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<br />ACO 0 CERTIFICATE OF LIABILITY INSURANCE
<br />010/24/2017"
<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 pollcyiles) must have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain pollclas may require an endorsement, A statement on
<br />this certificate does not confer rights to the certificate holder hl (leu of auch ondorsement s .
<br />PRODUCER
<br />CONTACT
<br />Willis of 9oattlo, Inc.
<br />a/o 26 Century Blvd
<br />B.P. Box 305191
<br />AR
<br />PHONE1^888^467-2978
<br />1' 1-871-948-7378 €AIC Noy
<br />M�mcertificates6willis.com
<br />INSURER(B) AFFORDING COVERAGE
<br />�NAICY
<br />Nashville, TN 372308191 USA
<br />INSURER A Coverys specialty Insurance Company
<br />15686
<br />EACH OCCURRENCE
<br />_
<br />INSURED
<br />INSURER d1 Greenwich Insurance Company
<br />22322
<br />Care Ambulenoe services, Inc.
<br />1517 west eradan Court
<br />INSURER C; Steadfast Insurance Company
<br />26387
<br />INSURER D: XL Specialty Insurance Company
<br />37885
<br />cranes, CA 92868
<br />INSURER E1
<br />MED EXP (Ay oneperson)
<br />$ 5,000
<br />INSURER PI
<br />Mad.
<br />COVERAGES CERTIFICATE NUMBERI W4092490 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 MICH 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 />ILT
<br />TYPED? INSURANCEAUUL
<br />R
<br />POLICY NUMBER
<br />POLpGY EFF
<br />POLIO E%P
<br />LIMITS
<br />MMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />S 1,000,000
<br />CLAIMS.MALIE FV-11OCCURP
<br />tXV]ductfi-claima
<br />EMI5E oemr
<br />8 1,000,000
<br />MED EXP (Ay oneperson)
<br />$ 5,000
<br />A
<br />Mad.
<br />y
<br />5-10013
<br />10)01/2017
<br />10/01/2018
<br />PERSONAL aAOV INJURY
<br />8 1,000,000
<br />GEHL AGGREGATE LIMIT APPLIES PER:
<br />GENCRALAGGREGATE
<br />$ 2,000,000
<br />X POLICY ❑ jEpGT 0 LOC
<br />PRODUCTS -COMPtOPAGG
<br />S 2,000,000
<br />S
<br />O 11ER'
<br />AUTOMOBILE LIABILITY
<br />C 18 OSINGLE LIMIT
<br />S 1,000,000
<br />GORILY INJURY (Per pamen)
<br />$
<br />X ANYAUTO
<br />B
<br />A TUTU EDONLY SCHEDULED
<br />Y
<br />PADE00047602
<br />10/01/2017
<br />10/01/2015
<br />BODILY INJURY (Par accoonq
<br />S
<br />HIRED NON-0Mal)
<br />AUTOS ONLY AUTOOONLY
<br />ROPERT DAMAGE
<br />r=DAMAGE
<br />Per
<br />S
<br />S^
<br />C
<br />,1(
<br />UMDRELLALIAB
<br />RODEOS LIAR
<br />X
<br />OCCUR
<br />OLAIMSAIADE
<br />y
<br />01165414770-04
<br />10/01/2017
<br />10/01/2018
<br />CACHOCCURRENCE
<br />$ L5, ORO, UUO
<br />AGGREGATE
<br />4 15,000,000
<br />DED I I RETENTION
<br />S
<br />D
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANYPROPRIETORIPARTNERI58RCUTIVE YIN
<br />OFPICERIMEMBEREXOLVOE07 No
<br />(MandetOgM NH)
<br />NIA
<br />AN03000955-02
<br />10/01/2017
<br />10/01/2018
<br />T
<br />X PTATUTE ER
<br />E.L. EACH ACCIDENT
<br />$ 1, 000, 000
<br />E.., DISEASE -EA EMPLOYEE
<br />S 11000,00
<br />E.L. DISEASE- POLICY LIMIT
<br />$ 1,000,000
<br />II yyes, tlesmla order
<br />pESCR PTION OFF OPERATIONS bel !
<br />A
<br />)Ais. Hadical Professional
<br />5-10013
<br />10/01/2017
<br />10/01/2018
<br />Por Claim
<br />81,000,000
<br />Liability
<br />Aggregate
<br />82,000,000
<br />Claims Had.
<br />Abuse S Molestation
<br />81,000,000
<br />DESCRIPTION OPOPBRATIONB I LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Saheduls, maybe aRachad it more space is mqulrod)
<br />Crabralla/EXOeS5 Ir011cws Bloom.
<br />The City of Santa Ana and their raepootive officers, officials, employees, rapreeentative and volunteers are included
<br />as Additional Insureds per Contract or Agreements with the City of Santa Ana in accordance with the policy provisions
<br />of the General Liability, Automobile Liability, and Umbrella/Gxoeroa Liability policies.
<br />"-/7 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />7HE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />The City of Sento Ma /q s, �e r,!! AUTHORIZED REPRESENTATIVE
<br />20 Civic Center Plaza c -C /
<br />Santa Ane, CA 92701
<br />(c)1988-2015 ACORD CORPORATION. All rlahts reserved.
<br />ACORD 26 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />OR %D: 15222435 ZhecH, 489677
<br />
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