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0 DATE (MMIDDIYYYY) <br />AC"R" CERTIFICATE OF LIABILITY INSURANCE 10110P2016 <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 />Marsh Risk & Insurance Services <br />-NAME: ... .... .. .... .. . . .. ....... ... .... .. . . . .... .. .......... <br />PHONE IF—AX <br />CA License #0437 153 <br />-JAtQ-N% ExtL— No):" <br />777 South Figueroa Street <br />E-MAIL <br />Los Angeles, CA 90017 <br />INSURER(S) AFFORDING COVERAGE NAIC # <br />502512-FINPR-E&O-1 6-17 <br />INSURER A; Nauitkis Insurance Company 17370 <br />INSURED <br />SURER 8 , Axis Surplus Insurance Company 26620 <br />Richards, Watson & Gershon <br />. .... ... .. . ... . .. ..... . ....... . . --- <br />355 South Grand Avenue, 40th Floor <br />-INSURER C : <br />Los Angeles, CA 90071-3101 <br />INSURER D: <br />. ... .... .. . <br />INSURER E <br />INSURER F <br />COVERAGES CERTIFICATE NUMBER: LOS-001858147-25 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 />XUDIC -S-tJ8—R . . .... .. . .. .... POLICY EFF —POEKCY—EfXi� <br />LTR TYPE OF INSURANCE INSD WVDF POLICY NUMBER (MM0131Y YY1 (MMJDC LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />FACT -I OCCURRENCE <br />DAMA 0 RE TED <br />CLAIMS -MADE OCCUR <br />PREMISE�a occurreme <br />MED EXP (Any one person) <br />$ <br />PERSONAL I& ADV-INJURY -- <br />.. .... ... . . ....... <br />GENT <br />AGGREGATE LIMIT APPLIES PER, <br />GENERAL AGGREGATE <br />PRO - F7 <br />7 <br />POLICY JECr LOG <br />ffODUCTS - COMPIOP AGG <br />$ <br />OTHER <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LINUT <br />$ <br />AEP <br />ANY AUTO <br />BODILY INJURY (Per person) <br />$ <br />ALL G8VVNED SCHEDULED <br />BODILYINJURY (Per acc <br />s <br />AUTOS AUTOS <br />NON -OWNED <br />PROPERTY DAMAGE <br />$ <br />HIRED AUTOS AUTOS <br />$ <br />UMBRELLA LfAB <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />EXCESS LIAR <br />CLAIMS -MADE <br />AGGREGATE <br />$ <br />DEDI I RETENTION $ <br />$ <br />WORKERS COMPENSATION <br />I PER DTH- <br />'UTE I [EIR <br />iAND EMPLOYERS' LIABILITY YIN <br />3A <br />ANY PROPRIETORIPARTNERIEXECUTIVE <br />F—N� <br />F.L EACH ACCIDENT <br />$ <br />OFFICERYMEMBER EXCLUDED? <br />NIA <br />(Mandatory in NH) L <br />EL DISEASE - EA EMPLOYEE <br />$ <br />If yes. describe under <br />DESCRIPTION OF OPERATIONS below <br />E L. DISEASE - POLICY LIMIT <br />$ <br />Lawyers Professional Liability <br />PLP 1000238 P-6 <br />10/08/2016 <br />10/08017 <br />Each ClaiM 7,500,000 <br />B <br />ENN 72126110112016 <br />10/08/2016 <br />1010812017 <br />Sell -Insured Retention 250,000 <br />1 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is requXed) <br />PP VED AS 'OF, RM <br />Schwa"Zman <br />a dt I n <br />Senior -Assistant City ttorney <br />City of Santa Ana <br />Santa Ana City Attofney's Office <br />Attn: Tamara Bogosian <br />20 Civic Center Plaza, M-29 <br />P.O.Box 1988 <br />Santa Ana, CA 92702-1988 <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 Risk & Insurance Services <br />Parny Marcos <br />@ 1988-2014 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD <br />