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AC40R& CERTIFICATE OF LIABILITY INSURANCE 9/30/2014 OATE(MMIODIWYY) 9/17/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER Lockton Companies CONTACT 8110 E. Union Avenue Suite 700 Denver CO 80237 PHONE FA% AIC No: E-MAIL ADDRESS, INSURERS AFFORDING COVERAGE NAICM (303)414-6000 INSURER A: antll Insurance,17370 INSURER B: Sentinel Insurance Coninariv. Ltd. 71-000 Y INSURED Na hCare, Inc. 1326378 2040 Columbiana Road, Suite 4000 INSURER c: The Travelers Ins Co Accident Dept) Birmingham, AL 35216-2158 IN$DRER D INSURER E: MED EXPAn one Poison) INSURER P, COVERAGES INAPCA01 CERTIFICATE NUMBER: 11111 hU116 RFVIRIr1N NIIMRFR• vvVllvv THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INTER LYRN TYPE OF INSURANCE AOD Sees POLICY NUMBER POLICY EFF MMIDOrrY POLICY EXP MMISDIVYYY LIMITS A X COMMERCUILGENERALLUU$ILITY CLAIMSMADE OCCUR Y N GPFPI000079PS 9/30/2013 9/30/2014 EACH OCCURRENCE I-LaM4QL-- DAMAGE TO RENTED PREMISES Ea cccuvence) $ 50000 MED EXPAn one Poison) PERSONAL S ADV INJURY $ 1,000,000 MEWL X AGGREGATE LIMIT APPLIES PER: POLICY ❑ SECT LOC GENERAL AGGREGATE $ PRODUCTS-COMP/OP AGO § OTHER: $ AUTOMOBILE LIABILITY NI N 34ULJNAQ53869/30/2013 9/30/2014 (Ea acdden0 $ X ANYAUTO BODILY INJURY (Per pomm) $ ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS AUTOSWNEO BODILY INJURY Per acddent PROPERTY DAMAGE $ XxxXxxx $XXXXXXX AUMBRELLALIAO OCCUR N N CFX[000051P5 9/30/2013 9/30/2014 EACH OCCURRENCE $ 5,000,000 X EXCESS LIAR CLAIMSMADE AGGREGATE $ 5-000000 OED RETENTION$ $ G C WORKERS COMPENSATION ANDEMPLOYERS'LIABILRY ANY PROPRIETOWARTNERTEXECUTIVE YIN OFFICER/MEMBEft EXCLUDED Y NIA N TRKUB425IB76013 TRKUB4251B760I3 9/30/2013 9/302013 9/30/2014 9/30/2014 - X STATUTE ER E.L. EACH ACCIDENT $ (Mandatory in NH) If es, desetlbe under E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L.DISEASE-POUCYLIMIT $ 1,000,000 10 OF OPERATIONS below A Professional Liability N N PFPI000098P5 9/30/2013 9/30/2014 Each Claim: $1M I Annual Agg.: $5M DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101, AddiSanal Remarks Schedula, may be aHaehad if more space Is required) RE: RFP #14-034; The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, CA 92701; its officers, employees, agents, volunteers and representatives arc named as Additional Insured's with regard to General Liability if required by written contract. The politics shall not be canceled or reduced in coverage or changed in any other material aspect without 30 days prior written notice to the City. 13116944 City of Santa Ana Purcharsing Division M-16 20 Civic Center Plaza RM 429 Santa Ana CA 92701-4058 AS TO FORM Laura A. Rossini Assistant City Attorney SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ©1988 7814 ACI ACORD name and logo are registered marks of ACORD M reserved.