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,d► °� R°� CERTIFICATE OF LIABILITY INSURANCE °ATE,YM/DD/WVY) <br />06/34/3011 <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 INSU RER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: H the certificate holder Is en ADDITIONAL INSURED, the pollcy(lee) must be endorsed. IT SUBROGATION IS WAIVED, eubJect to <br />the terms antl eondltlona of the INSllcy, eertaln polic lee may raqulre en endoraamant. A atatamsnt on this esrtlflcate does not confer rlghts to the <br />ceRi }ICats holder In Ilau of such endorsament(s). <br />PRODUCER 1 -TTO -553 -423$ <br />Grayling Znauranee Brokerage <br />MONTA S.rry NOy01. <br />-- <br />vNONE 990- 552 -4225 � Ne 566- 550 -4083 <br />450 Nerthridga Parkway <br />suit. 102 <br />� <br />qp qlE jerry.noyol.egreylinq.00m <br />____ - <br />INEURERI6)AFF_OggNO COVERAGE <br />-- <br />MAIL. <br />ACS nnti. AA 303$0 <br />INSURER A: Co�eice 4 SaduECiy Inauranc. Cempeny <br />NaCisE OrmEZE <br />X <br />INSVREp <br />TRC Selutiea.. In<. <br />INSURER e; Charcie Hy.01E11Cy Ineui.nce C ®Reny <br />MSURERC: 11rin City Fira Inaur.nc. Company <br />INSURER O: <br />1]3 TaclVaology Dri V. <br />IN6URER E: - <br />ZZV1ne. G 92619 <br />INSURER F' <br />CLAIMS -MADE OOCCVq <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAV BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO /ILL THE TERMS. <br />EXCLUSIONS AND CONDITIONS OF SUGH POLIOIEH. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSq TYPE OF INSURANCE - AO - - POLKY EFF POl V EXP <br />POLICY MVYBER M LYrtE <br />A <br />GENERAL <br />LIABILRY <br />20 Civic Cantor Plaice - Roaa ]Lnnaz (M -3 fi) <br />I <br />OL 7169 709 <br />OT /O1 /1 <br />07/01/12 <br />Ep,CN OCCURRENCE <br />51.000,000 <br />X <br />COMMERCIAL GENERAL LIABILITY <br />PR MI e � TEo <br />S 500.000 <br />MED EXP (My me Parewl) <br />CLAIMS -MADE OOCCVq <br />53,000 <br />PER60NALAgDV INIU0.Y <br />5 1, 000.000 <br />_ _ __ <br />GENERAL AGGREGATE_ <br />-. <br />2.000,000 <br />GENT AGGREGATE LIMIT MPLIES PEfY <br />_ <br />pgODUCTS. COMP /OP AGG <br />_S <br />2.000,000 <br />POLICY X pR0- Y LOC <br />_S <br />f - <br />A <br />A <br />AVTOYOBILE <br />X <br />LIABILnY <br />qqY AUrO <br />G T16H lSA <br />G T36686fi A/O <br />OT /01/1 <br />O'l /01/13 <br />C INFO 1 L LIMIT <br />1, 000, 000 <br />BODILY INJURY(Pr pweo,) <br />S <br />AIL OWNED SCMEDVLED <br />AVTO9 AUTO$ <br />BODILY INJURY Pw e¢IJwllj <br />( <br />S <br />X <br />gIRED AUTQ, X NONO WNED <br />gDTpq <br />PRDPERTY DAMAGE <br />5 <br />i <br />H <br />Y <br />uYERELLA LYa <br />X <br />OCCUR <br />III® 9168930 <br />OT/01/1 <br />09/01/12 <br />EACH OCCURRENCE <br />S 10,000,000 <br />AOOREMTE <br />S lO, OD0. 000 <br />EXCESS LIAR <br />__ <br />CLnIM9 -MADE <br />OED X RETENTION 10,000 <br />S <br />L. <br />C <br />YrORNERE COMPENSATION <br />♦ND EMPLOYERS' LIABILITY <br />qNY PROPRIETOR /PARTNER /FJ(ECUTIVE Y/N <br />OFFICER/MEMBER EXCLUDEOI YO <br />N/A <br />20 NN N➢5434 A/O <br />20 NBA N$3433 III <br />O T / O 1/ 1 <br />OT /01/1 <br />OT /01/13 <br />0T /01/12 <br />X WC STATU- OTN- <br />E.L FACN ACCIDENT <br />S 1,000,000 <br />E.L. DI9EPBE -EA EMPLOYE <br />5- 1.000.000 <br />- - <br />S 1, 000, 000 <br />IMAraeb.r In MN) <br />If yes tlsvl4e u,me� <br />DE6CRIPTION OF OPERATIONS bslav <br />— <br />E -l. 019EI,SE - POLICY LIMIT <br />H <br />Prefaaaienal Liability <br />399a355 <br />OT /01/1 <br />OT /01/12 <br />Par Claim 10,000,000 <br />B40- In <luding ➢ellutivn Liab. <br />Aggregate 15,000,000 <br />DEECRIPTNJN OR OPERATONE / LOCATgNE / VENKLEE (AR �, ACORO 101. AOJIIbnN RwneNle Eel,eaub. N mnie epACe IF w9uNay) <br />Tha City of Hants ]Lna. 30 Civic Cantor Plana. Hants Ana G 93901, Sta off icara, ampleyaaa, agBnta, Voluntaara e <br />rayraaencativa• amed ae Addicienai Zaaurada under the Oenaral Liability i Aucemebile Liability wham required by <br />written <entractarihia insurance Sa yrimazy a aen- eencributory ov any ailalting Sneursa <• i i• limited to liability <br />rising cut of the operations eE the Hamad Insured 6 wham regulred by written contract. paivar of Hubrogation is <br />apyl icahle where required by wri cca,w } =E+yi <br />t�SctA�a3iS�ra <br />APpK <br />-1�- 5.:1.( Shce Y <br />� - - - - - -- - - -� <br />Laura <br />CIW 'Ylh Tir -�- <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE GNCELLED BEFORE <br />City of 6ants Ana /���(+(()p( <br />THE EXPIRATION GATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WRH THE POLICY PROVISIONS. <br />20 Civic Cantor Plaice - Roaa ]Lnnaz (M -3 fi) <br />AVTNORIZED gEPRESENTATVE <br />Santa Ana. G 93701 <br />/_ <br />/ /��.1 -'F� <br />D9A <br />® 7986 -2070 ACORD CORPORATION. All rlghts <br />ACORD 25 (2010/05) Tha ACORD name and logo era replete red marks of ACORD <br />JNOyela <br />21930015 <br />