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OP ID: MB <br />A1I. -I CERTIFICATE OF LIABILITY INSURANCE <br />DATE (M4 /2014 <br />10/14/2014 <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 Phone: 813 - 226.1300 <br />CONTACT <br />CONTACT Mia Bush <br />Brown & Brown of Florida, Inc. Fax: 813 - 226 -1313 <br />P. 0. Box 173086 <br />Tampa, FL 33672 <br />P <br />Joseph W. LoPrestl <br />PHONE 613- 226 -1337 FAx <br />arc No Exit, ac Na :813. 226.1313 <br />E -MAIL <br />mbush @bbtampa.com <br />PRODUCER <br />PRODUCE <br />CUSTOMER <br />10 #: HOI -I-A'4 <br />INSURERS) AFFORDING COVERAGE <br />NAIC# <br />EACH OCCURRENCE <br />INSURED Holland & Knight LLP <br />INSURERA: Federal Insurance Company <br />20281 <br />Holland & Knight Charitable <br />Foundation Inc. <br />100 North Tampa Street St 4100 <br />Tampa, FL 33602 <br />INSURER B: Sentry Insurance <br />24988 <br />rvsuRERC:Fed.lns Co/Liberty Ins Und <br />0810112015 <br />INSURERD: Great Northern Insurance <br />20303 <br />INSURER E: <br />$ 10,000 <br />PERSONAL &ADV INJURY <br />INSURER F: <br />X Insured Contract <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 />LTR <br />TYPE OF INSURANCE <br />ADDL <br />MD <br />POLICY NUMBER <br />MMIDDIYYVY <br />MML��IY YY <br />LIMITS <br />City of Santa Ana <br />GENERAL LIABILITY <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />David Cavazos, City Manager <br />AUTHORIZED REPRESENTATIVE <br />EACH OCCURRENCE <br />$ 1,000,000 <br />D <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE � OCCUR <br />Vvuo Yse w J P.S <br />' Yolk <br />ApM <br />35798711 <br />08101/2014 <br />0810112015 <br />DAMAGET U RENTED <br />PREMISES Ea occurrence <br />$ 1,000,000 <br />MED EXP (Any one person) <br />$ 10,000 <br />PERSONAL &ADV INJURY <br />$ 1,000,000 <br />X Insured Contract <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />G 1 AGGREGATE LIMIT APPLIES PER'. <br />PRODUCTS - COMP /OP AGO <br />$ Included <br />POLICY PRO- X LOC <br />JECT <br />$ <br />D <br />AUTOMOBILE <br />X <br />LIABILITY <br />ANY AUTO <br />74986035 <br />0810112014 <br />0810112015 <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />$ 1,000,000 <br />BODILY INJURY (Per person) <br />$ <br />ALL OWNED AUTOS <br />BODILY INJURY (Per accident) <br />$ <br />X <br />SCHEDULEDAUTOS <br />HIREDAUTOS <br />PROPERTY DAMAGE <br />(Peraccident) <br />$ <br />X <br />NON -CWNEDAUTOS <br />$ <br />X <br />No Owned Autos <br />$ <br />UMBRELLA LIAB <br />X <br />OCCUR <br />EACH OCCURRENCE <br />$ 49,000,000 <br />AGGREGATE <br />$ 491000,000 <br />C <br />EXCESS LIAB <br />CLAIMS -MADE <br />7981835511000053016.03 <br />0810112014 <br />0810112015 <br />DEDUCTIBLE <br />$ <br />$ <br />RETENTION $ <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANY PROPRIETOR /PARTNER /EXECUTIVE 1 <br />OFFICER /MEMBER EXCLUDED? <br />(Mandatory In NH) <br />NIA <br />901492301/9014920302 <br />08/0112014 <br />08101/2015 <br />X WCSTATU- OTH- <br />TORY LIM T <br />E.L. EACH ACCIDENT <br />$ 1,000,000 <br />E.L. DISEASE - EA EMPLOYEE <br />5 1,000,000 <br />Ifyes,describeunder <br />OE SCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT <br />$ 1,000,000 <br />D <br />Personal Property <br />35798711 <br />08/0112014 <br />0810112015 <br />Spec.Form 115,892,000 <br />D <br />Data Process.Equip <br />35798711 <br />08/01/2014 <br />0810112015 <br />InclTheft Included <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If mare space Is required) <br />See "Certificate Attachment - Holland & Knight, LLP dated 8 -1 -14" attached. <br />CERTIFICATE HOLDER CANCELLATION <br />©1988 -2009 ACO7ZZ7;S:7 <br />ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACOR <br />� <br />Assistant G1ky / 13 <br />CITYSAN <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE <br />CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL <br />BE DELIVERED IN <br />City of Santa Ana <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />David Cavazos, City Manager <br />AUTHORIZED REPRESENTATIVE <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 <br />Vvuo Yse w J P.S <br />' Yolk <br />ApM <br />©1988 -2009 ACO7ZZ7;S:7 <br />ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACOR <br />� <br />Assistant G1ky / 13 <br />