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2110C-0000 HBC
<br />CERTIFICATE OF LIABILITY INSURANCE D07131/2019ATE Y)
<br />07f31/2019
<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($), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les). must have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder in Hen of such endorsement s).
<br />PRODUCER LIOenSa # 0084249k2aEACT
<br />Heffernan Insurance Brokers
<br />18004 Sky Park Circle, Suite 210
<br />Irvine, CA 92614
<br />PHONE �— Ai „No : 949 771.3401
<br />AIc.Na,Ext�1._(949�,771_340U �.1.... �_�..._..
<br />..........._.,.._........
<br />E. IL
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<br />...............INSURE..Rtai.Al?FOROINQ...QbYPeCLAGE
<br />IN B :Non roffta Insurance Allis a of California
<br />011 4
<br />INSURED
<br />SURE .�__....
<br />URERC:
<br />2-1.1 Orange County
<br />150$ E. 17th Street
<br />SuiteIDS
<br />....___...............�e...._..........-_.__................._._........�...
<br />NSUR D:
<br />......_.....___......._....-s.._.....�.e..._.._.,,........._.....
<br />Santa Ana, CA 92705
<br />INSU ERR fii......_.._...............-__..............__._........_....._.......�...___..
<br />INSURER F:
<br />COVERAGES
<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 />INSR
<br />TYPE OF INSURANCEJNM
<br />ADOL
<br />SUBR
<br />Me
<br />POLICY NUMBER
<br />Duey PF
<br />POLICY EXP
<br />02/01/2020
<br />LIMITS
<br />Lm
<br />A
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE OCCUR
<br />improper Sexual Cond
<br />X
<br />201903104NPO
<br />02101/2019
<br />GH OCCURRENCE
<br />11000,000
<br />DAMnoE TO RENTED
<br />00, 00
<br />MEDFXPnvo"udQ.ld.
<br />s 20,000
<br />X
<br />PE ONAL bV N RY
<br />S 11000,000
<br />bEN'L AGGREGATE LIMITAPP IES PER:
<br />POLICY O j�a M LOG
<br />tlTHE`
<br />AUTOMOBILE LIABILITY
<br />RA E
<br />2,000,000
<br />PR DUCTS -CO IO AGG
<br />2,000,000
<br />SOCIAL SERVICE
<br />60MBINE —SINGLE LIMIT
<br />$ 1,000,000
<br />1,000,000
<br />S
<br />AApNNWYNNAUTO
<br />201903104NPO
<br />02/01/2019
<br />02/0112020
<br />ODI YI JURY P ar
<br />ODI YINJURY Peraucidarrt
<br />AUTOSONLYNLY SCHEAUTDULED
<br />X Ai1T090NLY X ALIT05 ONNErD,
<br />Parreociatlenl AMAGE
<br />S
<br />A
<br />X
<br />UMBRELLA LIAR
<br />Excess OAS
<br />X
<br />OCCUR
<br />CUIMS-MADE
<br />201903104UMSNPO
<br />02101/2019
<br />02101/2020
<br />EA HDCCURRENC
<br />2,000,000
<br />RED TE
<br />2,000,000
<br />DEp RETENTIONS
<br />ZNEKMRSOOEMSNIAALONY
<br />ANY PROPREIETOERRIPARTNERIEXECUTIVE
<br />iandato, In NJH)EZGlUOSof LJ
<br />NIA
<br />FER ERH
<br />L.
<br />i4,�v
<br />E.L pISEASE- MPLOYE
<br />E,pISA--Y—LIM-IT
<br />_,,,,��
<br />—
<br />u gsC, Rdescribe
<br />N under P RATIONS below
<br />...--
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES {ACORD 101, Additional Romarka Schedule, may be attached If more space Is required)
<br />Re: As Per Contract or Agreement on File with Insured. City of Santa Ana, its officers, agents, employees, representatives, and volunteers are included as an
<br />additional Insured (primary and noncontributory) on General Liability policy per the attached endorsement, if required, The Cancellation notice endorsement
<br />has been requested for the General Liability policy from the insurance company and if approved will be forwarded when received. this certificate replaces and
<br />supersedes all previously issued certificates.
<br />REVIEWED & APPROVED
<br />By RISK ANAgEMENT DIVISION
<br />City of Santa Ana
<br />Risk Management Division
<br />20 Civic Center Plaza, 4lh floor
<br />Santa Ana, CA 92702
<br />OULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />M. LAMBE TTHB EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />n lnRR.41111N ACORD
<br />The ACORD name and logo are registered marks of ACORD
<br />Aunts reserved,
<br />
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