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HASSE-1 OP ID: BR
<br />A`CQRl7 CERTIFICATE OF LIABILITY INSURANCE
<br />GATE 09/109/201609/2016
<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 />The Business Benefits Group
<br />4069 Chain Bridge Road, Top FI
<br />Fairfax, VA 22030
<br />Brock Reynolds
<br />CONTACT Certificate Team
<br />PHONE FAX
<br />A/c No Ext703-385.7200 AIC Ne: 7O3-756.0202
<br />E-MAIL
<br />ADOREss: certificates@bbgbroker.com
<br />INSURER(S) AFFORDING COVERAGE NAIC#
<br />04/11/2016
<br />INSURER A: Hartford Casualty Insurance Co 29424
<br />EACH OCCURRENCE $ 1,000,00
<br />INSURED Hassett Willis & AssociatesLLC
<br />T/A Hassett Willis & Company
<br />1100 New York Ave NW #940W
<br />INSURER B: Beazley Ins. Co
<br />INSURER C:
<br />INSURER D:
<br />Washington, DC 20005
<br />INSURER E
<br />PRODUCTS - COMP/OP AGO $ 2,000,00
<br />INSURER F:
<br />AANYAUTO
<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. 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 />ILTR
<br />TYPE OF INSURANCE
<br />DAVD-
<br />POLICY NUMBER
<br />POLICY EFF
<br />POLICY EXP
<br />LIMITS
<br />A
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS.MADE ❑X OCCUR
<br />X Business Owners
<br />X
<br />Santa Ana, CA 92701
<br />42SBAIG6094
<br />04/11/2016
<br />04/11/2017
<br />EACH OCCURRENCE $ 1,000,00
<br />PREMISES Ea occurrence $ 300,00
<br />MED EXP(Anyone Person) $ 10,000
<br />PERSONAL&ADV INJURY $ 11000,00
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICY r7 PROT- ❑
<br />JECLOC
<br />OTHER:
<br />GENERAL AGGREGATE $ 2,000,00
<br />PRODUCTS - COMP/OP AGO $ 2,000,00
<br />$
<br />AANYAUTO
<br />POMOBILE
<br />LIABILITY
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />NON -OWNED
<br />HIRED AUTOS X AUTOS
<br />X
<br />42SBAIG6094
<br />04/11/2016
<br />04111/2017
<br />COMBINED SINGLE LIMIT $ 1,000,00
<br />Ea accident
<br />BODILY INJURY (Per person) $
<br />(Per accent
<br />) BODILY INJURY id $
<br />PROPERTY DAMAGE $
<br />Per accident
<br />A
<br />X
<br />UMBRELLA LIAB
<br />EXCESS LIAB
<br />X
<br />OCCUR
<br />CLAIMS -MADE
<br />42SBAIG6094
<br />04/11/2016
<br />04111/2017
<br />EACH OCCURRENCE $ 1,000,000
<br />AGGREGATE $ 1,000,00
<br />DED I X RETENTION$ 10000
<br />$
<br />A
<br />WORKERS COMPENSATIONYIN
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICERIMEMBER EXCLUDED? ❑
<br />(Mandatory In NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />NIA
<br />42WECCQ6606
<br />04/11/2016
<br />04/11/2017
<br />X PER OTH-
<br />STATUTE ER
<br />E.L. EACH ACCIDENT $ 1,000,00
<br />E.L DISEASE - EA EMPLOYEE $ 1,000,00
<br />E.L. DISEASE - POLICY LIMIT $ 1,000,00
<br />B
<br />Prof.Liab/E&O
<br />V156613140101
<br />04/23/2016
<br />04/23/2017
<br />LIMIT 1,000,00
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORO 101, Additional Remarks Schedule, may be attached if more space Is required)
<br />Certificate Holder, its officers, agents, and employees are named as
<br />Additional Insured in regards to General Liability per attached SS0008 04105
<br />CERTIFICATE HOLDER CANCELLATION
<br />SANTANA
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />City of Santa Ana
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />ATTN: Purchasing Department
<br />AUTHORIZED REPRESENTATIVE
<br />20 Civic Crater Plaza
<br />Santa Ana, CA 92701
<br />R /� -
<br />@ 1988.2014 ACORD COfial'lRMIO& JMvrffiA6R st*Ad.
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD SEP
<br />BYsc_Y_ l
<br />
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