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A -,20W -073
<br />ACOREP' CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MM/DD/YYYY)
<br />03/17/2011
<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 SUBROGATION IS 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 Phone: (626) 300-9000 Fax: (626) 570 -0908
<br />NEW CENTURY INS SERVICES, INC.
<br />16 N. 2ND ST.
<br />ALHAMBRA CA 91801
<br />CONTACT NEW CENTURY INS SERVICES, INC.
<br />NAME:
<br />HO "N Exl (626) 300 -9000 a Na: (626) 570 -0908
<br />E-MAIL info @usnci.com
<br />ADDRESS:
<br />PRODUCER 15724
<br />C STOMER ID:
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC #
<br />Agency Lic #: OB07085
<br />INSURED
<br />INC.
<br />341
<br />341 BONNIE CIRCLE, SUITE 101A & 102
<br />INSURERA : GOLD EN EAGLE INSURANCE CORP
<br />INSURERS NATIONAL UNION FIRE INS COMPANY
<br />$ 500,000
<br />INSURER ZURICH INSURANCE COMPANY
<br />$ 10,000
<br />CORONA, CA 92880
<br />INSURER D:
<br />INSURER E
<br />INSURER F
<br />$ 1,000,000
<br />COVERAGES CERTIFICATE NUMBER: 87383 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 ALLTHE TERMS,
<br />FXCLUS IONS AND CONDITIONS OF SUCH PC)LlrlFq LIMITc;;HC)WNMA
<br />HAVE SEEN RFni ICED BY PAID CLAIMS
<br />INSR TYPE OF INSURANCE ADD'L SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS
<br />LTR INSR WVD M DD YYY M DD YYV
<br />A
<br />GENERAL LIABILITY
<br />CBP8283936
<br />05/31/11
<br />05/31/12
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />X COMMERCIAL GENERAL LIABILITY
<br />DAMAGE TO RENTED
<br />PREMISES Ea occurence
<br />$ 500,000
<br />MED. EXP (Any one person)
<br />$ 10,000
<br />CLAIMS -MADE I� OCCUR
<br />PERSONAL & ADV INJURY
<br />$ 1,000,000
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICY PRO LOC
<br />PRODUCTS - COMP /OP AGG
<br />$ 2,000,000
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />ANY AUTO
<br />BA2442759
<br />02/22/11
<br />02/22/12
<br />COMBINED SINGLE LIMIT
<br />(Ea accident)
<br />$ 1,000,000
<br />X
<br />—
<br />BODILY INJURY (Per person)
<br />$
<br />ALL OWNED AUTOS
<br />BODILY INJURY (Per accident)
<br />SCHEDULED AUTOS
<br />PROPERTY DAMAGE
<br />HIRED AUTOS
<br />(Per accident)
<br />$
<br />NON -OWNED AUTOS
<br />$
<br />B
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />EBU019838312
<br />11/04/10
<br />11/04/11
<br />EACH OCCURRENCE
<br />$ 4,000,000
<br />AGGREGATE
<br />$ 4,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DEDUCTIBLE
<br />$
<br />RETENTION $
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y / N
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICER/MEMBER EXCLUDED?
<br />p
<br />t2.
<br />NIA
<br />9i [3
<br />1 R
<br />40077411 \ C�; l i pS
<br />�j �/ g , ,71 g O> 1 V S\
<br />y02/06/11
<br />.1"
<br />02/(]6/12
<br />TORY LIMIT OTH
<br />x( TO ST ,T
<br />$
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L. DISEASE -EA EMPLOYEE
<br />$ 1,000,000
<br />(Mandatory In NH)
<br />If yes, describe under
<br />E.L_ DISEASE-POLICY LIMIT
<br />$ 1,000,000
<br />DESCRIPTION OF OPERATIONS below
<br />fl�;� �,: Stl . Sheedy
<br />__„
<br />T
<br />r , .� ttorrii
<br />DESCRIPTION OF OPERATIONS! LOCATIONS! VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
<br />THE CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS, VOLUNTEERS AND REPRESENTATIVES ARE NAMED AS ADDITIONAL
<br />INSURED - VENDOR PER POLICY FORM NUMBER: GECG602 09 -02. THIS CERTIFICATE IS VALID ONLY IF THE CERTIFICATE HOLDER REQUIRES IN
<br />WRITTEN CONTRACT TO BE NAMED AS ADDITIONAL INSURED. THIS POLICY IS PRIMARY & NON - CONTRIBUTORY. 10 DAYS NOTICE OF
<br />l 0113 ICI-rT LIAI A _ _ _ _ _ _- _ _ _
<br />v-I lrl MIC r1VLIJI=n
<br />CANCELLATION
<br />The City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />Parks, Recreation and Community Services Agency THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />26 Civic Center Plaza ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE
<br />Attention: Silvia Cuevas *?--
<br />-ORD 25 (2009/09) c 1988 -2009 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and l000 are reaistered marks of ACORD
<br />
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