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<br />DATE (MM/DD/YYYY)
<br />CERTIFICATE OF LIABILITY INSURANCE
<br />11/01/2017
<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(ies) 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 />CONTACT
<br />PRODUCER
<br />NAME:
<br />Willis of Texas, Inc.
<br />FAX
<br />PHONE
<br />1-888-467-2378
<br />1-877-945-7378
<br />(A/C, No):
<br />(A/C, No, Ext):
<br />c/o 26 Century Blvd
<br />E-MAIL
<br />certificates@willis.com
<br />ADDRESS:
<br />P.O. Box 305191
<br />Nashville, TN 372305191 USA
<br />INSURER(S) AFFORDING COVERAGENAIC #
<br />20303
<br />Great Northern Insurance Company
<br />INSURER A :
<br />20281
<br />Federal Insurance Company
<br />INSURED
<br />INSURER B :
<br />Ventiv Technology, Inc.
<br />Chubb Indemnity Insurance Company
<br />12777
<br />INSURER C :
<br />227 W. Monroe Street
<br />Continental Casualty Company
<br />20443
<br />Suite 2000, 20th Floor
<br />INSURER D :
<br />Chicago, IL 60606
<br />Illinois Union Insurance Company27960
<br />INSURER E :
<br />INSURER F :
<br />W4243079
<br />COVERAGESCERTIFICATE NUMBER:REVISION NUMBER:
<br />ADDLSUBRPOLICY EFFPOLICY EXP
<br />INSR
<br />TYPE OF INSURANCELIMITS
<br />POLICY NUMBER
<br />(MM/DD/YYYY)(MM/DD/YYYY)
<br />LTR
<br />INSDWVD
<br />COMMERCIAL GENERAL LIABILITY 1,000,000
<br />1,000,000
<br />10,000
<br />A
<br />YY
<br />3603359205/11/201705/11/2018
<br />1,000,000
<br />2,000,000
<br />1,000,000
<br />1,000,000
<br />AUTOMOBILE LIABILITY
<br />A
<br />7359388505/11/201705/11/2018
<br />10,000,000
<br />UMBRELLA LIAB
<br />B
<br />7989590605/11/201705/11/2018
<br />10,000,000
<br />EXCESS LIAB
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />Y / N
<br />1,000,000
<br />C
<br />No
<br />N / A
<br />7175494605/11/201705/11/2018
<br />1,000,000
<br />(Mandatory in NH)
<br />1,000,000
<br />DExcess Cyber E&O59669496305/11/201705/11/2018Limit:10,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />City of Santa Ana and its officers, employees, agents and volunteers are included as Additional Insureds in regards to
<br />their General Liability policy as required by written contract. A Waiver of Subrogation applies in favor of City of
<br />Santa Ana and its officers, employees, agents and volunteers with respect to the General Liability policy, as required
<br />by written contract.
<br />SEE ATTACHED
<br />CERTIFICATE HOLDERCANCELLATION
<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 />20 Civic Center Plaza, M-30
<br />Santa Ana, CA 92701
<br />© 1988-2015 ACORD CORPORATION. All rights reserved.
<br />ReviewedbyBrizaMorales
<br />ACORD 25 (2016/03)The ACORD name and logo are registered marks of ACORD
<br />11/01/2017
<br />15268145
<br />498201
<br />SR ID:
<br />BATCH:
<br />
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