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Ac®RbP CERTIFICATE OF LIABILITY INSURANCE <br />`---' <br />DATE(MM,°DV18 <br />11 /07/2018 <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 866-591-5050 866-791-2715 <br />R-T Workers Comp Specialty/ <br />CIA Insurance Services <br />500 S. Grand Avenue Suite 2100 <br />Los Angeles, CA 90017 <br />CONTACT Hal Reniff <br />PHONE 866-591-5050 "c No866-791-2715 <br />ADoal`es, hat oiainsuranceservice.com <br />INSURER(S) AFFORDING COVERAGE <br />NAIC# <br />INSURERA:Oak River Insurance Com an <br />INSURED 800-599-7385 <br />Card Integrators Corporation <br />3625 Serpentine Drive <br />Los Alamitos, CA 90720 <br />INSURERS: <br />NSURERC: <br />INSURER D: <br />INSURER E: <br />INSURER F : <br />COVERAGES CERTIFICATE NUMBER' 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 />TYPE OF INSURANCE <br />ADDLSUBR <br />POLICY NUMBER <br />POLICY EFF <br />MMIDDIYY <br />POLICY EXP <br />MMIDDNYYY <br />LIMITS <br />GENERAL LIABILITY <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE ❑ OCCUR <br />EACH OCCURRENCE <br />$ <br />DAMAGET RENTED <br />PREMISES Ea occurrence <br />$ <br />MED EXP (Any one person) <br />$ <br />PERSONAL d ADV INJURY <br />$ <br />GENERAL AGGREGATE <br />$ <br />GEN'L AGGREGATELIMIT APPLIES PER: <br />POLICY PE � LOC <br />PRODUCTS-COMP/OP ADS <br />$ <br />_ <br />$ <br />AUTOMOBILE <br />LIABILITY <br />ANYAUTO <br />ALL OWNED SCHEDULED <br />NON-OAUTOS AUTOS <br />HIRED AUTOS AUTOS <br />COMBINED SINGLE LIMIT <br />Ice accident <br />BODILY INJURY (Per person) <br />$ <br />BODILY INJURY Per accitlent <br />( ) <br />$ <br />PROPERTY DAMAGE <br />(Per <br />Per accident <br />$ <br />$ <br />UMBRELLA LIAB <br />EXCESS LIAB <br />OCCUR <br />CLAIMS -MADE <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />DED RETENTION$ <br />$ <br />A <br />WORKERS COMPENSATION <br />ANDEMPLOYERS'LIABILITV YIN <br />OFFICER/MEMBER EXCLUDED' ECUTIVE ❑ <br />(Mandatory in NH) <br />yes, describe under D <br />ESCRIPTION OF OPERATIONS below <br />NIA <br />✓ <br />CAWC716149 <br />12/20/2017 <br />12/20/2018ANY <br />WC STATLL OTH- <br />YLIMIT <br />E.L. EACH ACCIDENT <br />$1 OOO OOO <br />E.L. DISEASE - EA EMPLOYE <br />$1,Q00,000 <br />E.L. DISEASE -POLICY LIMIT <br />$1 QQQ QQQ <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) <br />d of Santa Ana - Police Dept <br />Civic Center Plaza <br />Tta Ana, CA 92701 <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 />1 <br />rnPPr1PATIr1M All A-h4e...­A <br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD <br />o9O�F'.POI/r=,c> �>�/�' fJz^�G�=G-'-/`1�w.� /��C (J�/7✓ '� � J' <br />