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<br />ACCT °° CERTIFICATE OF LIABILITY INSURANCE
<br />F37TE (MMIDDIYYYY)
<br />,R,M,,,, (Ea occurrence)
<br />1 4104/2016
<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 INISURER(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 />CONTACT Doris A. Chambers
<br />Dealey, Renton & Associates
<br />PHONE FAx
<br />No, Ext): 510 465-3090 51.0 45.2-2193
<br />P. O. Box 12675
<br />,(A/C,
<br />E MAIL
<br />ADDRESS: dchambers@dealeyrenton.com
<br />Oakland, CA 94604-2675
<br />.... ...... .... .
<br />510 465-3090 David C. Eckman
<br />INSURER(S) AFFORDING COVERAGE NAIC #
<br />INSURER A: Travelers Indemnity Co. of Conn 25682
<br />INSURED
<br />INSURER B: Travelers Property Casualty Co
<br />25674
<br />RMIC Water and Environment
<br />: can nsurance Company
<br />INSURER C ACE American I
<br />22 6�rjrr 11
<br />2175 N. California Blvd., Suite 315
<br />Walnut Creek, CA 9,4596
<br />INSURER D:
<br />INSURER E :
<br />INSURER F:
<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 />INISR — --------------- ---- . ........ . .......
<br />UTR TYPE OF INSURANCE AIJDLSUB� POLICY EFF CY XP
<br />) � (POLIE3/YEY
<br />1INSR iWVO _,. POLICY ..NUMBER (MMIDD(YYYY MMID Y Y)_ ... LIMITS
<br />A [GENERAL LIABILITY I X I X 16�805427 .. L498 110/14/2015110/14/201C EACH OCCURRENCE S1,000,000
<br />MERCIAL GENERAL LIABILITY
<br />CLAIMS-MADE F__�
<br />I Al OCCUR
<br />L AGGREGATE LIMIT APPLIES PER
<br />Mousy FX PRO- E
<br />JECT Loc
<br />A AUTOMOBILE LIABILITY
<br />ANY AUTO
<br />ALL OWNED H NON-OWNED SCHEDULED
<br />AUTOS AUTOS
<br />X
<br />HIRED AUTO AUTOS
<br />X I X I BA54271_23A
<br />B UMBRELLA LIAB I OCCUR X 1 X CUP7371Y987 II CLAIMS-MAOE!
<br />EXCESS LIAB
<br />DAMAGE TO RENTED
<br />1,009,P00
<br />,R,M,,,, (Ea occurrence)
<br />S
<br />MED FXP (Any are person)
<br />$10,000
<br />PERSONAL & ADV INJURY
<br />$1,000,000
<br />[GENERAL AGGREGATE
<br />52,000,000
<br />PRODUCTS - COMPIOP AGG
<br />52,000,000
<br />011412015
<br />10/14/2016
<br />L,U�UINLLI,)�IINULL Llw 1
<br />Ea ,
<br />aCCden
<br />I $I,(
<br />BODILY INJURY (Per person)
<br />$
<br />BODILY INJURY (Per accident)
<br />S
<br />FPF�EIRTY DAMAGE
<br />.Per Per arcident)
<br />011412015
<br />10/141201
<br />EACH OCCURRENCE
<br />$4(
<br />AGGREGATE
<br />54,(
<br />B WORKERS COMPENSATION X UB3916T448 07/0112015 O�7/01/2016 X J WC STATU- [OTH-
<br />AND EMPLOYERS' LIABILITY _T0aY U Ea.-
<br />Y/N
<br />ANY PROPRIETOR�PARTNERIEXECLJTIVEF--] EACH ACCIDENT 51,000,000
<br />OFFICEMMEMBER EXCLUDED? N ❑ I NIA,
<br />(Mandatory in NH) F L DISEASE - EA EMPLOYEE $1,000,000
<br />If yes, describe under ............ .
<br />!IC A11ON6 below E.L. DISEASE - POLICY LIMIT $1,000,000
<br />_RL _T?IION OF OPEP
<br />C Professional EONG21657372012 1011412015 10/14/201 $2,000,000 per Claim
<br />& Contractor's
<br />$2,000,000 Anni Aggr.
<br />Pollution Liab.
<br />DESCRIPTION OF OPERATIONS I LOCATIONS , VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
<br />GENERAL LIABILITY POLICY EXCLUDES CLAIMS ARISING OUT OF THE PERFORMANCE OF PROFESSIONAL SERVICES
<br />REF: ALL OPERATIONS OF THE NAMED INSURED. GENERAL LIABILITYIAUTOMOBILE LIABILITY ADDITIONAL INSURED: City
<br />of Santa Ana, its officers, employees, agents, volunteers, and representatives. Insurance is primary per
<br />policy form.
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />Clerk of the City Council ACCORDANCE WITH THE POLICY PROVISIONS,
<br />20 Civic Center Plaza (M-30)
<br />Santa Ana, CA 92702-1988 AUTHORIZED REPRESENTATIVE
<br />@ 1988-2010 ACORD CORPORATION, All rights reserved.
<br />ACORD 25 (2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD
<br />#S16585021M1494255 DAC
<br />
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