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'4CbRb' CERTIFICATE OF LIABILITY INSURANCE
<br />11.1
<br />DATE(MMIDDIYYYY)
<br />1 9/7/2017
<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
<br />Arthur J. Gallagher & Co.
<br />Insurance Brokers of CA. Inc, LIC # 0726293
<br />3697 Mt. Diablo Blvd, Suite 300
<br />CONTACT
<br />NAME:
<br />PHDNE . 925-299-1112 FAXAID .925-299-0328
<br />E-MAIL
<br />INSURERS AFFORDING COVERAGE
<br />NAIC 0
<br />Lafayette CA 94549
<br />INSURER A: Sentinel Insurance Company Ltd
<br />11000
<br />4/20/2017
<br />INSURED SCICONS-01
<br />INSURERB:Gemini Insurance Company
<br />10833
<br />INSURERC:Markel Insurance Company
<br />38970
<br />SCI Consulting Group
<br />Consequence Properties
<br />4745 1Boulevard
<br />-
<br />INSURER D:
<br />Fairfield CA 94534-4319
<br />INSURER E:
<br />MED EXP (Any one person) $10,000
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: 107064960 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 />INSR
<br />LTR
<br />rypE OF INSURANCE
<br />DD
<br />INSD
<br />5
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />(MMflDDP`YYYI
<br />POLICY EXP
<br />MMIODIYVVV
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />Y
<br />Y
<br />57SBARH8313
<br />4/20/2017
<br />4/20/2018
<br />EACH OCCURRENCE $2,000,000
<br />CMS -MADE OCCUR
<br />LAI
<br />DAMAGETORENTED
<br />PREMISES RENTrrence $1,000,000
<br />MED EXP (Any one person) $10,000
<br />PERSONAL &ADV INJURY $2,000,000
<br />AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE $4,000,000
<br />GEN'L
<br />X
<br />_
<br />POLICY � JECT PRO- LOC
<br />PRODUCTS - COMPIOP AGO $4,000,000
<br />$
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />57SBARH8313
<br />4/20/2017
<br />4/20/2018
<br />COMBINED SIN,LE IMT _T1
<br />2
<br />a ,000,000
<br />_
<br />BODILY INJURY (Per person) $
<br />ANY AUTO
<br />OWNED
<br />AUTOS ONLY SCHOS EDULED
<br />AUT
<br />BODILY INJURY (Per accident) $
<br />X
<br />HIRED
<br />AUTOS ONLY X AUTOS ONLY PROPERTY
<br />DAMAGE $
<br />Per accident
<br />AJUMBRELLA
<br />LIAB
<br />X
<br />OCCUR
<br />57SBARH8313
<br />4/20/2017
<br />4/20/2018
<br />EACH OCCURRENCE $1,000,000
<br />AGGREGATE $1,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED I I RETENTION$
<br />$
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY VIN
<br />y
<br />MW0000353307
<br />4/20/2017
<br />4/20/2018
<br />PER OTH-
<br />X STATUTE ER
<br />ANYCER/MEETOR/PARTNDED? CUTIVE 171
<br />OFFICER/MEMBER BER E%CLUDE09 Y
<br />NIA
<br />E.L. EACH ACCIDENT $1,000,000
<br />E.L. DISEASE - EA EMPLOYEE $1,000,000
<br />(MandatoryNH)
<br />fy6s,din
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE. POLICY LIMIT $1,000,000
<br />B
<br />Service& Technical Professional
<br />VCPL064897
<br />12/17/2016
<br />12/17/2017
<br />Each Claim $2,000,000
<br />Liability- Claims Made
<br />Aggregate $2,000,000
<br />Retroactive Date: 12/17/1998
<br />Deductible $25,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
<br />Excess Liability coverage is in excess of General Liability and Auto Liability Only
<br />The City of Santa Ana, its officers, employees, agents Volunteers and representatives are included as additional insured per policy form
<br />SS0008 0405 attached, but only with respect to liability arising out of the activities of the named insured. Waiver of Subrogation applies per
<br />form SS0008 04 05 attached. Primary Wording applies per form SS0008 04 05 attached. Waiver of Subrogation for Workers Compensation
<br />applies per form MWC1400 0510 attached.
<br />30 Days Notice of Cancellation, except 10 days for non-payment.
<br />See Attached...
<br />CERTIFICATE HOLDER CANCELLATION
<br />©1988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City Of Santa Ana
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />20 Civic Center Plaza (M-30)
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />P.O. Box 1988
<br />Santa Ana CA 92702-1988
<br />AUTHORIZED REPRESENTATIVE
<br />z Y
<br />USA
<br />©1988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />
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