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LEXIP -1 OP ID: CL
<br />A�'C"M® CERTIFICATE OF LIABILITY INSURANCE
<br />DATE
<br />08 /19 /2016Y)
<br />08119/2016
<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
<br />REIN $Associates, Inc.
<br />303 East Wacker Or Suite 1130
<br />Chicago, IL 60601
<br />Bruce Scodro
<br />CONTACT Cyndi LaMotte
<br />PHONE 312- 656 -9400 FAX
<br />Ac No, Ext: L No):
<br />EMAIL
<br />m s: clamotte rbn500.co
<br />-
<br />COMMERCIAL GENERAL LIABILITY
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC N
<br />IINSURERA:Valley Forge Insurance Company
<br />20508
<br />EACH OCCURRENCE
<br />INSURED Lexipol Holding Company
<br />_
<br />INSURERS: Continental Insurance Company
<br />35289
<br />Lexipol, LLC
<br />6 B Liberty, Ste 200
<br />Aliso Viejo, CA 92656
<br />INSURER C: Continental Casualty Company
<br />20443
<br />—
<br />INSURER D: Hartford Ins Co of the Midwest
<br />37478
<br />INSURER E:HiscoxInsurance Co. Inc.
<br />10200
<br />$ 300,000
<br />INSURER F :
<br />_PREMISES
<br />MED EXP (Any one person)
<br />$ 6,000
<br />COVERAGES CERTIFICATE NUMBER: 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 />ADDL'SUB
<br />INSD
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MMIDD/YYYY
<br />POLICY EXP
<br />MM /DD/YYYY
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 1,000,00
<br />CLAIMS -MADE ^ 1 OCCUR
<br />6043284498
<br />08120/2016
<br />08120/2017
<br />eR Occurrence
<br />$ 300,000
<br />_PREMISES
<br />MED EXP (Any one person)
<br />$ 6,000
<br />&ADV INJURY
<br />$ 1,000,000
<br />GENT
<br />AGGREI�GATE LIMIT APPLIES PER
<br />_PERSONAL
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />EX POLICY JECT PRO- D LOC
<br />PRODUCTS - COMP /OP AGO
<br />$ Excluded
<br />$
<br />OTHER:
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />$ 11000,000
<br />BODILY INJURY (Per person)
<br />$
<br />B
<br />ANY AUTO
<br />6043284484
<br />0812012016
<br />08120/2017
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />P,OMOBILE
<br />BODILY INJURY (Per accident)
<br />$
<br />HIRED AUTOS X NON -OWNED
<br />AUTOS
<br />PROPERTY DAMAGE
<br />Per accident)
<br />$
<br />X
<br />UMBRELLA LIAR
<br />X OCCUR
<br />EACH OCCURRENC__E__
<br />$ 5,000,000
<br />C
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />6043284520
<br />08/20/20161
<br />08/20/2017
<br />AGGREGATE
<br />$ 5,000,00
<br />DED X RETENTION$ 10,000
<br />$
<br />D
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANY EMBER/PARTNDE EXECUTIVE YIN
<br />(Mandatory in ER EXCLUDED?
<br />NIA
<br />83 WEC BZ5648
<br />08/2012016
<br />08120/2017
<br />X PER OTH-
<br />STATUTE ER
<br />_
<br />E. L. EACH ACCIDENT
<br />Is 1,000,00
<br />E. L. DISEASE EA EMPLOYEE$
<br />1,000,00
<br />Ifentlatoryin and
<br />Dyes, describe under
<br />DESCRIPTIONOFOPERATIONSbelow
<br />- -
<br />EL DISEASE - POLICY LIMIT
<br />$ 1,000,00
<br />E
<br />Professional Liab/
<br />US UUA 2688184.16
<br />0812012016
<br />0812012017
<br />Ea Claim 5,000,00
<br />Multimedia Liab
<br />Aggregate 5,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />The City of Santa Ana and Santa Ana Police Department, their officers,
<br />emplo ass agents and volunteers are Additional Insureds as respects General
<br />Liability as required by a written contractor written agreement. -
<br />Xl-
<br />APPROVED -F®
<br />CERTIFICATE HOLDER CANCELLATION
<br />SANTAAN
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City of Santa Ana
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Santa Ana Police Department
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92702
<br />AUTHORIZED REPRESENTATIVE
<br />Z�
<br />ACORD 25 (2014/01)
<br />© 1988.2014 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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