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A06(1- Isti ,a►k--- v® CERTIFICATE OF LIABILITY INSURANCE ,�5i2011 w' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Tri Ht1 ICusal NAME: C. M. Meiers Company, Inc. PNONE (818)224-6100 FAx A/C No:(Ole)224-6099 21045 Califs St. #100 pOMA1L TGr@@n@®ID@i@re. Com PRODUCER 00027846 INSURER(S) AFFORDING COVERAGE NAIC0 Woodland Hi11B CA 93.367 INSURED INSURERA.Hart£orC1 Casualty Insurance Co INSURER B$artPOrCl Fir@ Insurance Co. A LaSalle Ma rvin, Ina. INSURERC:U.S. SpeClalty Ing CO 2700 So. Grand Ava INSURER D: INSURER E /16/2012 Santa Ana CA 92705 INSURER F: COVERAGES CERTIFICATE NUMBER:CL116621047 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE POLICY NUMBER MPOLICY EFF INMVDUY/1'YYY I.JMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FX] OCCUR X 72SEANO6283 6/16/2011 /16/2012 DA PREMISES Ea ocunrence S 300,000 MED EXP (An)! ons rson) S 10,000 PERSONAL S ADV INJURY $ 1,000,000 GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG S 2,000,000 X POLICY PRO- LOC S B AUTOMOBILE LIABILITY J%� ANY AUTO ALL GVNJED AUTOS SCHEDULED AUTOS X HIRED AUTOS 72VECAN0364 APPROVED A 6/16/2011 TO F /16/2012 RM COMBINED SINGLE LIMIT (Ee —d—)S 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Par—dent) S PROPERTY DAMAGE S (Per accidenq X NON -OWNED AUTOS ' Odve other rar S Uninsured M—risl combined S 1,000,000 X I UMBRELLA LIAB X OCCUR `Aura CC Y EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMSMADE .A55tFia❑L Attorney AGGREGATE S 5,000,000 DEDUCTIBLE $ AX RETENTION S 10 000 723BiNU6283 6/16/2011 6/16/2012 S B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) Ir Yae dsarrbs VrWer DESCRIPTION OF OPERATIONS Iwlow N / A 72WECRg5643 6/16/2011 6/16/2012 X VOC STATU- 0TH - E.L. EACH ACCIDENT S 1,000,000 E.L. DISEASE - EA EMPLOYE S 1_000,000 E.L. DISEASE -POLICY LIMIT S 1 000 000 C Pro££osioraal Liability I I 331020500 6/16/2011 6/16/2012 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Addltlonal Remarks Schedule, M mare apace la —q..—I) City o£ Santa Ana is included Be Additional Snaured per t2— Buainesaa Lialbili ty Coverage form 330008 and a General Liability Waiver of Subrogation applies to the =B=uries a holder par loan 350008. rr-r-- r — ------ ----CLLR t I - mboot-ha@ Santa -ane. Org SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN City O£ Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Attn : Marilyn BOOtl1e AUTHORIZED REPRESENTATIVE 20 Civic Cantar Plaza (M-36) Santa Ana, CA 92702 ACORD 25 25 (2009/09) (D 1988-2009 ACORD CORPORATION. All rights reserved. I-- (too—) ow– -- — IOgu ar@ r@gl8i@r@O mars 0r -----