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Client#: 1258495 304COMPUMGM
<br /> ACORDTM CERTIFICr _ . E OF LIABILITY INSURAniCE DATE(MM/DDIVYVY)
<br /> 2/20/2012
<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 THEAyS•1SUING INSURER(S),AUTHORIZED
<br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. . .;. , ?• `,c�'
<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 n;thls certificate does not confer rights to the
<br /> certificate holder in lieu of such endorsement(s). R-'
<br /> PRODUCER CONTACT t,:,
<br /> NAME:
<br /> BB&T Insurance Services Ext):949 833-2462 FAAX,No); 8772971094
<br /> C
<br /> of Orange County ADDRESS: msuarez-zarate@bbandt.com
<br /> 19100 Von Karman Ave. Ste 900
<br /> Irvine, CA 92612 INSURER(S)AFFORDING COVERAGE NAILft
<br /> INSURER A:OneBeacon America Insurance Corn 20621
<br /> INSURED INSURER B;OneBeacon Insurance Company 21970
<br /> Compulink Mgmt Center Inc
<br /> INSURER C
<br /> dba Laserfiche
<br /> INSURER D
<br /> 3545 N. Long Beach Blvd.#110
<br /> Long Beach, CA 90807 INSURERS:
<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 ADDLSUBR POLICY EFF POLICY EXP
<br /> LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYYY) (MMIDD/YYYY) LIMITS
<br /> A GENERAL LIABILITY 7110103310005 02/13/2012 02/13/2013 EACH q�OEECTCTppURRENCE $1,000,000
<br /> X COMMERCIAL GENERAL LIABILITY PREMISES/EaocwrrDence) $1,000,000
<br /> CLAIMS-MADE X OCCUR MED EXP(Any one person) $10,000
<br /> PERSONAL&ADV INJURY $1,000,000
<br /> GENERAL AGGREGATE $2,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $2,000,000
<br /> 'POLICY PRO-JECT LOC
<br /> A AUTOMOBILE LIABILITY 7110103310005 02/13/2012 02/13/2013 COMBINED SINGLE LIMIT
<br /> (Ea accident) _.x1,000,000
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> _ AUTOS AUTOS
<br /> X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE
<br /> AUTOS (Per accident)
<br /> A
<br /> x UMBRELLALIAB X OCCUR 7110103310005 02/13/2012 02/13/2013 EACH OCCURRENCE $20,000,000
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $20,000,000
<br /> DED RETENTION$
<br /> B WORKERS COMPENSATION 406020072006 01/01/2012 01/01/2013 X IWORvLIMITS °BH
<br /> AND EMPLOYERS'LIABILITY Y/N T - _
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000
<br /> OFFICER/MEMBER EXCLUDED? N NIA
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $100,000
<br /> If yes,describe under
<br /> ____ DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
<br /> A Professional Liab 71101033100005 02/13/2012 02/13/2013 Limit$5,000,000
<br /> Ded $25,000
<br /> Retro Date: 02-13-2004
<br /> DESCRIPTION OF OPERATIONS!LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required)
<br /> **Supplemental Name**
<br /> First Supplemental Name applies to all policies-Compulink Management Center Inc dba Laserfiche
<br /> Policy#711010331005 - :Accu-flex, Inc A.k PRU V IA) AS '10 FORM
<br /> Policy#711010331005- : Laserfiche 401k Plan r/
<br /> Policy#711010331005- : Compulink International / �,9 ,�.
<br /> (See Attached Descriptions) `uta Stitt Shee Y
<br /> i
<br /> CERTIFICATE HOLDER CANCELLATION Asaista n, City Attorney
<br /> City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Attn: Bruce Fruchter ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 24 Civic Center Plaza M-42
<br /> Santa Ana, CA 92702 AUTHORIZED REPRESENTATIVES
<br /> 4dlrj ted &Lft,d
<br /> ©1988-2010 ACORD CORPORATION.All rights reserved.
<br /> ACORD 25(2010/05) 1 of 2 The ACORD name and logo are registered marks of ACORD
<br /> #S8208620/M8206308 MASUA
<br />
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