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<br />A CERTIFICATE OF LIABILITY INSURANCE FDA {MMDDIYYYY)
<br />613t2011
<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 Venbrook Insurance Services CA Lic OD80832 CONTACT NAME: Kerrie Guenther
<br />6320 Canoga Avenue, 12th Floor PHONE LAIC, No E)M: 818.598.8900 FAX WC No): 818.598.8910
<br />Woodland Hills, CA 91367
<br />E-MAIL ADDRESS: kguentherwenbrook. can
<br /> INSURER(S) AFFORDING COVERAGE ? NAIC*
<br />www.venbrook.com INSURERA : Hartford Casualty Insurance Co 29424
<br />INSURED Overland Pacific & Cutler Inc. INSURERB : Hartford Fire Insurance Company 19682
<br />3750 Schaufele Avenue, Suite 150 INSURER C : Tudor Insurance Company 37982
<br />Long Beach CA 90808
<br />INSURER D
<br /> INSURER E :
<br /> INSURER F :
<br />COVERAGES CERTIFICATE NUMBER: 10333527 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. NO-rWITHSTANDING 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 />EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAYHAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR
<br />LTR TYPE OF INSURANCE AD DL
<br />INSR SUBRI
<br />-MM POLICY NUMBER POLICY
<br />MM DDIYYFF DfYYYY
<br />MMILDI LIMITS
<br />A GENERAL LIABILITY 72UUNTR7859 6/12011 6112012 EACH OCCURRENCE $ 1,000,000
<br /> COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence ) $ 300,000
<br /> CLAIMS-MADE 1z OCCUR MED EXP (Any one person) $ 10,000
<br /> PERSONAL&ADV INJURY $ 1,000,000
<br /> GENERAL AGGREGATE $ 2,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000
<br /> POLICY [7] PRO- 7
<br />B AUT OMOBILE LIABILITY 72UUNTR7859 6/12011 6/12012 COMBINED SINGLE LIMIT
<br />(Ea accident
<br />$ 1,000,000
<br /> ANY AUTO BODILY INJURY (Per person) $
<br /> ALL OWNED
<br />AUTOS SCHEDULED
<br />AUTOS BODILY INJURY (Per accident)
<br />$
<br />
<br />/ NON-OVINED PROPERTY DAMAGE
<br /> HIREDAUTOS V AUTOS Peraccrdent} $
<br /> ,/ Comp Ded $1,000 $
<br /> V COII bed $1,000 $
<br />A ? UMBRELLA LIAB OCCUR 72RHUTR7849 6/12011 6112012 EACH OCCURRENCE $ 2,000,000
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ 2,000,000
<br /> DED =RETENTION $ $
<br />
<br />
<br />A WORKERS COMPENSATION 72WETQ9133 6/12011 6/12012 vvc sTATu- o
<br /> AND EMPLOYERS' LIABILITY TORY LIMITS R
<br /> YIN
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />F
<br />NIA E.L. EACH ACCIDENT $ 1,000,000
<br /> OFFICER/MEMBEREXCLUDED?
<br />(Mandatory in NH) E.L. DISEASE - EA EM PLOYEE $ 1 00 0
<br /> If yes, describe under
<br /> DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000
<br />C Professional Liab. EOP0037170 611/2011 6/12012 $2,000,000 Each Claim
<br /> Claims Made $2,000,000 Aggregate
<br /> $50,000 Deductible
<br />DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required)
<br />The City of Santa Ana, its officers, agents, employees, consultants, special counsel & representatives are named as additional insured per attached
<br />endorsement #HG00010605 (excl work comp) on primary & noncontributory basis where required by contract. Subject to policy terms, conditions,
<br />and exclusions.
<br />APPROV.i) AS F0 z'Od"M
<br />CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City of Santa Ana Laura
<br />Sl iu THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />,
<br />Public Works Agency
<br />M-36
<br />? ACCORDANCE WITH THE POLICY PROVISIONS.
<br />,
<br />Ci(v
<br />Box 1988 Assistar;t
<br />P
<br />O
<br />.
<br />.
<br />Santa Ana CA 92702 AUTHORIZED REPRESENTATIVE
<br />
<br /> (WH) Pamala Nash
<br />©1988-2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
<br />CERT NC.: 10333527 Kerrie Cuentter 6/3/2011 2:33:55 PM Page 1 of 5
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