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AC"Ra CERTIFICATE OF LIABILITY INSURANCE DATE(M7/1MIODIYYY) �/ 3/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER ICA Insurance Services 130 Vantis, Suite 250 Allso Viejo, CA 92656 NEACT Betty Tran AM PHONE FAX Ext: 949-297-5962 NC No: 949-297-5960 ftC—No ADDRESS: betty.tran@[oausa.com INSURERS AFFORDING COVERAGE NAIC9 PSB0001301 Scheduled Al Endt #PPB3130212 Professional Services www.loausa.com CA License 4OE67768 INSURER A: RLI Insurance Company 13056 INSURED Johnson -Frank & Associates, Inc. 5150 E. Hunter Avenue INSURER B: ✓ INSURER C: Wvr of Subr NSURER D Anaheim CA 92807 INSURER E: performed by the Insured INSURER F : AGGREGATE LIM IT APPLIES PER: POLICY Z JECT [i] LOC COVERAGES CFRTIFILATF NIIMFJ earn ell oCVIeInK, \OrMGeb. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL II SUBR WVD POLICYNUMBER POLICY EFF MMIDDIYYY POLICY EXP MMIDMYYYY LIMITS A ,/ COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑✓ OCCUR Prim/NonCon �/ r/ PSB0001301 Scheduled Al Endt #PPB3130212 Professional Services 12/1/2016 12/1/2017 EACH OCCURRENCE $ 1,000,000 DAMAGES Ea occurrence) $ 1,000,000 ✓ MED EXP(My one person) $ 70,000 Wvr of Subr PERSONAL& ADV INJURY $ 1,000,000 ✓ performed by the Insured AGGREGATE LIM IT APPLIES PER: POLICY Z JECT [i] LOC GENERALAGGREGATE $ 2,000,000 GEN'L are Excluded PRODUCTS - COMPIOP AGG $ 2,000,000 $ OTHER: A AUTOMOBILE ✓ ✓ LIABILITY ANY AUTO OWNEDSCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY ✓ AUTOS ONLY ✓ ✓ PSA0001076 Designated Insured Endt #CA20481013; Prim/NonCon and Blkt Wvr of Subr included on pg 2 of Form 12/1/2016 12/1/2077 ,CMBINE�D1SINGLE LIMIT $ 1 000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident _.._ $ ✓ Prim/NonCon ✓ Wvr of Subr 4PPA3000313 A ✓ UMBRELLA LIAB EXCESS LIAB V OCCUR CLAIMS -MADE PSE0001230 Excludes Professional Liability 12/1/2016 12/1/2017 EACH OCCURRENCE $ 4000000 AGGREGATE $ 4,000,000 DEO RETENTION$ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY y/ry ANVPROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBEREXCWDE07 � NIA ✓ PSWOOO229$ Waiver of Subrogation Endt#WC0403060484 12/1/2016 12/1/2017 ,/ SPER TATU_TE ERH - E.L. EACH ACCIDENT $ 1,000,000 -0 E. L. DISEASE - EA EMPLOYEE $ 1,000000 (Mandatory In NH) describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 A Professional Liability RDP0027023 12/1/2016 12/1/2017 $2,000,000 Each Claim Claims -Made $2,000,000 Aggregate DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Certificate Holder is an Additional Insured with respect to General Liability (GL) and Automobile Liability but only when required by written contract with the Insured prior to an occurrence as per Endorsements noted above. GL includes Separation of Insureds and Contractual Liability per limitations in the BusinessOwners' Coverage form. A Workers' Compensation Waiver of Subrogation as noted above is included for theparson or organization named in the Schedule that are parties to a contract requiring this Endorsement, provided that contract is executed before the loss. Coverage subject to all policy terms, conditions, limitations and exclusions. 30 Day Notice of Cancel/10 Days for Non -Payment in accordan with policy provisions. REVIEWED BY. EUNICE HEREDIA (PG f 0 ) I"QEAII2lffi1lI 141: W\Jrodol Yi Glp RFP 17-009 and Agreement #A-2011-098 Cit of Santa Ana, its officers and employees PO Box Box 1988 M-36 Santa Ana CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE AVC Alicia K. gram (9 1968.2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 36685714 1 1.2/16-17 GL/AUT0/EXCES3/NIC/PL I (.AVC) Eo[[y Tran 1 7/13/2017 4;59:14 PM 1PDT1 I Palo 1 of 5