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Ro CERTIFICATE OF LIABILITY INSURANCE OP ID BPs DATE (MM DD/YYYY/ <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 8/03/10 <br />HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />• e ce Ca e o er s an a Po cy es mus a endorsed. , subject o <br />Me terms and condhlons of the Policy, certain pollcles may require an endorsement. A statement on this certificate does not confer rights to the <br />eertificale holder In lieu of such endorsomenl(s). <br />PRODUCER <br />ILTR TYPE OF INSURANCE IN=VND POLICYNUMBER MM/D6PMOM ODVER LIMna <br />NAh1 E: <br />ISU- Robert: Ball Brokers <br />5256 S. Mission Rd. Suite 1006 <br />BOnsall CA 92003 <br />Phone1800-426-2634 Fax1760-631-5983 <br />INSVRED Box 3 <br />MIKE 9 S <br />P.O. Box 3913 <br />SAN CLEMENTE CA 92672 <br />ac No -.13: -- <br />ADDRESS: _ <br />CUSTOe.IERIDA, LINAMII <br />INSURER(S)AFFORDINO COVERAGE NAICY <br />INSURER A: COntinenLal Caau,IltV 20443 <br />INSURER B: <br />INSURER C: <br />CQV T/tel, <br />(% <br />INSURER D: --- <br />— <br />INSURER E: <br />INSURER F: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE —INSURED NAMED ABOVE FOR THE ICYPERI <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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 TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCEDBy PAID CLAIMS. <br />ILTR TYPE OF INSURANCE IN=VND POLICYNUMBER MM/D6PMOM ODVER LIMna <br />GENERAL <br />LIABILITY <br />EACH OCCURRENCE $3.,000,000 <br />A <br />UIERC4ll GENERAL LIABIDTY <br />4017604266 <br />07/15/10 <br />07/15/11 <br />PREMISE. enw 3 1, 000, 000 <br />CLAIh15-FAAOE QX OCCVR <br />T7:' <br />_M EXP _O E(Any one Person) $10,000 <br />BITSINESSOWNERS <br />X <br />_ <br />PERSONALSADVIWURY S 1, 000, 000 <br />LIABILITY _ <br />GENEPALAGGREGATE S2,000,000 <br />AGGREGATE LI M1UT APPLIES PER <br />PRODUCTS - COLIP/OP AGG $2,000,000 <br />GENL <br />POLICY X JERCOT LOC <br />3 <br />AUTOMOBILE <br />LIABILITY <br />COIdBINED SINGLE LIMIT <br />(BEOeD—ILYid—) $ <br />ANY AUTO <br />INJURY (Pepeon) S <br />AI-LOWNEDAUTOIS <br />`ra• <br />BODILY INJURY(Pacdnt) 3 <br />Q <br />1 <br />SCHEDULEDAUTOS <br />�© <br />PROPERTY DAAWGE $HIRED <br />ira <br />AUTOS <br />g pPROV%� <br />(Per aotldenl) <br />NONOINNED AUTOS <br />v <br />RCK <br />$ <br />UMBRELLA UAB OCCUR <br />�� <br />C( <br />AttD <br />y <br />EACH OCCURRENCE $ <br />UAB AB CIJUMS-h1ADE <br />AcJ$($ taut <br />AGGREGATE S <br />DEDUCTIBLE/L! <br />— <br />S <br />RETENTION 3 <br />/ <br />3 <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />N <br />TORY UMnS ER <br />E.L. EACH ACCIDENT $ <br />ANYPROPRIETORPARTNEREXEC 'V <br />OFFICEMMEhIBER EXCLUDTA7 <br />/A <br />(Mandatory In NN) <br />1l1ss destlf;!OF r <br />E.L. DISEASE - EA EMPLOYE S <br />EL DISEASE - POLICY LILUT S <br />DESCRIPTION OF OPERATIONS bOtON <br />DESCRIPTION OFOPERATIORS / LOCATIONS /VEHICLES ((Attach ACORD 1D1 AEdlllonal Remarks ScheduTe, If more a ace Is requirodl <br />'T10 DAYS NOTICE OF CANCELLAS 014 DUE Tb NON-PAYMENT OF <br />PREMIUM. THE <br />CERTHOLDER IS ADDITIONAL INSURED PER THE ATTACHED ENDORSEMENT SB -146932-C. <br />SHOULD ANY OF THE ABOVE DESCRIB¢Qnjl q{(i$�IEL-A- ED N D BEFORE <br />THE EXPIRATION DATE THEREOF, NO <br />ACCORDANCE WITH THE POLICY PROVISIONS. XXXXXXXXXXXX <br />CITY OF SANTA ANA AUTHORIZED REPRESENTATIVE <br />ATTNI FRANK HERNANDEZ <br />20 CIVIC CENTER PLAZA <br />SANTA ANA CA 92602 <br />^COR OrRr434ZAJLKaN. All rights reserved. <br />HI:VKU ZO (ZUU-dima) The ACORD name and logo are registered marks of ACORD <br />