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GICE <br />CERTIFICATE OF LIABILITY INSURANCE DA TD/YYYl7 <br />9/29/22912011 <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 (215) 567-6300 <br />The Graham Company <br />The Graham Building <br />1 Penn Square West <br />Philadelphia, PA 19102 <br />CONTACT <br />NAME, James H. Bonner, Vice President <br />PHONEFAx <br />): 215-567-6300 5294 o. EOR/aC. No): 215-525-0234 <br />E HMC <br />_unit g9ramco.com. <br />ADDRESS, bonnerha <br />- - <br />_CU-_TQMERID#:OPEX000 01 <br />INSURER(S) AFFORDING COVERAGE NAIC # <br />INSURED OPEX Corporation <br />INSURERA:Wausau Business Insurance Company 26069 <br />305 Commerce Drive <br />INSURERS: North River Insurance Company 21105 <br />Moorestown, NJ 08057 <br />INSURER G <br />INSURER D, <br />X COMMERCIAL GENERAL LIABILITY <br />_ CLAIMS -MADE OCCUR <br />INSURER E, <br />INSURER F: <br />10/1/2011 <br />COVERAGES CERTIFICATE NUMBER: 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 />I rypE OF INSURANCE <br />20 Civic Center Plaza - Room 1 <br />AUTHORIZED REPRESENTATIVE <br />POLICY NUMBER <br />MM/DDY/YYIY <br />MMIDD/YYYY <br />LIMITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE $ 1,000,000 <br />A <br />X COMMERCIAL GENERAL LIABILITY <br />_ CLAIMS -MADE OCCUR <br />YVKZ51290099021 <br />10/1/2011 <br />10/1/2012 <br />-1REMISE 111 occ $ 760•000 <br />MED EXP (Any one person) $ 5.000 <br />PERSONAL & ADV INJURY $ 1,000,000 <br />GENERAL. AGGREGATE $ 2.000.000 <br />GEN'L AGGREGATE LIMIT APPLIES PER <br />PRODUCTS - COMP/OP AGO $2.000,000 <br />POLICY X PRO LOC <br />$ <br />A <br />AUTOMOBILE <br />X <br />LIABILITY <br />ANY AUTO <br />ASKZ51290099031 <br />10/1/2011 <br />10/1/2012 <br />COMBINED SINGLE LIMIT $ 1,000,000 <br />(Ea accident) _ <br />BODILY INJURY (Per person) $ <br />- <br />ALL OWNED AUTOS <br />BODILY INJURY (Per accitlenQ $ <br />- <br />SCHEDULED AUTOS <br />HIRED AUTOS <br />PROPERTY DAMAGE $ <br />(Per accide ) <br />NON -OWNED AUTOS <br />$ <br />UMBRELLA LIAB <br />X <br />OCCUR <br />EACH OCCURRENCE $ 20.000.00 <br />B <br />EXCESS LIAB <br />CLAIMS -MAD E <br />5530945788 <br />10/1/2011 <br />10N <br />$ <br />AGGREGATE 40.000.00/2012 <br />-- -------------- <br />------_ --.— <br />DEDUCTIBLE <br />$ <br />$ <br />RETENTION $ <br />A <br />WORKERS COMPENSATIONX <br />EMPLOYERS' LIABILITY Y / N <br />ANY PROPRIETOR/PARTNEWEXECUTIVE <br />OFFICERAI MBER EXCLUDED? <br />E <br />(Mandatory In NH) <br />NIA A <br />WCKZ5129DD99011 <br />10/1/2011 <br />10/1/2012 <br />WC STATU- 9TH <br />_ --- S4.3Y_1LMI ER <br />EL EACH ACCIDENT $ 1.000.000 <br />EL DISEASE - EA EMPLOYEE$ 1.000.000 <br />If yes, describe under--�— <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE -POLICY LIMIT $ 1,OOD.DDD <br />RM <br />DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (Attach ACORD 101, Addltlonal Remarlts Schedule, If more space Is requlr <br />/ l <br />------- Il�ti9 Stitt Sheerly <br />CERTIFICATE HOLDER CANCELLATION ­LLInt City Attorney <br />© 1988-2009 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />City <br />CI of Santa Ana <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Attn: Mimila Vargas <br />20 Civic Center Plaza - Room 1 <br />AUTHORIZED REPRESENTATIVE <br />Santa Ana, CA 92701- <br />© 1988-2009 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD <br />