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't �® CERTIFICATE OF LIABILITY INSURANCE <br />1 2/27/2018rr <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 be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />Carl OT <br />NAMEGinger Pioli <br />edreda (425)740-5200 FAX F, 0I <br />Degginger McIntosh and Associates <br />3999 Harbour Pointe Blvd SW N-2018-037 <br />> DRE - gingerQOMAinsurance.com <br />wsu RERs AFFORDING COVERAGE MAICA <br />LIMITS <br />INsu RERA:HiSCOX Inc. V19704 <br />Mukilteo WA 98275 <br />INSURED <br />wsu RERB:American Fire and Casualty Co. <br />INSURER CEvanston Insurance Company <br />Ergometrics & Applied Personnel Research, Inc. <br />wsuRERD. <br />National Testing Network, Inc. <br />wsu RERE <br />18720 33rd Ave W STE 200 <br />1 INSURER F: <br />Lynnwood WA 98037 <br />COVERAGES CERTIFICATE NUMBER:17/16 GL BA SG CMB PRO 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 <br />OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO <br />WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE <br />TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE <br />BEEN REDUCED BY PAID CLAIMS. <br />INIRR <br />TYPE OF I NSO RANCE <br />[pl <br />POLICY ND FIBER <br />POLICY IBD,FF <br />(MMIn �Y"XIP <br />LIMITS <br />A <br />GENERAL LIABILITY <br />PL1884842.17 <br />18/2]/281] <br />8/27/2818 <br />EACHOCCURRENCE $ <br />1,000,000 <br />n $ <br />MET EXE An on ew,$ <br />50,000 <br />5,000 <br />jXMMENCIAL GENERAL LIABILITYa <br />CLAIMS -MOUE OOCCUR <br />X <br />PERSONAL&ATV INJURY $ <br />1,000,000 <br />GENERAL AGGREGATE $ <br />2,000,000 <br />GENLAGGREGATELI <br />MITAWLIE&PER: <br />PRODUCTS-MMPOPA66 $ <br />2,000,000 <br />7X POLICY <br />Po LOC <br />PEST <br />$ <br />B <br />AUTOMOBILE <br />LIABILITY <br />a.8229925 <br />8/2]/281] <br />8/27/2818 <br />CUB PI,E01ING LELI A T <br />11000,000 <br />BODILY INJURI penin) $ <br />AUTO <br />HXANY <br />ALL OWNED SCHEDULED <br />AUTOSHIREDALROS <br />BODY INIURY(LX:acden8$A1R05 <br />X NOTOSWNEO <br />ROPERTY MA E $ <br />C <br />MBRELLA LIAB <br />X <br />OCCUR <br />W]36981] OB <br />8/2]/281] <br />8/27/2818 <br />EACH OCCURRENCE $ <br />2,000,000 <br />AGGREGATE $ <br />2,000,000 <br />EXCESS LIAB <br />CLAIMS -MODE <br />OED I X I RETENTIONS 18.888 <br />$ <br />A <br />X900(INEXX xx <br />PL1884842.17 <br />8/2]/281] <br />18/27/281e <br />we sTATu- �. DTH <br />XoREEMPLOYERS' LIABILITY YIN <br />ANY PRSERIETOWPARTNETEXECUTIVE❑ <br />A STOP GAP <br />EL EACH ACCIDENT $ <br />1 000 000 <br />OFFICERrMEMeER EXCLUDED? <br />NIA <br />(MaMamom NH) <br />E1. DISEASE -EA EMPLOYE $ <br />1,000,000 <br />lyes tleun0e under <br />DE SORPTION OF OPERATIONS Eebw <br />EL. DOEASE-PoLICY LIMIT $ <br />1 000,000 <br />A <br />PROPESSIONAL LIABILITY <br />PL1004042.1] <br />0/2]/201] <br />0/27/2018 <br />EACH OCCURRENCE <br />$2,000,000 <br />DEDUCTIBLE: $5,000 <br />AGGREGATE <br />$3,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES NUMIM1ACORD 181, Addlum al Remarks Rmetlule.lf mme s1- la re'enedi <br />City of Santa Ana its officers, employees, agents <br />and representatives are included as Additional <br />Insured <br />per attached form MLP0002 CW(1014) with respect to <br />any and all operations of the Named Insured. <br />Coverage <br />s Primary/Non-Contributory per same form. Notice <br />of Cancellation, Non -Renewal and Material Change <br />on <br />General Liability and Professional Liability applies <br />per attached Endorsement WCLE6047C1V(O5/13). <br />All <br />endorsements apply per required Written Contract. <br />RE: NTN Testing Services <br />ren <br />U <br />CERTIFICATE HOLDER <br />CANCELLATION <br />( 714) 647-6956 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCf LED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />City of Santa Ana <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Clerk of the City Council <br />Civic Center Plaza (M-30) <br />AurnoRlzeO REPRESENTATIVE <br />PO Box 1988 <br />Santa Ana, CA 92702-1988 <br />_ <br />Ken McIntosh/OGDON <br />ACORD 25 (2010105) 91988-2010ACORD CORPORATION. All rights Demanded. <br />INS025(mlws)0l The ACORD name and logo are registered marks of ACORD <br />