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SCOTFAZ-01 LYNNA
<br />44 0R0° CERTIFICATE OF LIABILITY INSURANCE
<br />DATDIYYYV)
<br />51124122412016
<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 License # OE67768
<br />IOA Insurance Services
<br />4350 La Jolla Village Drive
<br />Suite 900
<br />San Diego, CA 92122
<br />CONTACT All Smith
<br />NAME:
<br />PHONE FAX
<br />A a Est), (619) 574-6220 AIc Not: (619) 574-6288
<br />EMAIL loausa.com
<br />ADDRESS: AII.Smith@ioausa.com
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE ®OCCUR
<br />X
<br />INSURER($) AFFORDING COVERAGE NAIC#
<br />INSURER A: RLI Insurance Company 13056
<br />0610512016
<br />INSURED
<br />INSURER B:ContlnentalCasualty Company 20443
<br />INSURER C
<br />Scott Fazekas & Associates, Inc.
<br />INSURER D
<br />17777 Del Paso Drive
<br />Poway, CA 92064
<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 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 />POLICY NUMBER
<br />POLICVEFF
<br />MMODNYVY
<br />POLICVEXP
<br />MMIDDIYYYV
<br />LIMITS
<br />A
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE ®OCCUR
<br />X
<br />PSB0003027
<br />0610512016
<br />06/05/2017
<br />EACH OCCURRENCE $ 1,000,000
<br />PREMISES Ea occurrence $ 1,000,000
<br />X Cont Llab/Sev of Int
<br />MEO EXP (Any one person) $ 10,000
<br />PERSONAL &ADV INJURY $ 1,000,000
<br />GENT AGGREGATE LIMIT APPLIES PER:
<br />POLICY � JEST 1:1 LOC
<br />GENERAL AGGREGATE $ 2,000,000
<br />PRODUCTS - COMP/OP AGG $ 2,000,000
<br />Deductible $ 0
<br />OTHER:
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT $ 1,000,000
<br />Ea accident
<br />A
<br />ANVAUTO
<br />PSB0003027
<br />06105/2016
<br />06/0512017
<br />BODILY INJURY (Per person) $
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />( BODILY INJURY Per accident) $
<br />-PROPERTY-DAMAGE
<br />X
<br />X
<br />HIRED AUTOS X NON -OWNED
<br />AUTOS
<br />Autos' Owned
<br />Per accitlent $
<br />$
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />EACH OCCURRENCE $ 2,000,000
<br />A
<br />EXCESSLIAS
<br />CLAIMS -MADE
<br />PSE0001119
<br />06105/2016
<br />06/05/2017
<br />AGGREGATE $ 2,000,000
<br />DED XI RETENTION$ 0
<br />$
<br />A
<br />WORKERS COMPENSATION
<br />ANDEMPLOYERS'LIABILITV YIN
<br />ANY PROPRIETORIPARTNEMEXECUTIVE
<br />OFFICERIMEMBER EXCLUDED? ❑
<br />N I A
<br />PSW0001945
<br />06/05/2016
<br />06/05/2017
<br />PER OTH-
<br />X STATUTE ER
<br />E.L. EACH ACCIDENT $ 11000100
<br />E.L. DISEASE - EA EMPLOYEE $ 1,000,00
<br />(Mandatory In NH)
<br />If yes, descrbe under
<br />DEnda
<br />SCRIPTION OF OPERATIONS below
<br />E.L. DISEASE -POLICY LIMIT $ 1,000,000
<br />B
<br />Prof Liab/Clms Made
<br />MCH288352513
<br />06/05/2016
<br />06/05/2017
<br />Per Claim 1,000,00
<br />B
<br />Ded.: $20k Per Claim
<br />MCH288352513
<br />06/0512016
<br />06/0512017
<br />Aggregate 1,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
<br />Re: All Operations
<br />City of Santa Ana, its officers, employees, volunteers, representatives and agents are Additional Insureds with respect to General Liability per the attached
<br />endorsement as required by written contract.
<br />30 Days Notice of Cancellation with 10 Days Notice for Non -Payment of Premium in accordance with the policy provisions..
<br />91Vti
<br />CERTIFICATE HOLDER 1 U V ` cANrFI I ATIPIN
<br />ACORD 25 (2014/01)
<br />©1988.2014 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<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 />City of Santa Ana
<br />Ci Civic Center Plaza (M-20)
<br />,� 1/ A I ` ,
<br />4
<br />Santa Ana, CA 92702
<br />ACORD 25 (2014/01)
<br />©1988.2014 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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