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Client :1 9431
<br />3ORDOOR
<br />ACORD.. CERTIFICATE'OF LIABILITY INSURANCE
<br />DATE (MMIDI]WYY)
<br />1/2112011
<br />THIS ERTIFi ATE 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 E TIFIC TE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE ENTATIVE R PRODUCER, ARID 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 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 />BB&T Insurance Services
<br />of Orange County
<br />11019E• Christy .Mat NA.
<br />PHONE 7145T8.-7370AfO No �A
<br />Exo .AICF o
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<br />E-MAIL
<br />PRODUCEi t @Bl"1dT,CDn"I
<br />D
<br />680 Lan sdorf rive Suite 10
<br />Fullerton, CA 92831INSURER(S)
<br />R
<br />CUSTOMER ID #
<br />AFFORDING COVERAGE MAIC #
<br />INSURED
<br />INSURER A : Hartford Casualty Insurance Com 29424
<br />erdoacrporation
<br />INSURER B Everest National insuranceCo 2
<br />1401 N. Broadway
<br />Property asualt Ins Co of H 34690
<br />Les Angeles, CA 90012
<br />INSURER e:
<br />INSURER E
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<br />COVERAGES CERTIFICATE UMBER: REVISION NUMBER:
<br />THIS 13 TO CERTIFY THAT THE POLICIES F INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQURE TENT, TERN OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE #'v#AY BE ISSUED OR NIAID 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 />INSF
<br />LTRNSR
<br />TYPE # INSURANCE
<br />DDt_
<br />UBR
<br />0
<br />LILY EFF
<br />POLICY UMBEF �4lhtfDD
<br />POLICY ECR LIMITS
<br />MMIDD
<br />A
<br />GENERALLLkBILITY
<br />X1COM MERGIAL ENEI AL LMILIT
<br />CLAWS -MADE I—XI OCCUR
<br />X
<br />72 BA P31 1120/20i
<br />. ..
<br />01 /201201
<br />.... ... ...... .. .
<br />EACH OCCURRENCE 1000.000
<br />DAMAGE TO
<br />P E SES EaE€�ccur encss300,OOO
<br />MED EXP (Any ore person) $10,000
<br />PERSONAL & ADV I NJ U RY S1,000,000
<br />G E NL AG G R EGATE LJMITAPPLIr;SPER:
<br />.LXJ. POLICY. L] PR- F] LOO
<br />GENERAL AGGREGATE x2,000,000
<br />PRO11UCTS-COM PICPA C x2,000,000
<br />AUTOMOBILE LIABILITY
<br />X ANY AUTO
<br />ALL OWNED AUTOS
<br />SCHEDULED AUTOS
<br />HIRED AUTOS
<br />[[yi
<br />X NON -OWN ED �.+ 4
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<br />C�3M�181I�IEr� SINGLE I-IP�41T
<br />(Ea accident) 1
<br />BOO ILY INJ URY (Per person) $
<br />BOD) LY INJURY (Per aocident)
<br />PROPERTY DAMAGE
<br />tPer acadent)
<br />...,
<br />UMBRELLA LIA8
<br />EXCESS LIAB
<br />X
<br />OCCUR
<br />CLAIMS -MADE
<br />72SBACP313
<br />1/20/2011
<br />1 /2012012.
<br />EACHOCCURRENCE— $5,000,000
<br />AGGREGATE -$51.0001000
<br />€]EOUCTIBLE
<br />RETENTION S 10000
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />EMPLOYERS' LIABILITYQSY-FR
<br />ANY PROPRIETORMARTNERIEXECU I IVE Y # �
<br />OF ICERIMEMBE E CLUDEW I
<br />(Mandatory In NH)
<br />desen-be under R� CRiPTI ON 0 F OPERATIONS bet
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<br />� C STA►T€[ 10THAND
<br />B.L. EACH ACCIDE T $1,000,000
<br />B.L. DISEASE - EA EMPLOYEE $1,000,000
<br />B.L. DISEASE -POLICY LIM;T $1,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach A ORD 101, Additional Remarks Schedule, If more space Is requIred)
<br />Per farm SS0003 04105 pages 11-13 of 24 attached, the fol I ow ig are E{Tamed as Additional Insureds, as
<br />respects General Liability, as required by written Contract.
<br />(See Attached Descriptions)
<br />CERTIFICATE FOLDER
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />City of Santa Ana ACCORDANCE WITH THE POLICY PF VI ION .
<br />20 Civic Center Plaza
<br />Santa Ana, OA 92702-1908 AUTHORIZED REPRESENTATIVE
<br />o
<br />0 1988-2089 AC CRD CORPORATION. Al rights reserved-.
<br />ACORN 2 (2009199) 1 of 2 - The ACORD name and logo aro registered marks of A ORD
<br />
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