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4 <br />1I --?-5-I- r__' <br />A� CERTIFICATE OF LIABILITY INSURANCE R045 <br />DATE (MM/DD/YYYY) <br />09-03-2010 <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 SUBROGATIONIS 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 <br />EMPLOYEEMATTERS INS/XACTPAY WEB <br />250776 P:(877)287-1316 F:(888)443-6112 <br />PO BOX 33015 <br />SAN ANTONIO TX 78265 <br />CONTACT <br />NAME: <br />PHONE FAX <br />(877)287-1316 (A/c,N°): (888)443-6112 <br />EMAIL°'ExU: <br />ADDRESS: n <br />PRODUCER <br />CUSTOMER ID It, � <br />INSURER(S) AFFORDING COVERAGE .,y..., MAIC # <br />INSURED <br />INSURERA: Hartford ITIS CO Of thZ"•Ii'idw <br />INSURER B <br />REDLANDS SOFTWARE INC. <br />2656 REDLANDS DR <br />INSURER C <br />INSURERD: 55r. <br />COSTA MESA CA 92627 <br />INSURER E : "y; a• <br />.. .� <br />___�;;; <br />INSURER F <br />COVERAGES CERTIFICATE NUMBER: RFVISION NUMRFR--Ir. = <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE R T OLICY 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 />INTR <br />TYPE OF INSURANCE <br />INSR <br />WVD <br />POLICY NUMBER <br />POtlCY EFF <br />/MM/DO/YYYY) <br />POLICY EXP <br />(MM/DD/YYYYI <br />LIMITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE $ <br />COMMERCIAL GENERAL LIABILITY <br />DAMAGE N <br />PREMISES IEa occurrence! 1 $ <br />MED EXP (Any one person) $ <br />CLAIMS -MADE F7 OCCUR <br />PERSONAL & ADV INJURY $ <br />GENERAL AGGREGATE $ <br />GENT AGGREGATE LIMIT APPLIES PER: <br />POLICY D PRO [::] LOC <br />PRODUCTS - COMP/OP AGG $ <br />Vi <br />$ <br />AUTOMOBILE <br />LIABILITY <br />ks <br />� 1 <br />COMBINED SINGLE LIMIT $ <br />(Ea accident) <br />ANY AUTO <br />ALL OWNED AUTOS <br />� <br />p T3pR. V <br />/5 <br />BODILY INJURY (Per person) $ <br />BODILY INJURY (Per accident) $ <br />SCHEDULED AUTOS <br />HIRED AUTOS <br />iTt `�LiCt <br />�7ne T�,y <br />PROPERTY DAMAGE <br />(Per accident) $ <br />$ <br />NON -OWNED AUTOSi. <br />;_�tl' <br />%�.SSlSt23e <br />$ <br />UMBRELLA L/AB <br />OCCUR <br />EACH OCCURRENCE $ <br />EXCESS UAB <br />CLAIMS -MADE! <br />AGGREGATE $ <br />DEDUCTIBLE <br />$ <br />g <br />RETENTION $ <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS'LIABILITY Y / N <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBEREXCLUDED? <br />/Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />N/A <br />76 WEG LP1504 <br />08/03/2010 <br />08/03/2011' <br />WC STATU- OTH- <br />X TORY LIMITSI ER <br />E.L. EACH ACCIDENT $ 1, 000, OOO <br />E.L. DISEASE EA EMPLOYE S 1,000,000 <br />E.L. DISEASE - POLICY LIMIT S 1 , 0 0 0 , 0 0 0 <br />DESCRIPTION OF OPERA TIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Addkiona/ Remarks Schedule, it more space is required) <br />circ I IFICA I E HOLDEN CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br />The City Of Santa Ana BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE <br />Public Works Agency{{yy DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. <br />JANTA ANA, CA 92701 0 CIVIC CENTER PLZ # M21 AUTHORIZED REPRESENTATIVE v <br />7A -z- 7a_a4_�_� <br />ID 1988-2009 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD <br />