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RICHWAT-01 DPALAD!INO
<br />A �a DATE (MM1DDNYYY)
<br />CERTIFICATE OF LIABILITY' INSURANCE 10/9/701
<br />A I
<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 pollcy(les) 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 can this certificate does not confer rights to the
<br />certificate holder In lieu of such endorsement(s).
<br />PRODUCER License# 08147'58
<br />Hoffman Brown Compan
<br />50,00 Van Nuys Blvd, Oth 6ort1
<br />Sherman Oaks, CA 91403
<br />--
<br />CONTACT
<br />NAME:
<br />PHONE
<br />N (f
<br />986-82001UG No's �1) 986-8510
<br />E-MAIL-ADDRE-MNL s:
<br />INSURERIS) AFFORDING COVERAGE NAIC
<br />kNSDRERA:Vi llant Ins. Company 20397
<br />INSURED
<br />Richards, Watson $ Gershon
<br />365 South Grand Ave 40th Fir
<br />Los Angeles, CA 130071-3101
<br />INSURPRe:Federal Insurance Co. 20261 .
<br />INSURER C :
<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, NOTWiTHST,ANDiNG 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 />ILTR
<br />TYPE OF INSURANCE
<br />INSD
<br />M
<br />D
<br />POLICY' NUMBER
<br />h'IAAIDDIYYYY .....
<br />MM1DDCYYY LICY P
<br />LIMBTS
<br />A
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS.MADE L'' i OCCUR
<br />X
<br />X
<br />36293250
<br />1010112015
<br />10/0112016PREMISES
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />(Ea o_cTEIT ca)
<br />$ 1,000,000
<br />MED EXP (Any oneperson)
<br />$ 10,000
<br />_
<br />PERSONAL & ADV INJURY
<br />$ 1,000,660
<br />_
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICY ❑ PER L_l' LOC
<br />OTHER:
<br />OENERALAGGREGATE
<br />$ 2,000,000
<br />PRODUCTS-COMPIOPAGG
<br />$ Included
<br />$
<br />13
<br />AUTOMOBILE LIABILITY
<br />ANY AUTO
<br />ALL OWNED SCHEDULED
<br />X AUTOS AUTOS
<br />NON -OWNED
<br />HIRED AUTOS AUTOS
<br />74967929
<br />10101/2015
<br />10/0112019
<br />OOMBI ED SIN LE LIMIT
<br />Ea oecldent
<br />$ 1.000 000
<br />r
<br />BODILY INJURY (Per person)
<br />$
<br />BODILY INJURY (Par accident)
<br />$
<br />PROPERTY DAMAGE
<br />Peracaldont
<br />$
<br />B
<br />X
<br />UMBRELLA LIAR
<br />I EXCESSLIAB
<br />X
<br />OCCUR
<br />CLAIMS -MADE
<br />79911689
<br />1010112019
<br />1010112016
<br />EACH OCCURRENCE
<br />$ 9,000,000
<br />AGGREGATE
<br />$ 9,000,000
<br />..
<br />X
<br />DEI) RETENTION $..
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS` LIABILITY Y d N
<br />ANY PROPRIETOWPAR7NERIEXECUTIVE
<br />OFMCERIMEMBER EXCLUDED' [ N
<br />(Mandatory In NHI
<br />If yea, tleacribe under
<br />DESCRIPTION OF OPERATIONS below
<br />PA
<br />71729476
<br />10/01/2816
<br />1010112019
<br />PER O
<br />X ATUTE ER
<br />—
<br />E.L. EACH ACCIDENT
<br />_
<br />$ 1,000,000
<br />_
<br />E.L. DISEASE - EA EMPLOYEE!
<br />$ 1,000,000
<br />E.L. DISEASE -POLICY LIMIT
<br />$ 1,000,000
<br />DESCRIPTION. OF OPERATIONS I LOCATIONS IVEHICLES (ACORD 401, Addlttonal Remarks Schodule, may be attached If more apace Is raqurred)
<br />City of Santa Ana, Its employees, officers and agents are named as an Additional insured as required by written contract per Endorsement For 0-0 -2367
<br />attached, Coverage subject to policy terms, conditions and exclusions. PROV TO r
<br />.C'�d 4V«lt llTbiiili5
<br />ar
<br />1-A
<br />City of Santa Ana
<br />Office of the City Attorney
<br />Twenty Civic Center Plaza
<br />SHOULD ANY OF THE ABOVE DESCRMD POLICIES BE CANCELLED BEFORE
<br />THE EXPIRA'ITON DATE THERE F, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY P OVI IONS.
<br />ID 198E-2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
<br />
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