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Francine R. ogienves�avn.,,e,�x.
<br />Villareal wmxoronx.w iasnsi
<br />ee W'
<br />Al'CC)I?vr CERTIFICATE OF LIABILITY INSURANCE
<br />�
<br />1912020
<br />DATE (MM/OD YYYY)
<br />1111
<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(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 lieu of such endorsement(s).
<br />PRODUCER
<br />MARSH USA INC.
<br />1050 CONNECTICUT AVENUE, SUITE 700
<br />WASHINGTON, DC 20036-5386
<br />CONTACT
<br />NAME:
<br />PHONE x : Me No:
<br />E-MAIL
<br />ADDRESS:
<br />INSURERS AFFORDING COVERAGE
<br />NAIL#
<br />INSURER A: XL Insurance America, Inc.
<br />24554
<br />CN102986235-Serco-GAPp-20-21
<br />INSURED Serco, Inc.
<br />INSURER B: Arch Insurance Company
<br />11150
<br />INSURER C: Arch Indemnity Insurance Company
<br />30830
<br />12930 Worldgate Drive
<br />Suite
<br />Herndon,on, VA 20170
<br />INSURER D: XL Insurance Company SE
<br />INSURER E: Chubb European Group SE
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER: CLE-006499RON16 RFVIRIf1M N utfil • 1A
<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 />rypE OF INSURANCE
<br />ADOL
<br />SUBS
<br />POLICYNUMBER
<br />POLICY EFF
<br />MM/DDIYYYY
<br />POLICY ILTR
<br />MM/ODIYYYY
<br />LIMITS
<br />A
<br />X
<br />CO MMERCIALGENERAL LIABILITY
<br />CLAIMS -MADE OCCUR
<br />US00103371L120A
<br />1013112020
<br />10/3112021
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />DAMAGE TO RENTED
<br />PREMISES Ea occurrence
<br />$ 500,000
<br />MED EXP (Any one person)
<br />$
<br />PERSONAL &ADV INJURY
<br />$ 2,000,000
<br />AGGREGATE LIMIT APPLIES PER:
<br />POLICY ❑JECT LOD
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />GENT
<br />X
<br />PRODUCTS - COMPIOP AGO
<br />$ 2,000,000
<br />$
<br />OTHER:
<br />B
<br />B
<br />AUTOMOBILE
<br />X
<br />LIABILITY
<br />ANY AUTO
<br />IICAB1045500(ADS)
<br />11 CABI045600(MA)
<br />1013112020
<br />10/3112020
<br />1013112021
<br />1013112021
<br />COMBINED SIBELL LIMIT
<br />En accident
<br />$ 2,000,000
<br />BODILY INJURY(Par person)
<br />$
<br />OWNED 50HEDULEO
<br />AUTOS ONLY AUTOS
<br />BODILY INJURY Per accident
<br />( )
<br />$
<br />HIRED NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />X
<br />UMBRELLA LIAB
<br />OCCUR
<br />IE0002426BLI20A
<br />W3112020
<br />IW3112021
<br />EACH OCCURRENCE
<br />$ 10,000,000
<br />AGGREGATE
<br />$ 10,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED I I RETENTION$
<br />$
<br />C
<br />G
<br />WORKERS COMPENSATION
<br />AMD EMPLOYERS' LIABILITY
<br />ANYPROPRIETORIPARTNEWEXECUTIVE YIN
<br />OFFICERIMEMBEREXCLUDED?
<br />(Mandatory In NH)
<br />de If yea, scribe under
<br />DESCRIPTION OF OPERATIONS below
<br />NIA
<br />1IWC11045300(AOS)
<br />14WC 1045400 (California(CA)
<br />DC, L. IN, MD, MN, M0, NC, OR, TX
<br />1 1
<br />1013112020
<br />1913112/21
<br />1013112021
<br />X PER OTH-
<br />STATUTE Eft
<br />E.L. EACH ACCIDENT
<br />$ 1,000,OOO
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />E.L. DISEASE -POLICY LIMIT
<br />$ 1,000,000
<br />E
<br />SERCO GROUP PROFESSIONAL
<br />FINPM2000089
<br />11131121121
<br />1/11112/21
<br />LIMIT
<br />1,000,000
<br />(LIMIT SHOWN IS IN
<br />'GREAT BRITISH POUNDS)'
<br />RETENTION
<br />500,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
<br />The City, its officers, employees, agents, volunteers and representatives are included as Additional Insured under the General Liability and Auto Liability policies where required by written contract. Coverage is
<br />Primary and Non -Contributory. The Umbrella/Excess Liability policy provides coverage over the underlying General Liability and Auto Liability policies. 30 Days Notice of Cancellation and Notice of Material Change
<br />applies as required by written contract.
<br />City of Santa Ana
<br />Risk Management Division
<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 />of Marsh USA Inc.
<br />Mannar! Mukherjee '-c...
<br />©1988.2016 ACORD C
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
<br />REete Managemwk TXWswn
<br />o ( REVIEWED&APPROVEDNY
<br />Risk ManagemeRt,Analyst
<br />d.» E
<br />
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