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AtE RW CERTIFICATE OF LIABILITY INSURANCE OP ID NK Vrt """ MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH MGTOF-1 02/25/10 PRODUCER PE OF INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION DATE (MMIDDIYY`YY) Earl Bacon Agency, Inc LIMITS ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 3131 Lonnbladh Road GENERAL LIABILITY HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 12039 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Tallahassee FL 32317 A X X COMMERCIAL GENERAL LIABILITY CLAIMS MADE Fx—1 OCCUR Phone:850- 878 -2121 Fax:850- 878 -2128 07/01/09 INSURERS AFFORDING COVERAGE NAIL# INSURED MGT of America, Inc. MED EXP (Any one person) INSURER A: valley Forge Ins Co. 20443 and Public Resourse Management INSURER Continental Casualty 20443 a wholly owned subsidiaOfOr MG T MG INSURER C American Cas,CO.of Reading PA 20443 2123 Centre Point Blvd. Tallahassee FL 32308 Blkt Waiver of Su INSURER D Travelers Cas &Surety Cc of Ame 25623 1 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR INSIRD PE OF INSURANCE POLICY NUMBER DATE (MMIDDIYY`YY) DATE (MMIDD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ $1,000,000 A X X COMMERCIAL GENERAL LIABILITY CLAIMS MADE Fx—1 OCCUR 2093390918 A -XV RATING 07/01/09 07/01/10 PREMISES E occurein $ $ 300,000 MED EXP (Any one person) $ $ 5,000 PERSONAL & ADV INJURY $$1,000,000 Blanket Add' l Ins Blkt Waiver of Su GENERAL AGGREGATE s$2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP /OP AGG $ $2,000,000 JPRECT X POLICY O LOC C AUTOMOBILE X LIABILITY ANY AUTO 2093563501 A -XV RATING 07/01/09 07/01/10 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS APPROVED AS TO E C RM BODILY INJURY (Per accident) $ X X HIRED AUTOS NON -OWNED AUTOS � J Laura PROPERTY DAMAGE (Per accident) $ t Sheedy GARAGE LIABILrrY Assistant "City AttorneS, AUTOONLY - EAACCIDENT $ ANY AUTO OTHER THAN EA ACC AUTO ONLY AGG $ $ EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $ 4,000,000 $ OCCUR ❑ CLAIMS MADE 2093563496 A -XV RATING 07/01/09 07/01/10 AGGREGATE $4,000,000 $ $ DEDUCTIBLE X RETENTION $10,000 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR /PARTNER /EXECUTIVE El OFFICER/MEMBER EXCLUDED? (Mandatory inNH) If yes, describe under SPECIAL PROVISIONS below 311086712 A -XV RATING BLANKET WAIVER OFSURRO 07/01/09 07/01/10 - X TORY LIMITS ER E. L. EACH ACCIDENT f-, $ 500000 EL .DISEASE - E �YEE $ "5'00000 E.L. DISEASE- P60I LIMIT $ 300000 B OTHER Workers Comp - CA 311086788 A -XV RATING 07/01/09 07/01/10 ' T Empl Liab $1,000,000 D I Prof Liab- (E &O) Clm 104968324 RETRO:7/5/95 07/01/09 07/01/10 Liab /Aggr J3, 000, 000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS *45 Days Written Notice of Canc- Nonrenewal. *10 Days Written Notice of Canc - Nonpayment. Included as an additional insured under the general liability is the City of Santa Ana, its officers, employees, agents volunteers and representatives - GL form written on primary & noncontributory basis. ctK I IrICA I t MULLitK CANCELLATION City of Santa Ana Attn.: Will Hayes 20 Civic Center Plaza (M -30) P. O. Box 1988 Santa Ana CA 92702 -1988 ACORD 25 (2009/01) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION SAANSA4 DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30* DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE _ The ACORD name and logo are registered marks of ACORD reserved.