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CERTIFICATE OF LIABILITY INSURANCE
<br />F DATE (MM/DDIYYYY)
<br />05/09/2019
<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 />CONTACT Cindy Hales
<br />NAME:
<br />Milestone Risk Management &Insurance Services
<br />PHONE(949) 852-0909 q/c, (949) 852-1131
<br />Ext : No :
<br />License No. OB72766
<br />E-MAIL chafes@milestonepromise.com
<br />ADDRESS:
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC #
<br />8 Corporate Park, Suite 130
<br />Irvine CA 92606
<br />INSURERA: Colony Insurance Company
<br />39993
<br />INSURED
<br />INSURER B: Ohio Security Insurance Company
<br />24082
<br />INSURER C : Hartford Fire Ins Co
<br />19682
<br />KMEA
<br />2423 Hoover Ave.
<br />INSURER D :
<br />INSURER E :
<br />National City CA 91950
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER: 19 -20 GL-PL-Poll-BA-WC 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAYBE 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 />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />INSD
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM/DD/YYYY
<br />POLICY EXP
<br />MM/DD/YYYY
<br />LIMITS
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 5,000,000
<br />CLAIMS -MADE 7 OCCUR
<br />PREM SES Ea occurDrence
<br />$ 300,000
<br />MED EXP (Any one person)
<br />$ 25,000
<br />PERSONAL &ADV INJURY
<br />$ 5,000,000
<br />A
<br />PACE302770
<br />05/19/2019
<br />05/19/2020
<br />GEN' LAGGREGATE LIMITAPPLIES PER:
<br />GENERAL AGGREGATE
<br />$ 5,000,000
<br />POLICY ❑X JECT ❑ LOC
<br />PRODUCTS-COMP/OPAGG
<br />$ 5,000,000
<br />$
<br />OTHER:
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$ 1,000,000
<br />X
<br />BODILY INJURY (Per person)
<br />$
<br />ANYAUTO
<br />B
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />BAS58331982
<br />05/19/2019
<br />05/19/2020
<br />BODILY INJURY (Per accident)
<br />$
<br />XHIRED
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />�/ NON -OWNED
<br />AUTOS ONLY /� AUTOS ONLY
<br />UMBRELLA LAB
<br />X
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />B
<br />X
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />'ESA58331982
<br />05/19/2019
<br />05/19/2020
<br />AGGREGATE
<br />$ 1,000,000
<br />DED RETENTION $
<br />*EXCESS AUTO ONLY
<br />$
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y / N
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE Y
<br />OFFICER/MEMBER EXCLUDED?
<br />(Mandatory in NH)
<br />N/A
<br />72WEZ10371
<br />05/19/2019
<br />05/19/2020
<br />X STATUTE EORH
<br />E.L. EACH ACCIDENT
<br />1,000,000
<br />$
<br />E.L. DISEASE- EA EMPLOYEE
<br />$ 1,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE -POLICY LIMIT
<br />1,000,000
<br />$
<br />Pollution Liab -Occurrence Form
<br />Ea Cond Lmt/Agg Limit
<br />$5,000,000
<br />A
<br />Professional Liab/Claims Made Form
<br />PACE302770
<br />05/19/2019
<br />05/19/2020
<br />Ea. Wrongful Act Lmt/Agg
<br />$5,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />Certificate Holder/Additional Insured: The City of Santa Ana, its officers, employees, agents, and representatives are hereby named as additonal insured, as
<br />required by written contract, per the attached GL and Auto Al Endorsements.
<br />A "30" day NOC may be given if cancelled.
<br />CERTIFICATE HOLDER CANCELLATION
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />The City of Santa Ana (see remarks)
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza
<br />AUTHORIZED REPRESENTATIVE
<br />Santa Ana CA 92701
<br />© 1988-2015ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />
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