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Y.1� z�to- vt•-t <br />.acoRa"" CERTIFICATE OF LIABILITY <br />�� <br />INSURANCE <br />DATE (MI♦A'DD/YYYY) <br />6 18 2010 <br />PRODUCER pyyone: 850 -878 -2121 Fax: 85o -B78 -2128 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Earl Bacon Agency, Snc. <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />P.O. Box 12039 <br />Tallahassee FL 32317 ?��� pl)l� .y � <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />POLICY EXPIRATION <br />LIMITS <br />A <br />I SU ERS AFFORDING COVERAGE <br />NAIC # <br />INSURED -: <br />MGT o£ America, Snc., & Public R�- {��i�cC? M mt !' <br />Group, a wholly owned subsidiary o3= `MGT -g � /`INS <br />- A -Valle For e Snsurance Co <br />20508 <br />RB:American Cas.Co.o£ Readin P <br />20427 <br />INSURER C:Continental Casualt Company_ <br />__ <br />20443 <br />2123 Centre Point Blvd. <br />wsu.RER D. Travelers Casualt & Surety__C <br />31194 <br />Tallahassee FL 32308 <br />INSURER E' <br />$ 3 Q Q QQQ <br />MED EXP (Any one person) <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. <br />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 <br />TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />T <br />ADD' <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />POLICY EXPIRATION <br />LIMITS <br />A <br />X <br />_GENERAL LIABILITY <br />2 0 9 3 3 9 0 919 <br />7 1 2 Q 1 Q <br />7 1 2 Q 11 <br />/ / <br />EACH OCCURRENCE ___ <br />$ _ 1_,_�_Q_Q 0 � 0 <br />X COMMERCIAL GENERAL LIABILITY <br />A A� Et�NTED <br />PREMISES Ea occurrence <br />$ 3 Q Q QQQ <br />MED EXP (Any one person) <br />_ <br />$ rj Q Q Q <br />CLAIMS MADE � OCCUR <br />PERSONALSADV INJURY <br />$1000 QQQ <br />X A -XV RaYin� <br />GENERAL AGGREGATE <br />$ 2 O O O Q Q Q <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMP /OP A_GG <br />$ 2 QQQ O O O <br />X POLICY PRO LOC <br />B <br />AUTOMOBILE <br />X <br />LIABILITY <br />ANY AUTO <br />2 Q 9 3 5 6 3 5 Q 1 <br />7 1 2 Q 1 Q <br />7 1 2 Q 11 <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />$ 1, 0 0 0, 0 0 0 <br />BODILY INJURY <br />(Per person) <br />$ <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />/1, � " �(,� [ / � _ <br />X <br />BODILY INJURY <br />(Per accitlent) <br />$ <br />HIRED AUTOS <br />NON -OWNED AUTOS <br />-XV Rating <br />1 <br />�. � - "'- -- - <br />_ i L � <br />�C: {. ..y��� <br />�_��� i ` Ll , <br />� � ' <br />_ _ <br />X <br />X <br />PROPERTY DAMAGE <br />(Per accitlen[) <br />$ <br />GARAGE <br />LIABILITY <br />/»:,I� CH i <br />'ZJl l y !t L I OC>; L <br />AUTO ONLY - EA ACCIDENT <br />$ <br />OTHER THAN EA ACC <br />$ <br />ANY AUTO <br />$ <br />AUTO ONLY: AGG <br />C <br />EXCESS /UMBRELLA LIABILITY <br />X OCCUR � CLAIMS MADE <br />2 0 9 3 5 6 3 4 9 6 <br />- <br />7/ 1/ 2 Q 1 Q <br />7/ 1/ 2 Q 11 <br />EACH OCCURRENCE <br />S 4 QQQ Q Q Q <br />AGGREGATE <br />$ 4 QQQ O Q Q <br />$ <br />g <br />DEDUCTIBLE <br />g <br />RETENTION $ <br />A <br />C <br />WORKERS COMPENSATION <br />AND EMPLOYERS'LIABILITY <br />ANY PROPRIETOR /PARTNER /EXECUTIVE � <br />OFFICER /MEMBER EXCLU DED7 <br />3011086712 <br />3 011 0 8 6 7 8 8 CA <br />7/1/2010 <br />7/ 1/ 2 Q 1 Q <br />7/1/2011 <br />7/ 1/ 2 011 <br />WC STATU- OTH- <br />X X <br />CA EL -below <br />E.L. EACH ACCIDENT <br />$ rj Q Q Q Q Q <br />E.L. DISEASE - EA EMPLOYE <br />$ Cj Q Q Q Q Q <br />(Mantlatory In NH) <br />If yas, describe untler <br />SPECIAL PROVISIONS below <br />E.L. DISEASE - POLICY LIMIT <br />$ Q Q Q Q Q <br />D <br />OTHER <br />Professional Liab. (E6�0) <br />Claims -Made form <br />104968324 <br />7/1/2010 <br />7/1/2011 <br />Limit 2, 000, 000 <br />ggregate 3,000,000 <br />7/5/95 Retro Dale <br />DESCRIPTON OF OPERATIONS /LOCATIONS /VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS <br />lanket Additional Insured endorsement under General Liability. Blanket waiver of Subrogation applies to General <br />lability, California and All Other Workers Compensation policies- Umbrella: A -XV Rating. All Other Workers' Comp <br />nd CA Workers' Comp: A -XV Rating. California Employers Liability Limits: $1,000,000 Each Accident /$1,000,000 Disease <br />olicy Limit /$1,000,000 Disease Each Employee <br />45 Days Written Notice o£ Canc- NOnrenewal. X10 Days Written Notice of Canc - Nonpayment_ Included as an additional <br />ee Attached__ <br />�., r =rt I It -1\.,M 1 C tTV LVCR l.A1Y l.CLLA I IVIV <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br />BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER <br />WSLL ENDEAVOR TO MAIL 30 DAYS WRSTTEN NOTICE TO THE <br />City O f Santa Ana , At to . Wi 1 1 Haya S CERTIFICATE HOLDER NAMED TO THE LEFT , BUT FAILURE TO DO SO <br />20 Civic Canter Plaza (M -30) SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON <br />P. O. Box 1988 THE INSURER, STS AGENTS OR REPRESENTATIVES. <br />Santa Ana CA 92702 -1988 <br />AUTHORIZED REPRESENTATIVE <br />�� /_yiC! /!� <br />ACORD 25 (2009/01) ©1988 -2009 ACORD CORPORATION_ All riofrts reserved_ <br />The ACORD name and logo are registered marks of ACORD <br />