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Cllent#: 390893 UPAI6CEM <br />ACORO>r CERTIFICATE OF LIABILITY INSURANCE °��D;o ' <br />THtS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER_ THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EJC -FEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW_ THi3 CERTIFICATE OF WSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(3), AUTHORIZED <br />REPRE3ENTATtVE OR PRODUCER, AND THE CERTIFICATE HOLDER <br />IMPORTANT: the certl8caffi holder b an ADDI- f10NAL INSURED, the polcy(les) must be endorsed_ H SUBROGATION IS WAIVED, aub)ect to <br />the terms and condRlo+IS of the policy, certain pdicles may raqulre an endarsament A ateterrwnt on this eartNicate dons not tooter rlghte to the <br />certlflcate kidder In geu of such endorsemerlt(s)_ <br />PRODUCER <br />NAYE- <br />USI Southern Cal(fomia <br />Lit N 035„ 62 c� o r L' — c> n �^ <br />w/c Ea .818 251 -3000 Ant No <br />ADDRESS: <br />_�� <br />21800 Oxnard Street, 8th Floor <br />oENERAL LMBBJTY <br />Woodland Hills, CA 91367 <br />MXC3045687516 <br />7/01/2010 <br />B13U AFFORDING COVERAGE <br />NAK:/ <br />INSUREn <br />UPA #16- Central Orange County <br />INSURER w _American Insurance Company <br />21857 <br />INSUweR B - <br />°' <br />5665 Greenbrier Drive <br />R o <br />s50 000 <br />- Yorba Linda, CA 92887 _ <br />S10 000 <br />X PD Ded-500 <br />INSURER E - <br />e19URER F <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE UJSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICTED_ NOTWn- I- ISTANdNG ANY REQUIREMENT, TERM OR CONDTON OF ANY CONTRACT OR OTHER DOCUMENT WI-fH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND GONOITION.4 OF SUCH POLICIES. LIMTTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAI �i. <br />TYPE OP e1SlRIUiCE, <br />POLICY NUYaER <br />Y EPF <br />CY <br />LIMITS <br />A <br />oENERAL LMBBJTY <br />MXC3045687516 <br />7/01/2010 <br />07/01/201 <br />EACH OCCURRENCE <br />s2000000 <br />X CMNMERCIAL GENERAL WBIUTY <br />CLAMS -MADE Q OCCUR <br />s50 000 <br />MED EJV+ err ,aan <br />S10 000 <br />X PD Ded-500 <br />PERSONAL a Aw IwuRY <br />s2 000 000 <br />GENERAL AGGREGATE <br />s4 000 000 <br />GEML ^�- -GATE <br />LNNT APPLIES PER <br />PRODUCTS- COMPgP AGG <br />52 000 000 <br />S <br />POLICY <br />PRO- LOC <br />AUTOMOBILE LIABILITY <br />ANY AVro <br />ALL OWNED AUTOS <br />SCHEDIA_ED A VTOS <br />HBiED AUTOS <br />�- ,i i_� 1 1- . -_. ^ <br />[`�} f� • � J Q <br />_ -_ � <br />O >7 l <br />l�((� <br />COMBINED SINGLE LIMIT <br />(Ea soeWant) <br />s <br />BODILY BLA /RY (Par parson) <br />S <br />BODILY INJURY (Par arrJaare) <br />f <br />PROPERTY DAMAGE <br />(Par ciOaMl <br />s <br />s <br />NoNOwNED Alrros <br />. r <r, <br />:. , ��� <br />� <br />� <br />s <br />UMBRELLA LIAR <br />EXCEa$ LUU! <br />OCCUR <br />CLABAS -MADE <br />"r_I- ,}r y <br />r Oro ey <br />EACH OCCURRENCE <br />f <br />AG TE <br />s <br />DEDIx;neLE <br />s <br />s <br />NIORKERS COMPENSATKIN <br />VVC STATI} OTH- <br />ANO EMPLOYERS LIABILITY Y / M <br />ANY PROPRIETORIPARTNERIF.XECUTIVE� <br />OFFlCEWN816ER EXCLUDEOT <br />WA <br />Ei. EACH ACCIDENT <br />s <br />EL. - EA EMPLOYEE <br />S <br />(Ma,IdaOOrY M NHI <br />r aareJd ulcer <br />E1. OISFi�SE - CY LIMIT <br />S <br />A <br />Pollution Cieanup <br />MXC8045687516 <br />7/012010 <br />07/01/2011 <br />55,000 <br />DESORPTION OF OPERATK)1B / LOCATlON9 /VEHICLES (ALaaII ACORD t/1, AdAabIW Ra+1larRa SohaAUN, K eve apace Ia rvquMaa) <br />Currant Member Jason Hunt <br />The City of Santa Ana, its otiicers, employees, agents and repraaentatNes <br />(See Attached Desuipdons) <br />VAIaliCL1/� I I IY ra eni <br />SHOULD ANY OF THE ABOVE DESCRB3ED POUCMS BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELNERED IN <br />City Of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. <br />do PutHic Works AgsncylTtte Depot <br />20 Civic Canter Plaza, M -21 wvrHOR® REPRESENTATNE <br />Santa Ana, CA 92701 t <br />01968 -2009 ACORO CORPORATION_ Ali ridda reserved_ <br />ACORD 25 (2009/09) 1 Of 2 The ACORD name and logo are ragbtered minks of ACORD <br />tiS4520234/M446S740 M4CJA <br />