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<br />AG ORO' CERTIFICATE OF LIABILITY INSURANCE
<br />✓"
<br />DATE (MMIDDNWV)
<br />0912712018
<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 pollcy(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 suchp endorsement(s).
<br />PRODUCER LICense # OL48969
<br />NA FACT
<br />PHONE 619 233-8000 AIC, N.):(619)864-7106
<br />(AIC, No, Eat): ( )
<br />C3 Risk & Insurance Services
<br />404 Camino Del Rio S. STE 410
<br />San Diego, CA 92108
<br />ADOaEEE, policy@c3insurance.com
<br />INSURERS AFFORDING COVERAGE NAICk
<br />INSURERA: Hanover Insurance Company 22292
<br />INSURED
<br />INSURERB:Agmerica Financial Benefit Insurance Company 41840
<br />INSURER C: Underwriters at Lloyds of London 15792
<br />NBS Government Finance Group
<br />INSURER D:
<br />32605 Temecula Parkway, Suite 100
<br />Temecula, CA 92592
<br />INSURER E
<br />INSURER F:
<br />09/2412018
<br />rn%/FRAnF;A rFRTWICATF NI)MRPR• RFVIRION NIIMRFRu
<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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAYBE 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 />TYPE OF INSURANCE
<br />ADDL
<br />SUBR
<br />POLICY NUMBER
<br />POLICY EFF
<br />MMIOD/YYW
<br />POLICY EXP
<br />MMIDDIP/W
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE 2,000,000
<br />CLAIMS -MADE OCCUR
<br />X
<br />X
<br />OH3A43196305
<br />09/2412018
<br />09/24/2019
<br />DAMAGE TO RENTED
<br />EBEM15E5 (EP $ 2'000,000
<br />MED EXP (Any oneperson) $ 10,000
<br />PERSONAL &ADV INJURY $ 2'000'000
<br />AGGREGATE LIMIT APPLIES PER
<br />POLICY F] nRa [_] LOC
<br />GENERAL AGGREGATE $ 4,000'000
<br />GEN'L
<br />X
<br />PRODUCTS-COMPIOPAGG $ 4,000'000
<br />OTHER:
<br />B
<br />AUTOMOBILE LIABILITY
<br />(CEeaBc:EEDtSINGLE LIMIT $ 1,000,000
<br />aODILY INJURY Per erson $
<br />X_ ANY AUTO
<br />X
<br />X
<br />AW3A42745805
<br />09/24/2018
<br />0912412019
<br />BODILYBgODILY INJURY Per accident $
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />PA,)"I My AMAGE $ --
<br />A67D ONLY ACTNO ONL�
<br />A
<br />X UMBRELLA LIAB
<br />X
<br />OCCUR
<br />EACH OCCURRENCE $ 1,000,000
<br />AGGREGATE $ 1,000'000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />OH3A43196305
<br />09/24/2018
<br />09/24/2019
<br />DED RETENTION $
<br />$
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILIry
<br />ANYPROPEMBEREXCLUDED? CUTIVE YIN
<br />OFFICERIMEMBER EXCLUDED?
<br />(Mandatory in NH)
<br />NIA
<br />X
<br />WH3A427457
<br />09/24/2018
<br />09/24/2019
<br />XSTATUTE ERH
<br />E.L. EACH ACCIDENT 1,000,000
<br />E.L. DISEASE -EA EMPLOYE $ 1,000,000
<br />E.L. DISEASE -POLICY LIMIT $ 1,000,000
<br />ryes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />C
<br />E&O/Professional Lia
<br />TPLOODOO5601
<br />09/24/2018
<br />09/2412019
<br />Ea. Claim/Aggregate 2,000,000
<br />C
<br />E&O/Professional Lia
<br />TPL000005601
<br />09/24/2018
<br />09/24/2019
<br />Retention 20,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more apace is required)
<br />City of Santa Ana, its officers, employees, agents, volunteers and representatives are named additional insured regarding General Liability.
<br />Blanketforms apply when required by written contract:
<br />GENERAL LIABILITY:
<br />Additional Insured -Special Broadening Endt: 391.10060816
<br />Additional Insured -Completed Operations: 391.1602 0816
<br />Primary & Non -Contributory: 391.1003 08 16
<br />Waiver of Subrogation: 391-1003 08 16
<br />SEE ATTACHED ACORD 101
<br />r PPTICIr ATP Lint nPD r.ANrPI I ATInN
<br />ACORD 25 (2016103) ©1988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
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<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />Cit of Santa Ana
<br />Y
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza (M-30)
<br />P.O. Box 1988
<br />AUTHORIZED REPRESENTATIVE
<br />Santa 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
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