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CERTIFICATE OF LIABILITY INSURANCE <br />°AT12M8/205YYY' <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(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 on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />Aon Risk Services South, Inc. <br />Franklin TN Office <br />501 Corporate Centre Drive <br />Suite 300 <br />CONTACT <br />NAME: <br />PHONE () -IL 05 <br />(PHO, No. Exq:8662837122 FANC. No.: 800-363-01 <br />E-MAIL <br />ADDRESS: <br />Franklin TN 37067 USA <br />EXCLUSIONS AND CONDITIONS OF SUCH <br />INSURER(S) AFFORDING COVERAGE NAICIf <br />INSURED <br />INSURERA: XL specialty Insurance Co 37$$5 <br />Ca1115onRTKL Inc.INSURER <br />901 S. Bond Street <br />B: Greenwich Insurance Company 22322 <br />INSURER C: <br />Baltimore MD 21231 USA <br />LTR <br />FINSURER D: <br />INSD <br />NSURER E: <br />POLICY NUMBERMMIDDI`/YYY <br />INSURER F: <br />�Wvrv+v Q CER RFiCA C NLA5BER: OIUUOUOUOOlO REVISION NUMBER' <br />THIS IS TO CERTIFY THAT THE POLICIES <br />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 <br />WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY <br />PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL <br />THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />Limits shown are <br />as requested <br />LTR <br />TYPE OF INSURANCE <br />INSD <br />Me <br />POLICY NUMBERMMIDDI`/YYY <br />MMIDDIVYYY <br />LIMITS <br />X CO MMERGIALGENERALLIABILITY <br />GEC <br />EACH OCCURRENCE <br />$1,000,000 <br />General LiabilityA <br />PREMISES Ea occurtende <br />$1,000,000 <br />CLAIMS -MADE X❑ OCCUR <br />X COntr.cWel <br />MED EXP (Any one person) <br />$10,000 <br />PERSONAL B ADV INJURY <br />$1,000,000 <br />m <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE$2,000,000 <br />0 <br />POLICY ❑X PE° ❑X LOC <br />PRODUCTS -COMPIGP AGO <br />$2,000,000 <br />OTHER: <br />od <br />A <br />AUTOMOBILE LIABILITY <br />AECO01075814 <br />01/01/201601/01/2017 <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$1,000,000 <br />'^ <br />Auto (ADS) <br />BODILY INJURY (P ........ <br />% ANY AUTO <br />O <br />ALL OWNED SCHEDULED <br />Z <br />BODILY INJURY (Per Icdden0 <br />AUTOS AUTOS <br />y <br />PROPERTY DAMAGE <br />X HIRED AUTOS X NON -OWNED <br />U <br />AUTOS <br />Per accident <br />Y <br />AUECO01075914 <br />X <br />UMBRELLA LIAB <br />X <br />OCCUR <br />01 /01/2016 <br />01/01/2017 <br />EACH OCCURRENCE <br />$1,000,000 <br />m <br />=% <br />umbrella <br />AGGREGATE <br />$1,000,000 <br />EXCESS LWB <br />CLAIMS -MADE <br />DEO I X <br />RETENTION 310, 000 <br />A <br />AND <br />RWD943516310 <br />01/01201601/01/2017 <br />X STATUTE <br />EMPLOYERS'LIABILITYYIN <br />ILITYPART <br />Workers Compensation <br />ETH <br />EL EACH ACCIDENT <br />$1,000,000 <br />A <br />ANYPROERS'LIAIETOR RIEXECUTIVE <br />OFFIOERIMEMBER E%CLUDE01 N <br />NIA <br />RWR94351671Q <br />O1/D1/2 Q16 <br />Q1/01/201% <br />E. L. DISEASE -EA EMPLOYEE <br />$1,000,000 <br />(6landalory in NH) <br />State Of Wisconsin <br />If yes, describe under <br />E.L. DISEASE -POLICY LIMIT <br />$1,000,000— <br />DESCRIPTION OF OPERATIONS below <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES <br />(ACORD tet, Additional Remarks 9eM1ed0s, may be ad..h.d if more space is rec u ed) <br />City of Santa Ana, its officers; employees, <br />agents, volunteers and representatives are included as Additional Insured <br />in <br />accordance with the policy provisions <br />of the General Liability policy. Severability of Interests applies as if each <br />Named <br />insured were the only Named Insured; <br />and separately to each insured against whom claim is made or suit" is brought. <br />CERTIFICATE HOLDER <br />CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE <br />WITH THE <br />POLICY PROVISIONS. <br />City Of Santa Ana <br />AUTHORIZED REPRESENTATIVE <br />20 civic Center Plaza <br />Santa Ana CA 92701 USA <br />reJiGtYCYa � ��9•� <br />©198&2014 ACORD CORPORATIONZ,1,16C. All UI- ri hts reserved. <br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD ),,�+.� <br />��' <br />