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CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDm ) TYPE OF INSURANCE 05/31/2018 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 endorsement(s). PRODUCER CONTACT NAME: Automatic Data Processing Insurance Agency, Inc. PONEo l: AIC, No: 1 Adp Boulevard ADDRESS: Roseland, NJ 07068 INSURER S) AFFORDING COVERAGE _ NAIC M INSURER A: State Campensatlon Insurance Fund 35076 INSURED INSURER B EACH OCCURRENCEAIMS-MADE NEUTRAL GROUND oA A E PREMISES Ea occurrence $ INSURER C 1733 VALENCIA MED EXP (Anyone persai) $ Santa Ana, CA 82706 INSURER D: AGGREGATE LIMIT APPLIES PER: POLICY ❑jRC)T- F7LOG OTHER: INSURERS PRODUCTS• COMNOP AGO It INSURER F: COVERAGES CERTIFICATE NUMBER: 910597 REVISION NUMBER: THIS le 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 CR 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. LTR TYPE OF INSURANCE 00 INSO U8R me PtlL10V NUMBER POLICYEFF MMIDD(YYW POLICY EXP MM/DDA'YYY LIMITS LIABILITY OCCUR T=0' EACH OCCURRENCEAIMS-MADE oA A E PREMISES Ea occurrence $ GEML MED EXP (Anyone persai) $ PERSONAL &ADV INJURY $ AGGREGATE LIMIT APPLIES PER: POLICY ❑jRC)T- F7LOG OTHER: GENERAL AGGREGATE $ PRODUCTS• COMNOP AGO It $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS AUTOSWNED OSO PEOME NFD SINGLEL IT $ a accl ent BODILY INJURY (Per person) $ BODILY INJURY (Par accldenf $ ) Pe�accitlenk AMAGE $ UMB RELLA LIAB EXCESS LIPS H OCCUR CLAIMS -MADE EACHOCCURRENCE $ AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YINSTATUTE ANY OFFICERIMOPJMBEREXCTNEEE ECUTIVE ❑Y (MandaNryln NH) If yes, describe antler OF OPERATIONS below NIA N 9221268.2017 11/1312017 11/13/2018 X PER 0 ER E.L. EACH ACCIDENT $ 1,000,000 EL. DISEASE - EA EMPLOYEd$ 1,000,000 1,000,000DESCRIPTION E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORO 101, Addlllonal Remarks Schedule, may he attached If more apace Is raqulrad) t� @t1(Yv V CERTIFICATE HOLDER CANCELLATION A@ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES SE CANCELLED BEFORE City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Terri Eggers ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza AUTH99ORIZ90 REPRESENTATIVE flaw rh�1l,.,m Banta Ana, CA 92701 A@ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD