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A►CC>R" CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MMIDDIYYYY)
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />1 012 81201 6
<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
<br />CONTACT'
<br />NAME:
<br />Marsh USA, Inc.
<br />PRONE IFAX
<br />1156 Avenue of the Americas
<br />/C ,No. Exit �..,�..._I fAjc,No):
<br />New York, NY 10036
<br />E-MAIL
<br />aoDl6ss:
<br />Attn: Nolwalk.certrequest@marsh•com Fax: 212-948-0929
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />INSURER(S) AFFORDING COVERAGE NAIC ##
<br />849434 -GAIN --16-17
<br />INSURER A . ACE American Insurance Company 22667
<br />INSURED
<br />INSURER B ; Indemnity Insurance Company of North America 43575
<br />Iron Mountain Inc.
<br />One Federal Street
<br />_._.__..
<br />INSURER c : ACE Fire Underwriters Ins. Co.
<br />20702
<br />INSURER D : Agri General Insurance Company
<br />42757
<br />Boston, MA 02110
<br />INSURERE_,'..
<br />CLAIMS -MADE OCCUR
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: NYC -008041915-13 REVISION NUMBER:O
<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 />INSR
<br />LTR
<br />TYPE OF INSURANCE .�..m._
<br />ADDL8t1BR�'.
<br />POLICY NUMBER
<br />EFF
<br />MMI0IDiYYYY_.
<br />MCY LICY EXP
<br />MIDDIYYYY
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />HDO627859596
<br />1110112015...
<br />1110112017
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />]
<br />�AMAGE-TZD FiENTE�
<br />1,000,000
<br />CLAIMS -MADE OCCUR
<br />PREMISES Ea occurrencej, _.._,_.........
<br />MEd EXP (Any one person)
<br />$ 25,000
<br />INJURY
<br />$ 1,006,000
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />GENERAL. AGGREGATE
<br />`& 2,000,000
<br />X
<br />POLICY PRO -
<br />L J'EG'1 LOC
<br />1_._.m..
<br />PRODUCTS - COMPIOP AGG
<br />$ 1,000,000
<br />OTHER
<br />$
<br />A
<br />AUTOMOBILE LIABILITY
<br />ISAH0905188D
<br />1110112015
<br />1110112017
<br />COMBINED SINGLE LIMIT
<br />{Ea accident
<br />$ 2,000,000
<br />X ANY AUTO
<br />BODILY INJURY (Per person)
<br />$
<br />'.... BODILY INJURY (Per accident)
<br />$
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />PROPERTY DAMAGE
<br />a
<br />$
<br />NON -OWNED
<br />HIRED AUTOS AUTOS
<br />'.... Per accident
<br />UMBRELLA LIAROCCUR
<br />H
<br />'..EACH OCCURRENCE
<br />',.. AGGREGATE
<br />$
<br />EXCESS LIAR
<br />CLMMS-MADE
<br /> J-1
<br />DED RETENTION.$
<br />B
<br />WORKERS COMPENSATION
<br />WLRC4910554A (AOS)
<br />1110112016
<br />1110112017
<br />X PER OTH-
<br />STATUTE,,,
<br />A'
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE YIN
<br />VVLRC49105563 (AZ,CA,MA)
<br />1110112016
<br />1110112017
<br />_,_„_, „ER
<br />E.L. EACH ACCIDENT
<br />-.
<br />1,000,000
<br />$
<br />D
<br />OFFICER/MEMBER EXCLUDED' [-N
<br />(Mandatory in NH)
<br />WLRC49105575 TN
<br />( }
<br />1140112016
<br />1110112017
<br />E.L. DISEASE - EA. EMPLOYEE
<br />Wmm ,
<br />$ 1,000,000
<br />C
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />SCFC49105(551 WI
<br />1110112016
<br />1110112017
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 1,000,000
<br />A
<br />EXCESS WC 8
<br />CUC49105587(OH a1 WA)
<br />1110112015
<br />11/0112017
<br />Each Accident/Emp for Disease 1,000,000
<br />EMP. LIABILITY
<br />SIR 500,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />City of Santa Ana/CH-Mainframe, its officers, agents, volunteers and employees are added as an additional insured (excluding workers c ompensatien), but only as relales to
<br />services and limits of insurance required by written contract or agreement.
<br />CERTIFICATE HOLDER
<br />City of Santa Ana/CH-Mainframe
<br />Attn: Lynda Kelly
<br />20 Civic Center Plaza M12
<br />Santa Ana, CA 92702
<br />ACORD 25 ('2014%01 )
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />of Marsh USA Inc.
<br />Sam Badge
<br />iD 1988-2014 ACORD CORPORATION. All rights reserved..
<br />The ACORD name and logo are registered marks of ACORD
<br />
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