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'`� °® CERTIFICATE OF LIABILITY INSl1RONC_F DATE (MM /pOM'YY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDERy THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NO�i CONSTITUTE A CONTRACT BETWEEN TP.E ISSUING INSU RER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIF ICAT� HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subj¢ct to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this c¢rtificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Mary Am1r1 James G Parker Insurance Associates j PHONE Eael (661)287 -4195 ILA /C N1 (661)254 -SETS Li Censer #0554959 nooARlESS:mamiri @jgpar7cer. com 27200 Tov rney Rd #350 PRODUCER 00073996 Valencia CA 913SS ____ _ __ _ _ _. _ __ -- UBIOMER ID # _ —__ _ _ - INSURERiS)AFFORDIN_G COVERAGE NAIC_ #___ INSURED _ INSURERA Star Insurance: Company 1H023 Mi on Ga rderls 2nc INSURER B Main St INSURER C -,_ __ INSURER D Santa Ana CA 92707 o�0lO �� INSURERE� _ - -- -- INSURER F - 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 ADOL INSR SUBR WVD - - � POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MM /DD/YYW LIMITS GENERAL LIABILITY EACH OCCURRENCE $ GENERAL LIABILITY DAMA �E TO RENTED _ _ � - "- - ' - -- - _ _COMMERCIAL PREMISES lEa occ ante -} $.___ _ � CLAIMS -MADE C I OCCUR MED EXP (Any one p rson) $ - _ _ PERSONAL & ADV INJURY $ - - -- GENERAL AGGREGATE S GEN'L AGGREG_A_TE LIMIT APPLIES PER: - PRODUCTS - COMP /OP AGG S POLICY PRO- JECT � LOC _. .- -__. _ $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accitlen0 $ ANY AUTO ALL OWNED AUTOS BODILY INJURY (Per parson) S _._ - -_ __._ ___. __._ ___ __ _._ BODILY INJURY (Per accident) _ _ SGHEDU LED AUTOS $ _ _ __ _ PROPERTY DAMAGE $ HIRED AUTOS (Per accitla n[) NON -OWNED AUTOS __ - - � _- __ $ $ UMBRELLA LIAR OCCUR -._ EXCESS LIAB CLAIMS i EACH OCCURRENCE $ -- -- - -. _ I -MADE AGGREGATE $ _ OE DU CTIBLE $ RETENTION $ 'i S A WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY Y / N IORY_LIM ITS -_. _ _E - _._ E.L. EACH ACCIDENT .. _ _ _ _ _ ANY PROPRIETOR /PARTNER /EY,ECUTIVE OFFICER /MEMBER EXCLUDEDP � N / A $ _____ 1000 OOO (Mandatory In NH) 0045330602 6/1/2011 6/1/2012 Yes, tlescribe untlar I E.L. DISEASE - EA EMPLOYE $ 1 � 000 � 000 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1 000 000 AP ROVED AS DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (Attach ACORD 101, Atltlltfonal Remarks Sche,iule, if more space is requlretl) Job: Santa Ana Medians „- -' ,.... �.,. � Laura Stitt Shee y -- - - _ a�Farva..cl_t_nallvry __- - - "'__ �.•�.� ��••.. +cy SHOULD ANY OF THc ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City o£ Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Admin. Services Div. Public Works Agency 2D i_'1V1C Center Plaza M -2Z AUTHORI2ED REPRESENTATIVE Santa Ana, CA 92702 1 J Parker III /iCATHYP � —�+�� "�� ACORD 25 (2009109) � ©'1988 -2009 ACORD CORPORATION. All rights reserved. INS026 (zoosos) The ACORD name and logo are registered marks of ACORD