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A1Z"® CERTIFICATE OF LIABILITY INSURANCE 12/�/20113 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 ONE, Inc. dba Peak 360 1600 Emerson St. Deriver CO 80218 COMNICT Gary Friedman PHONE . (b,d303)534-7325 FAXfAIC Nob (303)623-7325 ADORIEs:gfriedman@peak360. com INSURERS AFFORDING COVERAGE NAIC # INSURERAArch Specialty Insurance INSURED WellDyne Holding Corporation 7472 S. Tucson Way ,^ �o l.� /� / �� I�� Centennial CO 80112 91 INSURERB:Continental Insurance INSURERC:CNA Insurance Company INSURER D:HartfOrd INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:CL1312701175 REVISION NUMBER: 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. INBR R TYPE OF INSURANCE ADD BR POLICY NUMBER POLICY M DD EYY MMIDOD YYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY I CIAIMS-MAOE ❑X OCCUR LP0052651-01 12/7/2013 12/7/2014 DAMAGE 10 PREMISES (Ea occurr' c $ 100,000 MILD EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 3,000,000 GEHL AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO $ 3,000,000 X POLICY PRO-LOCCOMINED $ AUTOMOBILE LIABILITY (Ea accdentSINGLE LIMIT 1,000,000 BODILY I NJURY(Per person) $ B x ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS 4026985883 12/7/2013 12/7/2014 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS AUTOS X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 A EXCESS LIAB CLAIMS -MADE DEXETENTION 10,00 $ LP0052651-01 12/7/2013 12/7/2014 Q WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y1N ANY PROPRIETORIPARTNERIEXECUTIVE OFFICEWMEMBER EXCLUDED? In NH) NIA C5093687712 6/1/2013 6/1/2014(Mantlatory X I TWO STATDCRY LIM - I OTH- ED E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1,000,000 A PROFESSIONAL LIABILITY LP0052651-01 12/7/2013 12/7/2014 OCCURRENCE/AGGREGATE $IN / $3M D TPA E&O LIABILITY GOPGO257328 12/7/2013 12/7/2014 OCCURRENCE/AGGREGATE $IN / $1 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Certificate Holder is an additional insured under the General Liability policy in accordance with all the terms, conditions, and limitations of the policy and then only for liability caused by the negligent acts of the named insured �Iand ti`igr}pgly,�s ,,igi; �ijzyest may appear by way of written contract. GNltUlla Cl ekindig@santa-ana.org CITY OF SANTA ANA CHRISTY KINDIG 20 CIVIC CENTER PLAZA SANTA ANA, CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Gary Friedman/GARY i.._ _A ©1988-2010 ACORD CORPORATION. All rights reserved. INS625 (minom) m The ACr1Rn namn anH Inrin am ronieforeH me,kc of Ar.npn