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DRMAU-1 OF ID: ,4�oiz® TE (MM)DDNYYY) CERTIFICATE OF LIABILITY INSURANCE DA06/14/2018 o5wa/aola 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. �j)tn +moi G nM,- yet --n, rt IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) mos{ e e do ST3'd��SUBRm TION 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). C`I'i'1tI� C PRODUCER CONTACT r•epYaat^Qaw Ml�all:.� A A Brokers Ne 1 ! E-MAIL / V x SS:. Carole -In INSURER A: Westchester Surplus Lines Ins INSURED Dr. Maureen Sassoon INsuRERB: ' P O Box 2028 Palos Verdes Peninsula CA 90274 INSURERC: COVERAGES CERTIFICATE NUMBER- 1 RFVICIn NI MIIMRFR- 949-31 THIS IS 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 OR 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. ILTR TYPE OF INSURANCE Attn. Stella Fajardo,Risk Mngr R POLICY NUMBER POLICY EFF MMIDDITfYY POLICY EXP MMIDDIYYri LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE ❑X OCCUR X X 624270427006 07101/2018'07/0112019, PREMISES Ea occurrence $ 50,000 X Add'I Insured MED EXP (Any one person) $ 5,000 X Prof & Pollut-CLM PERSONAL&ADV INJURY $ 1,000,000 GENTAGGREGATE LIMITAPPLIES PER: X POLICY ❑ jECT LOC GENERALAGGREGATE $ 2,000,000 PRODUCTS COMP/OP AGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLELIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Par accicard) $ NCN.O HIRED AUTOS AUTOS PerOac DAMAMAGE $ -- UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAe CLAIMS -MADE DED RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY OFFICER/MEMBER EXCLUDED?ECUTIVE ❑NIA PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L.DISEASE-EAEMPLOYE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ A Professional Llab, G24270427005 07101/2018 07101/2019 Prof.Liab 1,000,000 A Contractors Poll. G24270427005 0710112018 07101/2019 Pollution 1,000,000 DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (ACORD 101, Additional Romance Schedule, maybe attached it more apace is required) Policy Provides 30 days notice of cancellation except 10 days for nonpayment Applicable Endorsements Attached are Applicable where required by Written Contract. Emailed to: BMorales5@santa-ana.org CFRTIFICATF HOI nFR CANCFI I ATInrU CSANTAA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn. Stella Fajardo,Risk Mngr ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 1988, MS -28 AUTHORIZED REPRESENTATIVE Santa Ana, CA 92702 © 1988-2014 ACORD CORPORATtOWJAII rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD i