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<br />ArDATE "' 'Dotyyy
<br />CERTIFICATE OF LIABILITY INSURANCE E2/ 18 /M2 0 16
<br />THIS CERTIFICATE 17 S LIED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLIDER. T
<br />CERTIFICATE DOES NOT
<br />BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING IINSURER(S), AUTHORIZ
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER,
<br />w
<br />IIMPORTANT; ADDITIONAL pendorsed. , IS WAIVED, subject
<br />the terms and Conditionsppolicies enidorsement. A statement on this certificate does not confer rigihtsto t
<br />certificate holder in: lieu of such endorsendontis),
<br />PRODUCER
<br />i
<br />k
<br />� rr
<br />Insurance & Risk Mgmt Services /1 b w iR IY '^ IM
<br />12900PrestonRoad,r 500 TN5UKhH(S)
<br />AFFORDING
<br />Dallas TX 75230 INSURERA:Phoenix Insurance Company
<br />INSURED INISURERB:Travelers Casualty and Surety
<br />FlowerCE Dean Enterprises,Inc.
<br />,INSURER C:Charter Oak Fire Insurance Co.
<br />LD Systems
<br />2221 Justin RdSte 119
<br />' ,w '. .1 Il, ^.., It 1 I .. 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. NOTI THSTANDINCS ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH! THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY
<br />PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS 'SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH
<br />POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />7N -SRT--' —. ____
<br />R TYPE OF INSURANCE
<br />TD -DL SUBr3 ___.—._______ - POLICI° EFF POLICY EXP
<br />POLICY NUMBER _JMM1DD1YYYYIJWMMQ1y=LIMITS
<br />GENERAL LIAMUTY
<br />EACH OCCURRENCE $ 1,000,1000
<br />COMMERGIALGENERALLIABILITY
<br />I?Ah�AGE TO RENITE—D--
<br />PR MD - Faaccurrence—. $300,000
<br />ACLAIMS-MATTE ® OCCUR
<br />680-0661W261-16-42/25/2016 /25/2017 MED EXP (Any one person) $ 5,10010
<br />PERSONAL AADV INJURY $ 1,000,000
<br />.
<br />GENERAL AGGREGATE:....... $ 2,000,000
<br />GENT AGGREGATE LIMIT APPLIES PER
<br />$.. 2,000,000
<br />.1". Pt7LICY '... PRO-
<br />LOC
<br />$
<br />AUTOMOBILE LIABILITY
<br />COM BIINED SINGLE LIMIT
<br />Eaacaldent
<br />$ I. p'pa pp0 i
<br />BODILY INJURY (Perpersar)
<br />$
<br />ANY AUTO
<br />BODILY INJURY (Peracddentl)
<br />$
<br />ALL OWNED SCHEDULED
<br />680-0661W261-16-42
<br />/25/2016
<br />/25/201.7
<br />AUTOS AUTOS
<br />PROPERTY DAMAGE
<br />Per aacidert
<br />$
<br />HIRED AUTOS AUTOS
<br />AUJTOS
<br />$
<br />X 1 UMBRELLA LIAB..' OCCUR
<br />IEACH I OCCURRENCE
<br />$.. 3, 000 , 000
<br />AGGREGATE
<br />$.. Paoa,aaP
<br />�
<br />EX.CESSLIAB7CLAIMSmMADE
<br />$
<br />LEC RETENTION$ 1.0,00
<br />CUP7584Y575
<br />/25/2016
<br />/25/2017
<br />C
<br />WORKERS COMPENSATION
<br />X7TWC STACRY LIMT11 OrWi-
<br />-�
<br />A,ND EMPLOYERS' LIABILITY
<br />YPN
<br />—.---.-
<br />ANYPROPRDETCRIPARTNERYEXECNTIVE
<br />E.L.EACIHACCIIDENT
<br />$.. ,500.000
<br />(Mandatory In 1= EXCLUDED?
<br />(Mandatoiry In NH)
<br />NAA
<br />IOUB59,37L148
<br />/25/2'016
<br />/2 5/2017
<br />E.L DISEASE - EA EMPLOYE
<br />_d_..
<br />$ 500 ,000
<br />It yes describe under
<br />DESCRIPTION OF OPERATIONS d0ow
<br />E.L. DISEASE - POLICY LIMP
<br />$�� 500 ,0100
<br />DESCRIPTION OF OPERATIONS C LOCATIONS 1 VEHICLES (Attach, ACORDD 101, Additional Remarks Schedule, If more space Is requiredl)
<br />The City of Santa .Aria, 2,0 Civic Center Plaza, Santa Ana, CA 92701; its officers, employees, agents,
<br />volunteers and representatives are named as additional insured as required by written contract.
<br />b
<br />CERTIFICATE HOLDER
<br />CANCELLATION
<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 PROVISION'S,
<br />City of Santa Ana
<br />Treasury Manager
<br />20 Civic Center plaza
<br />AUTHORIZEDREIaRESENTATIVE
<br />Santa Ana, CA 92701
<br />Mark Prederiksen/MKC
<br />AC RID' 20 (2010105)
<br />@ 1950-2010 ACC'RD CORPORATION. All rights reserved.
<br />INSn2 s r7nirurup.o of
<br />"IThaza ,58 .0Pn s'a�,m a mnrl Inewn 2raa ranictarari' m2rka of .6r NPP
<br />
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