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ACORD CERTIFICATE OF LIABILITY Y INSURANCE DATE 0 PRODUCER (818) 224-6100 FAX: (818,1224-6099 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE r ATIFICATE C. M. Meiers Company, Incl. HOLDER. THIS CERTIFICATE DOES NOT AMEND, ":XTEND OR 21045 Califa St. #100 ALTER THE COVERAGE AFFORDED BY THE POLIC!'E�. BELOW. Woodland Hills CA 913.67 INSURERS AFFORDING COVERAGE NAIC S INSURED 7A — INSURERA:Hartford CasualtyAM BEST A+ XV LaBelle Marvin, Inc. ��-I�j��Z CC �� lINSURER B:Hartford Fire Insurance AM BEST A+ XV 2700 So. Grand Ave I� I - `' l INSURERCU. S. Specialty Ins. AM BEST A+ XIV INSURER D. Santa Ana CA 92705 INSURER E: 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. REG kTE LIMITS SHOWN AAY HAVE BE REDUCED BY PAD CLAIMS INSR ADD'L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE M DD1YYj POLICY EXPIRATION DATE MWDDIYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE ( RENTS❑ 300, 000 PREMISE RENT rtence)$ A X X COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR 72SBANU6283 6/16/2010 6/16/2011 MED EXP (Any oneperson) $ 10,000 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENL AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMPIOP AGG $ 2,000,000 X POLICY 7 JERCOT LOC AUTOMOBILE X LIABILITY ANYAUTO COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ B X ALL O+ANED AUTOS SCHEDULEDAUTOS 72UECAH0364 6/16/2010 6/16/2011 BODILY INJURY (Per accident) $ X X HIRED AUTOS NON-0WNEDAUTOS PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY � AUTO ONLY - EA ACCIDENT $ OTHER THAN EAACQ $ AUTO ONLY: q G $ ANYAUT0 ^�O UV J Y 1� A X EXCESS/UMBRELLA UABIUTY -X1 OCCUR CLAIMS MADE0 DEDUCTIBLE ul3 72SBANU628 �1SL'dDL C,L Ay 6/16/2010 6/16/2011 OCCURRENCE $ 5,000,000 AGGRE A $ 5,000,000 $ $ $ X RETENTION 10 000 B WORKERS COMPENSATION AND TNOYSTAT - 1H - EMPLOYERS LIABILITY E.L. EACH ACCIDENT $ 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. DISEASE - EA EMPLOYEE $ 1,000,000 OFFICEWMEMBER EXCLUDED? If yes, describe under 72WECRQ5643 6/16/2010 6/16/2011 E.L. DISEASE - POLICY UMIT $ 1,000,000 SPECIAL PROVISIONS below C OTHER Professional USS1020500 6/16/2010 6/16/2011 1,000,000 Liability DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCWSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS City of Santa Ana is named as Additional Insured per the Busineass Liability Coverage form SS0008 and a General Liability Waiver of Subrogation applies to the certificate holder per form SS0008. CERTIFICA jalvarado@sana-ana.org City of Santa Ana Public Works Agency M-36 Judy Alvarado Post Office Box 1988 Santa Ana, CA 92702 ACORD 25 (2001108) I NCMF ,n1 ne, no.. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE AUTHORIZED REPRESENTATIVE {erbert Rothman/TRISH�'�,.r., �_.. a ACORD CORPORATION 1988 Pone 1 n11