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667970 Miller Mendel, Inc. Certificate of Insurance (page 1 of 1) 12/31/2015 02',15:57 AM
<br />AI..J0 CERTIFICATE OF LIABILITY INSURANCE
<br />O12/31/2015ATF YV)
<br />12/31!2015
<br />THIS CERTIFICATE IS ISSUE[) 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. �� t p`Sn:... S Qi 6,gt 1 2
<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 a dorsoment. A statement on thlg_certlfIgats does not confer rights to the
<br />certificate holder In lion of such endorsement(s).
<br />PRODUCER
<br />GSE. fe# C.F
<br />Techlnsurance
<br />eo+ 1S01 Central Expy. South, Suite 115
<br />s o�Techlnsurance Allen, TX 75013
<br />Allen,
<br />PHONE 866-668-7020 iac Noh (877)826.9067
<br />ADDRESS,
<br />PRODUT[) CER
<br />USE
<br />INSU RE IXSd AF FORDING COVERAGE NAICN
<br />INSURED
<br />INSURERA: Beazley ln5uranCe COm any Inc. 37540
<br />INSURER B: Sentinel l nsurance Company,Limited 11000
<br />Miller Mendel, Inc.
<br />INSURER e:
<br />1425 Broadway Ste 430
<br />Seattle, WA 98122
<br />INSURER o:
<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 1.0 THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED, NOTWTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR IVIAY 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 />INS
<br />TYPE OF INSURANCE
<br />o
<br />R
<br />POLICY NUMBER
<br />POLICYEPF
<br />MMIODIYYYY
<br />POLICYCXP
<br />I'll DIYYPY
<br />LIMITS
<br />GENERALLIABILITY
<br />EACH OCCURRENCE_ .& 1.000,000
<br />MERCIAL GEPIERAL LIABILITY
<br />PREMISES(Ea oclAMAGE TO cccuEr.nor $'1,000,000
<br />P/CSOM,
<br />CLAIMS -MADE ✓OCCUR
<br />MED EXP(Any one person) $ 10,000
<br />PERSONAL B ADV INJURY_ .A 1,000,000
<br />B
<br />P GAP (see below for lint)
<br />Yan
<br />46SBMUF4112
<br />12126/2015
<br />12/2612016
<br />GENERAL. AGGREGATE $ 2,000.000
<br />GEN'L AGGREGATE
<br />LI MIT APPLIES PER:
<br />PRODUCTS, COMPIOP AGO $2,000,000
<br />$
<br />✓ POLICY
<br />JECTPRO LOC
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT $ 1000,000
<br />(Ea accldenl7
<br />ANY AUTO
<br />BODILY INJURY (Per person) $
<br />ALL OWNED AUTOS
<br />BODILY INJURY (Per accident) $
<br />B
<br />✓
<br />SCHEDULED AUTOS
<br />HIRED AUTOS
<br />Yes
<br />40SUMUF4112
<br />12126/2015
<br />12/2612010
<br />PROPERTY DAMAGE
<br />(Per ecoldenh S
<br />S
<br />✓
<br />NONDONED AUTOS
<br />S
<br />UMBRELLA LIAS
<br />OCCUR
<br />EACHOCCURRENCE
<br />__EXCESS
<br />AGGREGATE
<br />LIAB
<br />CLAIMS -MADE
<br />_DEDLOTSLE �_RETENTION
<br />is
<br />SWORKERS
<br />COMPENSATION
<br />V`C STATU- OTAND
<br />EMPLOYERS'LIABILITYANY PROPRIETORIPARTNER/EXECUTIVE YIN
<br />OFFICERNEMBER EXCLUDED? ❑
<br />in NH)
<br />NIA
<br />46SBMUF4112 (STOPGAP)
<br />12126/2015
<br />12/2612016(Mandatory
<br />E.L. EACi ACCIDENT 1,000,000B
<br />EL.DISEASE-EA EMPLOY1,000,000If
<br />E.L. DISEASE -POLICY LIMI1,000,000
<br />yyes desorlbe under STOPGAP
<br />I DESCRIPTION OF OPERATIONS below
<br />A
<br />Professional Lal (Errors and Omiselons)
<br />V17707140101
<br />12/26120157
<br />2016
<br />$1,0000o0/$1,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS) VEHICLES (Attach ACORD 101, Addalonal Reared s Schedule, If more apnea Is required)
<br />City of Sante Ana Is named as Additional Insured as their interests may appear in ragards to general Ilabllity and automobile li ility,
<br />la�
<br />X
<br />CERTIFICATE HOLDER CANCELLATION
<br />©1988-2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2914(01) The ACORD name and logo are registered marks of ACORD
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City of Santa Ana
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />20 Civic Center Plaza
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Santa Ana, CA 92701
<br />AUTHORIZED RCPR55ENTATIVE
<br />©1988-2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2914(01) The ACORD name and logo are registered marks of ACORD
<br />
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