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ACQRLJD�'
<br />CERTIFICATE OF LIABILITY INSURANCE
<br />�....�'�
<br />DATE(MMIODIYY}'Y)
<br />7/5/2018
<br />THIS CERTIFICATE 1S 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 be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the 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
<br />D aley Renton and Associates
<br />LiC. #0020739
<br />P.O. Box 10550
<br />Santa Ana Ana A 92711-0550
<br />F, T
<br />PHRobin Lee
<br />ONE FAX
<br />u: 714 427-6810 �__.Lnrc tuo};.714.427 6$18
<br />A DRESS: flee deale renton.com
<br />-----
<br />INSURERS} AFFORDING COVERAGE - _
<br />NAIL #
<br />INSURER A: AilantiC Species Insurance. Company
<br />INSURERS: Sentinel Insurance Co. LTD
<br />27154
<br />11000
<br />--------------------------
<br />.._....-------............................_...---------
<br />INSURED ANDERPART
<br />Andersonloenna Partners, Inc.
<br />3737 Birch Street Suite 250
<br />_ _ _
<br />INSURER C: Trumbull Insurance Company
<br />27120
<br />_ _
<br />INSURER 0:
<br />DAMAGE RENTED
<br />PREMISES (Ea M rren
<br />Newport Beach CA 92660
<br />----------'-
<br />INSURER E :
<br />MED EXP (Any one person)
<br />$10,000
<br />INSURER F:
<br />Contractual
<br />COVERAGES CFRTIFICATF N(1MRFR- 1191117n1AA DCVICIPIIJ IJI1aAQCM-
<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 />INBR
<br />LTR
<br />TYPE OF INSURANCE
<br />AbDL
<br />SUei1
<br />POLICY NUMBER
<br />POLICY EFf
<br />(M.MIDDNYYYI
<br />POLICYYEXP
<br />IMM1DDfYYYY1LIMITS
<br />_.. -
<br />8
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE OCCUR
<br />Y
<br />Y
<br />84SBW1VV85D2
<br />8!112017
<br />8/V2o18
<br />EACH OCCURRENCE
<br />$1,OD0,000
<br />DAMAGE RENTED
<br />PREMISES (Ea M rren
<br />$1,000,000
<br />MED EXP (Any one person)
<br />$10,000
<br />Contractual
<br />- X
<br />EIFPD, XCU
<br />PERSONAL & ADV INJURY
<br />$1.000,OW
<br />AGGREGATE LIMIT APPLIES PER:
<br />POLIGYI� JJEEC C LOC
<br />GENERAL AGGREGATE_
<br />$ 2,000,000
<br />GE_N'L
<br />PRODUCTS -COMP/OPAGG
<br />$2,00D,ODO
<br />------------ -
<br />----------
<br />$
<br />OTHER:
<br />C
<br />AUTOMOBILE
<br />LIABILITY
<br />Y
<br />Y
<br />84UEGM802
<br />8!1/2017
<br />811@018
<br />COMBINED SINGLE LIMIT
<br />Ee edoltlerdI
<br />S1,000,000
<br />ANY AUTO
<br />BODILY INJURY (Per person)
<br />$
<br />1XX
<br />UTOSNED AUTOSULED
<br />BODILY INJURY (Per accident)
<br />$
<br />NON -OWNED
<br />HIRED AUTOS x AUTOS
<br />PROPERTY DAMAGE
<br />!S raccldenO _
<br />$ _
<br />$
<br />I
<br />B
<br />-XJ
<br />UMBRELLA LU1BX
<br />OCCUR
<br />84SBWIW8502
<br />8/1/2017
<br />811P2018
<br />EACH OCCURRENCE
<br />$2,OW,WD
<br />AGGREGATE
<br />IS2,000,000
<br />EXCESS LIAR
<br />_CLAIMS -MADE
<br />DED RETENTION 3Is
<br />-
<br />—
<br />B
<br />AND KERSEMPLC MPEN A TIOI N Y 1 N
<br />ANY PROPRIETORlPARTNERIEXECUTIVE
<br />OFFICERiMEMBEREXCLUDED? ❑N
<br />NIA
<br />Y
<br />84VVEGAASKBS
<br />811f2017
<br />811/2018
<br />-
<br />X ST TUTE C7TH-
<br />E.L. EACH ACCIDENT
<br />$1,000,006
<br />E.L. DISEASE - EA EMPLOYEE
<br />-
<br />'----...—-
<br />$1,000,000 ---....---
<br />(Mandatory In NH)
<br />d yes, describe under
<br />E.L. DISEASE • POLICY LIMIT
<br />•--
<br />$1,00D,OW
<br />DESCRIPTION OF OPERATIONS below
<br />A
<br />Professional Llehllity
<br />Claims Made
<br />DPL705517
<br />81112017
<br />8/112018
<br />$2,000,006 per claim
<br />$2,000,000 Ann. Aegr
<br />S40,0W Dad Per Claim
<br />DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
<br />Umbrella policy is a follow -form to underlying General UabilitylAuto UsbilitylEmployers Liability
<br />Re: All Operations of the Named Insured - The City of Santa Ana, It's Officers , Employees, Agents, and Representative are named as additional insureds as
<br />respects General and Auto liability as required written contract or General Liability is Primary/Non-Contributory
<br />per agreement. per policy form wording,
<br />Insurance coverage Includes waiver of subrogation per the attached endorsement(s). SEE CANCELLATION SECTION of Certificate for 30 Day Notice of
<br />Cancellation.
<br />REVIEWED BY: EUNICE HEREDIA (PG OF )
<br />City of Santa Ana
<br />20 CIVIC Center Plaza
<br />Santa Ana CA 92701
<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 />AU MOR17ED REPRESENTATIVE
<br />kalp
<br />t)1 VUB-2014 AGORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
<br />
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