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A� °® CERTIFICATE OF LIABILITY INSURANCE <br />6/12/2013vv) <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 <br />POms 6 Associates Insurance Brokers, Inc. <br />CA License #0814733 <br />5700 Canoga Ave. #400 <br />Woodland Hills CA 91367 <br />CONTACT Wend y Delgado <br />NAME: g <br />PHONE (800) 578 -8802 FAXN (518)449 -9321 Ed, <br />AMAIL .wdelgado @pomsassoc. coal <br />INSURERS AFFORDING COVERAGE <br />NAIC It <br />INSURER A:FiremanIs Fund Insurance Co. <br />21873 <br />INSURED <br />MCCUNE S HARBER, LLP. <br />515 S Figueroa St <br />Los Angeles CA 90071 <br />INSURER BAmerlcan Casualty Co. of <br />20427 <br />INSURERCAXis Ins SSC <br />Wendy Delgado /WENDYD C,/1=t' <br />INSURER D: <br />INSURER E: <br />$ 2,000,000 <br />INSURER F: <br />X COMMERCIAL GENERAL LIABILITY <br />COVERAGES CERTIFICATE NUMBER:CL1342417423 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 ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />The City of Santa Ana <br />POLICY NUMBER <br />MWDDYryYYY <br />POLICY IYYYPY <br />LIMITS <br />AUTHORIZED REPRESENTATIVE <br />GENERAL LIABILITY <br />Santa Ana, CA 92701 <br />Wendy Delgado /WENDYD C,/1=t' <br />EACH OCCURRENCE <br />$ 2,000,000 <br />X COMMERCIAL GENERAL LIABILITY <br />DAMAGE T EN <br />PREMISES Ea occurrence <br />$ 100,000 <br />MED EXP(Any one person) <br />$ 10,000 <br />A <br />CLAIMS -MADE OCCUR <br />P4ZCB0826766 <br />4/18/2013 <br />4/18/2014 <br />PERSONAL B ADV INJURY <br />IS 2,000,000 <br />GENERAL AGGREGATE <br />$ 4,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER <br />PRODUCTS - COMPIOP AGO <br />$ 4,000,000 <br />$ <br />X POLICY PRO LOG <br />AUTOMOBILE LIABILITY <br />COMBINED SINGLE LIMIT <br />E ommi <br />2,000,000 <br />BODILY INJURY (Per person) <br />$ <br />A <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS ALT <br />X HIRED AUTOS X ANOT -0WNED <br />FLZC80826766 <br />4/18/2013 <br />4/18/2014 <br />BODILY INJURY (Per accident) <br />$ <br />PPReOPPER ^DAMAGE <br />$ <br />UMBRELLA LIAR <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />EXCESS LIAR <br />CLAIMS -MADE <br />DED I I RETENTION <br />$ <br />B <br />WORKERS COMPENSATION <br />X WC STATU- OTH- <br />AND EMPLOYERS' LIABILITY <br />ANY PROPRIETOR/PARTNEfoEXECUTIVE YIN <br />E.L EACH ACCIDENT <br />$ 1,000,000 <br />OFFICERIMEMBER EXCLUDED? <br />(Mandatory in NH) <br />NIA <br />034634058 <br />/15/2013 <br />/15/2014 <br />E.L. DISEASE - EA EMPLOYEE <br />1,000,000 <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT <br />1 $ 1,000,000 <br />C <br />Professional Liability <br />IffN753046012013 <br />/4/2013 <br />6/4/2014 <br />Limit $1,000,000 <br />Retention $25,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is re ulred <br />Evidence of Insurance Only. PPROi�RD FORM <br />Laura A. Rossini <br />Assistant City Attorney <br />CERTIFICATE HOLDER CANCELLATION <br />ACORD 25 (2010/05) <br />INS025 nm nns m <br />©1988 -2010 ACORD CORPORATION. All rights reserved. <br />Tho ArnPn nnmo enA Innn aro raniaterarl mmr4c of ArnOn <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />The City of Santa Ana <br />City Attorney's Office <br />20 Civic Center Plaza <br />AUTHORIZED REPRESENTATIVE <br />Mail Stop M -29 <br />Santa Ana, CA 92701 <br />Wendy Delgado /WENDYD C,/1=t' <br />ACORD 25 (2010/05) <br />INS025 nm nns m <br />©1988 -2010 ACORD CORPORATION. All rights reserved. <br />Tho ArnPn nnmo enA Innn aro raniaterarl mmr4c of ArnOn <br />