAICN <br />Schaumburg IL 60173 <br />INSURER A: Zurich American Insurance Co 16535 <br />PRA969865506 <br />INSURED <br />INSURER B: American Guarantee & Liab 26247 <br />Trust Temporary Services, Inc. <br />dba Helpmates Staffing Services <br />1200 Main Street, Suite A <br />INSURER c: American Zurich Insurance Co 40142 <br />INSURER D: Continental Casualty Co 20443 <br />INSURER E : <br />Irvine CA 92614 <br />INSURER F <br />Cr1VFRAr P -q CFRTIFICATF NIIMRF_R-739n91ARR 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 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. <br />ILTRTYPE <br />OF INSURANCE <br />ADDL <br />SUER <br />POLICY NUMBER <br />POLICY EFF <br />MMIDDIYYYYI <br />POLICY EXP <br />MMIDOIYYYY <br />LIMITS <br />A <br />X COMMERCIAL GENERAL LIABILITY <br />PRA969865506 <br />4/12018 <br />4112019 <br />EACH OCCURRENCE 1,000,000 <br />CLAIMS -MADE F x1OCCUR <br />-S <br />DAMAGE TO RENTEU <br />PREMISES Ea acounence $100.000 <br />MED EXP (Any oneperson) $10,000 <br />PERSONAL S AOV INJURY $1,000,MD <br />GEN'L AGGREGATE LIMIT APPLIES PER <br />GENERALAGGREGATE $3,000,000 <br />PRODUCTS - COMP/OP AGG 32.000,000 <br />X POLICY [::] PRO- LOC <br />1 $ <br />OTHER: <br />A <br />AUTOMOBILELIABILITY <br />PRA969865506 <br />4/1/2018 <br />4/12019 <br />COMBINED SINGLE LIMIT $1,000,000 <br />Ea accident) <br />BODILY INJURY (Per person) $ <br />ANY AUTO <br />BODILY INJURY(Peraccident) $ <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />PROPERTY DAMAGE $ <br />Per accident <br />X HIRED X NON-0WNED <br />AUTOS ONLY AUTOS ONLY <br />B <br />X <br />UMBRELLALIAB <br />X <br />OCCUR <br />UMB946720206 <br />4/1/2018 <br />4/1/2019 <br />EACH OCCURRENCE $5.000,000 <br />AGGREGATE $5.000.000 <br />EXCESS UAB <br />CLAIMS -MADE <br />OED I X I RETENTIONS <br />$ <br />C <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANYPROPRIETOR;PARTNERIEXECURIVE YIN <br />OFFICEMMEMBI EXCLUDED; <br />NIA <br />WC55713D705 <br />8192017 <br />8/912018 <br />X STATUTE ETI PER H <br />E.L. EACH ACCIDENT $1,000.000 <br />(Mandatory in NH) <br />E.L. DISEASE -EA EMPLOYE $1,00,000 <br />E.L. DISEASE -POLICY LIMIT $1,000,000 <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />A <br />A <br />Crime -3rd patty <br />Professional Liability <br />PRA%9865505 <br />PRAM9865506 <br />4112018 <br />4;1/2018 <br />4112019 <br />4/12019 <br />3,000,000 Limit 5,000 Ded. <br />$2MM occ.I $4MM agg. 25,000 Ded. <br />D <br />Cyber Liability <br />596881085 <br />4112018 <br />41112019 <br />ASS: $1.000.000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be aftached if more space Is required) <br />Proof of Insurance <br />It is agreed that the following are added as Additional Insured, when required by written contract, on the General Liability with respect to operations performed <br />by the Named Insured in connection with this project: THE CITY OF SANTA ANA, ITS OFFICERS , EMPLOYEES, AGENTS, AND REPRESENTATIVE <br />CERTIFICATE HOLDER CANCELLATION <br />©1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD <br />251-139 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />City of Santa Ana <br />20 Civic Center Plaza <br />Santa Ana CA 92701 <br />AUTHORIZED REPRESENTATIVE <br />.1n/ <br />©1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD <br />251-139 <br />