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<br />F LIABILITY INSUNCF)ATE(MM
<br />CERTIFICATE ORA E E VAD31I[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 />'D
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />TYPE OF INSURANCE
<br />ADUL
<br />tNSD
<br />SUBR�
<br />MID
<br />IMPORTANT: If the certificate holder is an, ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
<br />POLICY EFF
<br />iMWDDi
<br />It SUBROGATION IS WAIVED, subject to the terms and conditions of thefloficy, certain policies may require an endorsement, A statement on
<br />Limits
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />CONTACT
<br />SAME:
<br />Aon Risk Insurance Services west, Inc.
<br />__1PH_6'fflf---`— -
<br />FAx
<br />Los Anyeles CA Office
<br />_NVC.-No, ExII: (866) 289 71,'Y (AJC� No,L (HOW 163-0105
<br />0)
<br />:2
<br />707 wi shire Boulevard
<br />E-MAIL
<br />0
<br />suite 76111) A-2016-254
<br />ADDRESS:
<br />Los Angeles CA 9,0017-0460 USA
<br />S1,000,04'1o
<br />INSURER(Si AFFORDING COVERAGE
<br />MAIC #
<br />INSURED
<br />. . . ...... ..
<br />iNSURER k Nationa0 Fire Ins. Ed. of Hartford
<br />20479
<br />will1dan HOrre1and So�utions
<br />. ..... ...... _. ...... . ........... . .. . ...... ----- — —
<br />INSURER 8: 'The Continental Insurance Coripany
<br />--- - - -
<br />15289
<br />2401, E. KarelIa Avenue, Ste. 220
<br />Anah0m (A 92806 U5A
<br />TN RER C ex I ngton Insurance Company
<br />1.9437
<br />S 15, 110
<br />INSURER D:
<br />INSURER Ei
<br />PERSONAL s, AC)V IN JURY
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER! 570064388611
<br />REVISION, NUMRFR-
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE 0vMjRtb NAmiEb ABC vE FOP, THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDIi ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR orHER DOCUMENT WIret 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 POUCIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested
<br />INS R
<br />LTR
<br />TYPE OF INSURANCE
<br />ADUL
<br />tNSD
<br />SUBR�
<br />MID
<br />POLICY NUMBER
<br />POLICY EFF
<br />iMWDDi
<br />POLt EXP
<br />immdi)ON yyy
<br />Limits
<br />B
<br />X COMMERCIAL GENERAL LIABILITY
<br />EACH OCrURRENCE
<br />$1-000,000
<br />C1,,A11W5-MAQE (-)C(,LO4
<br />S1,000,04'1o
<br />,,o personi
<br />MED EXP (AnyN
<br />S 15, 110
<br />PERSONAL s, AC)V IN JURY
<br />_$I, 000, 000
<br />- — - - -___ - --
<br />1,300. AGGREGATE LiMIT APPLES PER
<br />GENERAL AGGPEaArE
<br />'S'2 , 0"
<br />poucy [E E
<br />JEcr
<br />Pic"x)UCTS - COMP�op 4i3r,",
<br />OTHER
<br />A
<br />AU to MOBILE LIABILITY
<br />6020541619
<br />1109 .6
<br />//201
<br />111019,12017
<br />C OMBINED SFNGLE LIMIT
<br />000, 1
<br />1] ANYAUTO
<br />VVN E D SCi El)
<br />BODILY INJURY (Err ii,,cideril)
<br />AUrOS ()N� AUTOS
<br />PROPER1 Y DAMAGE
<br />HFREDAUTr)G NON-OiNNED
<br />ONLY AuTOS ON LY
<br />UMBRELLA LAB OCCUR
<br />EACH OCCUR R E NCE
<br />EXCESS i CLAMS4ADE
<br />AGGREr,47E
<br />0171 FT11111 r,"I'll
<br />B
<br />WORKERS COMPENSA r ION AND
<br />b022647422
<br />11/09/2011)
<br />1110912U17
<br />x CC H.
<br />EMPLOYERS' LIABILITY YiN
<br />A05
<br />a
<br />ANY,PROIPMEPAR rNER EXECUI I
<br />0 F F C ERIM EMBER E XCL i.) DE, it 1
<br />NPA
<br />60205411372
<br />11/09/211016
<br />11/0,19,�2017
<br />L Lr i ACCCEN
<br />S 1, 000, 000
<br />EL f.ASEASE-E4 EMPI.OYEE
<br />S 1, 000, 0
<br />(Mandatoq its NH)
<br />CA
<br />11 yes desimbe wsidev
<br />L L SCRiP TION OF OPERANONS b�eiow
<br />E s E � P ITTE Y L M T
<br />Tf000, Ooo
<br />—
<br />C
<br />Arrh,t&Elrlqi Prof
<br />_J
<br />02MI 7491.2
<br />11/09/2016
<br />11109,12017
<br />Perclajin
<br />$1,000,000
<br />—
<br />SIR applies Per p�oicy ternis
<br />& conditions
<br />Agg„,egate
<br />"T”,
<br />SIR
<br />S250,000
<br />DESCRIPTION OF OPERATIONS jLOCATIONS VEHICLES lA00RD 1101 Additional Rentarks Schedule, may be attached if more space is requiirecf)
<br />RE:, Grant loaniagement Serviires. City of sainta Ana, irF offhZeirs,,pniployees, agents, volunteers and ir�ep resentatives are
<br />ai as Additional Tnsurt,�d with respect to the General Llal)I ty and Autoiv6bile 1.iability pollcies; and the General
<br />Liability policy evidenced herein is Primary ami Non ContribLitriry to Other insairance available, in accordance with the pol�cy
<br />provisions, Severabiilry of: Interests coverage is incIluded within the (3eneral Liability po,licy.
<br />CERTIFICATE HOLDER
<br />City of Santa Ana
<br />Atte; Clerk, of the City Council
<br />20 Civic Center Plaza(m.-30)
<br />Po Box 1988.
<br />Santa Aria CA 92701 ILPSA
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
<br />EXPIRATION DATE'THEREOF, soncE V41LL BE DELIVERED IN ACCORDANCE WITH THE
<br />POLICY PROVISIONS.
<br />AUTHORVED REPRESENTATIVE
<br />@1988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (201610,3,) The ACORD name ands I r,e ir,egistered marks of ACORD
<br />""I ell
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