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LABEL -2 OP ID: 1
<br />CERTIFICATE OF LIABILITY INSURANCE 007123/20/ YYI
<br />0712312014
<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 HOLD
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURE , (e m;&.3fted. 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 MY A
<br />SAN�A ANA
<br />INSURED LaBelle Marvin, Inc INSURERS: Hartford Fire Ins. Co.
<br />2700 S. Grand Ave. INSURER C: Praetorian Insurance Com an 37257
<br />Santa Ana, CA 92705
<br />INSURER D: Admiral Insurance Company
<br />Q INSURER E:
<br />J INSURER F:
<br />COVFRAr FS CFRTIFICATF MIIMRFR-
<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 />INTR
<br />TYPE OFINSURANCE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />SUBR
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM
<br />POLICY E%P
<br />LIMITS
<br />A
<br />A
<br />GENERAL UABILITY
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE Fx] OCCUR
<br />X
<br />X
<br />72SBANU6283
<br />PRIMARYINON COJMIBUTORY
<br />1
<br />'�
<br />06/16/2014
<br />06/16/2015
<br />EACH OCCURRENCE $ 1,000,06
<br />PRM o nence $ 300,06
<br />MED UP (Any one arson $ 10,00
<br />PERSONAL B ADV INJURY $ 1,000,000.
<br />GENERALAGGREGATE E 2,000,0011
<br />GEN'L AGGREGATE
<br />POLICY X
<br />LIMITAPPLIES
<br />PRO-
<br />PER:
<br />LOC
<br />PRODUCTS - COMPIOP AGS S 2,000,0011
<br />$
<br />BI
<br />AUTOMOBILE
<br />X
<br />LIABILITY
<br />AUTO
<br />ALLOWNED X SCHEDULED
<br />AUTOS AUTOS
<br />HIRED AUTOS X NON -OWNED
<br />AUTOS
<br />72UECAH0364
<br />06/16/2014
<br />06/16/2015
<br />COMBINED SINGLE UMIT 1
<br />(Ea aWden ,060,60
<br />BODILY INJURY (P., Person) $
<br />BODILY INJURY (Per accidenD g
<br />PROPERTYDAMAGE $
<br />PER ACCIDENT)
<br />$
<br />A
<br />X
<br />UMBRELLA LIAR
<br />E%LESS LUIB
<br />X
<br />OCCUR
<br />CLAIMS -MADE
<br />72SBANU6283
<br />66/16/2614
<br />66116/2615
<br />EACH OCCURRENCE $ 5,000,00
<br />AGGREGATE $
<br />DED X RETENTION E 10,000
<br />$
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITYUITE
<br />ANY CERIMEETORlEXCLUDRIE%ECUTIVEY�
<br />OFFICERIMEMBER EXCLUDED'
<br />(Mantletory in NH)
<br />If yes, de to and r
<br />DESCRIPTION OF OPERATIONS W.
<br />NIA
<br />EQB0102132
<br />06/1612014
<br />06/16/2D15
<br />X WC STATU- OTH-
<br />E.L. EACH ACCIDENT $ 1,000,00
<br />E.L. DISEASE - EA EMPLOYEE $ 1,000,66
<br />E.L. DISEASE - POLICY LIMIT $ 1,000,00
<br />D
<br />Professional Liab
<br />Claims Made
<br />E00001984503
<br />RETRO DATE: 1/4/2000
<br />06/16/2014
<br />06/16/2015
<br />Per Claim 1,000,000
<br />Aggregate 1,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Aftach ACORD 101, Addlfional Remak. Schedule, if ... .,.e 1..,.i.d)
<br />:ity of Santa Ana,its officers, employees, agents, volunteers and
<br />representatives are named as additional insureds (''additional insureds") ZZ4�
<br />with regard to liability and defense of suits arising from the operations PRS -rQ
<br />and uses performed by or on behalf of the named insured. Additonal insured
<br />and primary and non-contributory per form SS00080405. � /
<br />f:FRTupin ATF wni nFR
<br />r:ANf:FI 1 Armin
<br />u_
<br />©1988-2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
<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 />City of Santa Ana
<br />20 Civic Center Plaza
<br />AUTHORRED REPRESENTATNE
<br />Santa Ana, CA 92701
<br />©1988-2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
<br />
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