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SCOTFAZ-01 AUSTINA <br />,4coR0` CERTIFICATE OF LIABILITY INSURANCE <br />DATE 1 6/5/201188 Y) <br />6/5/2 <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(les) must have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER License # OE67768 <br />IDA Insurance Services <br />4370 La Jolla Village Drive <br />Suite 600 <br />CONTACT Ali Smith <br />NAME: <br />PHONE <br />AIc,No, E>tt: <br />FAX <br />(619 788-5795 50206 A/ ,,y,(619) 574-6288 <br />ADDRESS:Ali.Smith@ioausa.eom <br />X <br />San Diego, CA 92122 <br />INSURERS AFFORDING COVERAGE NAIC # <br />INSURER A: RLI Insurance Company 13056 <br />06105/2019 <br />_ <br />INSURED <br />INSURER B: Continental Casualty Company 20443 <br />INSURERC: <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 CERTIFICATF NIIMRFR- RFVI-SION NIIMRFR- <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 />INSTYPE <br />LTI <br />OF INSURANCE <br />INSD <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />POLICY EXP <br />LIMITS <br />A <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE X OCCURPSB0003027 <br />X <br />06/0512016 <br />06105/2019 <br />EACH OCCURRENCE $ 1,000,000 <br />DAMAGE TO RENTED 11000,000 <br />PREMIE Me ac o <br />X Cont Liab/Sev of Int <br />MED EXP (Any one erson $ 10,000 <br />PERSONAL& ADV INJURY 1'000'000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />POLICY [_X] yrof 171 LOC <br />GENERAL AGGREGATE $ 2'000,000 <br />PRODUCTS-COMP/OP AGG 2'000'000 <br />Deductible 0 <br />OTHER: <br />A <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT $ 1,000,000 <br />(Ea accidentl <br />BODILY INJURY Perperson) <br />ANY AUTO <br />PSB0003027 <br />06/05/2018 <br />06/05/2019 <br />OWNED SCHEDULED <br />AUTOS ONLY AUOoTNI.1OS <br />BODILY INJURY Per accident $ <br />Perr accident)PRODAMAGE <br />X <br />X <br />WW <br />AUTOS ONLY X AUTOSONLB <br />Autos'Owned <br />A <br />X <br />UMBRELLA LIAB <br />X <br />OCCUR21000,000 <br />EACH OCCURRENCE <br />AGGREGATE $ 2,000,000 <br />EXCESS UAa <br />CLAIMS -MADE <br />PSE0001119 <br />06/05/2018 <br />0610512019 <br />DED X RETENTION $ O <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YINUTE <br />ANY PROPRIETORIPARTNERIEXECUTIVE ❑ <br />PMandatoryInNH) EXCLUDED' <br />NIA <br />PSW0001945 <br />0610512018 <br />06/05/2019 <br />X I PER ORTH- <br />E.L. EACH ACCIDENT 1 10 0 010 0 0 <br />E.L. DISEASE - EA EMPLOYE $ 1,000,000 <br />If yes describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE -POLICY LIMIT 11000,000 <br />B <br />Prof Liab/Clms Made <br />MCH288352513 <br />06/05/2018 <br />06/05/2019 <br />Per Claim 1,000,000 <br />B <br />Ded.: $20k Per Claim <br />MCH288352513 <br />06105/2018 <br />0610512019 <br />Aggregate 1,000,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe 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 <br />Dprrroovisions.. <br />�J/ <br />� <br />CERTIFICATE HOLDER CANCELLATION <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 —T—I/ <br />20 Civic Center Plaza (M-20) �I'� <br />ISanta Ana CA 92702 <br />ACORD 25 (2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />