JOHNSON FRANK AND ASSOCIATES -2009

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DATE (MM/DD/YYYY) ACO CERTIFICATE OF LIABILITY INSURANCE III? 12/2/2010 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Insurance Office of America CONTACT NAME: 130 Vantis, Suite 250 PHONE A/C No Ext: 949-297-5962_ FAX AIC N.949-297596Q Aliso Viejo, CA 92656 INSURERS AFFORDING COVERAGE NAIC # www.ioausa.com CA License #OE67768 INSURER A : Travelers Property Ins Co of America 25674 INSURED Johnson-Frank & Associates, Inc. INSURER B: BeaZle Insurance Company 37540 5150 E. Hunter Avenue Anaheim CA 92807 INSURER C : INSURER D : INSURER E : --- -- - --- -- INSURER F : COVFRAI CFRTIPIRATF Kit IMRFR• QQno7no owr?rnu w uae?r.. THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DDfYYYY LIMITS A GENERAL LIABILITY ? 68068251-007 12/1/2010 12/1/2011 EACH OCCURRENCE $ 1,000,000 ? COMMERCIAL GENERAL LIABILITY Scheduled Al Endt #CGD3820907 DAMA? E TO RENTED PREMISES (Ea occurrence) $ 1,000,000 ? CLAIMS-MADE L v' J OCCUR Professional Services MED EXP (Any one person) $ 10,000 Primary/Non-Contributory performed by the insured PERSONAL BADV INJURY $ 1,000,000 ? Waiver of Subrogation are Excluded GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER'. PRODUCTS- COMP/OP AGG $ 2,000,000 POLICY PRO- ? T ? LOC $ A AUT OMOBILE LIABILITY ? BA68191_639 121112010 12/1/2011 B l NE D SINGLE LIMIT COM a o e t $ 1,000,000 ? ANY AUTO Designated Insured BODILY INJURY P Endt #CA20480299 ( er person) $ ALL OWNED AUTOS SCHEDULED Auros , Blanket Waiver of BODILY INJURY (Per accident) $ ? HIREDAUTOS NON-OWNED ? Subrogation #CAT3400808 PROPERTY DAMAGE _ _ AUTOS ' der accident) $ A ? UMBRELLA LIAB OCCUR CUP7915Y817 12/1/2010 12/1/2011 EACH OCCURRENCE $ 4,000,000 EXCESS LIAB CLAIMS-MADE Excludes Professional AGGREGATE $ 4,000,000 V/ RE DED TENTION$O Liability ?g/; r " P ?_(? h ',t tl. $ $ WORKERS COMPENSATION _ -?- TAU TH O Y AND EMPLOYERS' LIABILITY Y / N .._.? _ t fi TOR L MITS ANY PROPRIETOR/PARTNER/EXECUTIVE ?9 dufY / ? z ?' ,t ' OFFICER/MEMBER EXCLUDED? ? N/A . .. E.L. EACH ACCIDENT $ (Mandatory in NH) If yes describe under A,jj15t2t1 t E.L. DISEASE - EA EMPLOYEE $ , DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ B Professional Liability V15PR3100301 121112010 12/1/2011 $1,000 000 Per Claim Claims-Made , $2,000,000 Aggregate DESCRIPTION OF OPERATIONS /LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate Holder is an Additional Insured with respect to General Liability and Automobile Liability but only when required by written contract with Named Insured prior to an occurrence as per Endorsement(s) noted above. General Liability includes Separation of Insureds and Contractual Liability per limitations in the Liability Coverage form #CG00011001. Coverage is subject to all policy terms, conditions limitations and exclusions , . 30 Day Notice of Cancellation/10 Day Notice for Non-Payment of premium. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana, Its Officers and Employees THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P.O. Box 1988 ACCORDANCE WITH THE POLICY PROVISIONS. Santa Ana CA 92702 AUTHORIZED REPRESENTATIVE (AVC) Alicia K. Igram W IV05-ZUTU At-UKU L;UKFUKA I IUN. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD CERT NO.: 8898708 Teresa Frank 12/2/2010 1:13:50 PM Page 1 of 5