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ACil CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDmYY)
<br />L i 12/5/2014
<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 be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsement(s).
<br />PRODUCER CONTACT Cindy Stathos, Michael Stastny, or Terryn Castanon
<br />NAME:
<br />Marsh USA Inc. PHSNN Ex : (644) 892 -0092 FAX NO:
<br />1166 Avenue of the Americas �s���y— �0 E -MAIL
<br />New York, NY 10036 ADDRESS: Please see bottom of Cod page
<br />INSURER A: ACE American Insurance Company 22667
<br />INSURED INSURER B: ACE Fire Underwriters Insurance Company 20702
<br />SimplexGrinnell LP INSURER C: Indemnity Insurance Company of North America 43575
<br />12728 Shoemaker Avenue
<br />Santa Fe Springs, CA 90670
<br />United States
<br />COVERAGES CERTIFICATE NUMBER: 1369613 -A 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 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 />LTR
<br />TYPE OF INSURANCE
<br />Imp
<br />SU a
<br />POLICY NUMBER
<br />POLICY SEE
<br />MMIODIWYYY
<br />LIMITS
<br />•
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />C LAIMS -MADE OCCUR
<br />X
<br />X
<br />HDO G27337818
<br />1011/2014
<br />1011/2015
<br />EACH OCCURRENCE
<br />$ $1,000,000.00
<br />DAMAGES Ea occ ED
<br />PREMISES Ea occurrence
<br />$ $1,000,000.00
<br />MED EXP(Any one person)
<br />$ $10,000.00
<br />OWNERS & CONTRACTOR'S PROT
<br />X
<br />PROFESSIONAL LIABILITY
<br />PERSONAL &ADV INJURY
<br />$ $1,000,000.00
<br />AGGREGATE LIMIT APPLIES PER
<br />GENERAL AGGREGATE
<br />$ $2,000,000.00
<br />GEN'L
<br />X
<br />POLICY JECOT � LOG
<br />PRODUCTS - COMPIOP AGG
<br />$ $2,000,000.00
<br />$
<br />OTHER:
<br />•
<br />AUTOMOBILELIABILITY
<br />X
<br />X
<br />ISA H08828362 (All Other States)
<br />10/1/2014
<br />10/1/2015
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$ $1,000,000.00
<br />A
<br />ANY AUTO
<br />ISA H08828374 (MIT)
<br />10/1/2014
<br />10/1/2015
<br />BODILY INJURY(PerpmmH
<br />$
<br />NX
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />BODILY INJURY (Per accident)
<br />$
<br />PROPERTY DAMAGE
<br />Per eccldent
<br />$
<br />X NON -OWNED
<br />HIRED AUTOS AUTOS
<br />NEW HAMPSHIRE(CSL)
<br />$ $250,000.00
<br />UMBRELLA LIAB
<br />OCCUR
<br />EACH OCCURRENCE
<br />$
<br />AGGREGATE PRODUCTS-
<br />$
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED RETENTIONS
<br />NEW HAMPSHIRE (CSL)
<br />$
<br />A
<br />B
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />OFFICER/MEMBER EXCLUDED ?ECUnvE N❑
<br />(Mandl in NH)
<br />NIA
<br />X
<br />MA CA, AZ, WLR 048018737
<br />( )
<br />SIDE 048018749 (WI)
<br />VVLR C48018725 (All Other States)
<br />10/1/2014
<br />10/1/2014
<br />10/t/2014
<br />10/1/2015
<br />10/1/2015
<br />10/1/2015
<br />X T
<br />STATUTE PER O ER H-
<br />E.L EACH ACCIDENT
<br />$ $2,000,000.00
<br />E.L DISEASE - EA EMPLOYEE
<br />$ $2,000,000.00
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />1 $ $2,000,000.00
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD101, Additional Remarks SChedule,maybeatme hedifinerespeceisrequired)
<br />Project: City of Santa Ana its officers employees, agents, volunteers and representatives is included as additional
<br />insured as required by written contract, but limited to the operations of the Insured under said contract, per the
<br />applicable endrsement with respect of the General Liability and Automobile Liability policies.
<br />Please refer to attached ACORD 101 for further remarks.
<br />CFRTIFICATF HOI ri CANCFI I GTION
<br />Y
<br />f
<br />SANTA ANA POLICE DEPARTMENT
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />60 CIVIC CENTER PLAZA
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />SANTA ANA, 92710
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />United States
<br />AUTHORIZED REPRESENTATIVE
<br />fd
<br />MARSH USA INC, BY
<br />Jselca Cullen CasuaIN Pm ,a
<br />© 88 -2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014/01) The ACORD me and to ar registered s of ACORD
<br />PAO ✓A4,,
<br />
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