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A� �0 <br />CERTIFICATE of i�IAE�II..t�`�Y INSURANCE <br />DATE (PA 012 fYY) <br />7,2,202 <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(les) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policfes 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 />insurance Solutions <br />License #0746539 <br />33302 Valle Rd, Suite 200 <br />San Juan Capistrano CA 92675 <br />9NI T Cheryl Jafar <br />PHONE (949) 348 -7400 Na: (449) 348 -2373 <br />ADD Es .cherylj @ins- solut<ions.com <br />INSURERS AFFORDING COVERAGE <br />NAIG0 <br />INSURER A :Sentinel Ins Co. LTD <br />11000 <br />INSURED <br />PELLETIER & ASSOCIATES INC <br />PO BOX 388 <br />LAfCE FOREST CA 92609 <br />€NSUPER B:Hartford Fire Ins Co <br />19682 <br />€NSUReR0,14ount Vernon Fire Ins Company <br />26522 <br />INSURER D: <br />INSURERS: <br />$ 1,000,000 <br />1 IRSURERF: <br />$ 1,000,000 <br />r,�Iril�,l TG !11 illllOi`�.l 'J /1'{ WFVIN11 IN NI 1MK"W! <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEDr TO THE INSURE) NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHFR 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 />ILN.7R <br />TYPE OF INSURANCE <br />AR <br />UB) <br />POLICYNUMBER <br />MrrUDYYYY <br />POLICY Qk VYy <br />LIMITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ 1,000,000 <br />_ <br />p GEs �a °.. <br />$ 1,000,000 <br />Co'MMLRCIAL GENERAL LIABILITY <br />- <br />MEOEXP (Any OnO - MW) <br />$ 10,000 <br />A <br />CLAVAS -PWE aOCCUR <br />12sBATuI3130 <br />13/2012 <br />13/2013 <br />PERSONAL &AOVINJURY <br />$ 1,000,000 <br />G> NERAL AGGREGATE <br />$ 2,000,000 <br />GEMLAGGREGATELTARAPPLIESPER: <br />PRODUCTS- COMPIOPAGG <br />$ 2,000,000 <br />$ <br />X POL)CY PR0. 1.00 <br />AUTOMOBILE LIABILITY <br />d)I_EDSINOLELIMir <br />j 000 000 <br />ebimyiNjuRY (per pmw) <br />$ <br />A <br />Y AUTO <br />AN AEI.OWNEA SCHFDULED <br />72SSAT08130 <br />/3/2012 <br />/3/21)13 <br />BOOILYINdURY(Peroccidant) <br />$ <br />AUTOS NON -OWNED <br />X x' <br />PROPERTY DAMAGE <br />Pei went <br />$ <br />HIRED AUTOS AUTOS <br />UMBRELLA UAB <br />OCCUR <br />EACH OCCURRENCR <br />$ _ <br />AGGREGATE <br />$, <br />EXCESSLIAB <br />CLUAS -MADE <br />DER, RETENTI0:4 <br />$ <br />u <br />_ <br />IZSTATU- OTH_ <br />$ <br />Y14P.k R3C011,PENSATFON <br />Y ER <br />AND EMPLOYERS' LIABILITY YfN <br />ANY PROPRIETORIIPARTRERIEXECUTIVE j <br />E.L. EACH ACCIDENT <br />$ 1,000,()00 <br />E.L. DISEASE - FA EMPLOYEE <br />$ 1,000,000 <br />OFRCERIMEMBER EXOLLJ©507 1I <br />IPdandalorpinNH) <br />NIA <br />2�g0�p3277 <br />/)./2011 <br />/1/2012 <br />E.L. DISEASE - POLICY I-WIT <br />3 1,000,()00 <br />IPyym descrbe urw�w <br />DaCCRIPTIAN OF OPERATIONS Wow <br />C <br />Errors & Omissions <br />P 2009690C <br />/25/2012 <br />/25/2013 <br />Um-t- $ 2,0W.000 <br />DodLtr;kW $) OW <br />DESCRIPTION OF OPERATIONS J LOCATION$ l VEHICLES (Attach ACORD 101, Additional Remarks Sehedula, if nlara space Is required) <br />City* of Santa Ana, 20 Civic Center Plaza, California 927011 its officers, employees, agents, volunteeze <br />and representatives are named as additional insured per the Business Liability Coverage From 380008 <br />attached to the poli.oy. <br />A TO <br />Lei a:iIIaLtl_l1;.wiLwi -EL51 M <br />City of Santa Ana <br />Attn: Risk Management, U28 <br />20 Civic Center Plaza <br />Santa Ana, CA 92702 <br />RD 26 (2010106) <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES HE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />Aleasandra /PETERS <br />O 1988.2010 ACORI) CORPORATION, All rights reserved. <br />INS026(2otaw).o1 The ACORD name and logo are registered marks of ACORD <br />