R.P. LAURAIN & ASSOCIATES, INC. 2 - 2011

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C I ie nt#: 394653 RPLAURAI ACORD- CERTIFICATE OF LIABILITY INSURANCE IDATE 1 /1/2012/2011YYY) 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 NAME: USI of Southern California SC PHONE FA (A/C No, Ea):. 800-854-3296 (A/C, No): Lic # 0351162 E-MAIL- -- _ 29A Technology Drive ,t / y /V �'/- O/" PRODUCER CUSTOMER_IDn; Irvine, CA 92618 IN SURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: Hartford Casualty insurance Com 29424 Associates Inc. INSURER B : Preferred Employers Ins Company R_P. Linden 10900 A Linden Avenue #200 Scottsdale Insurance Company INSURER c : P Y 41297 Lon Long Beach, CA 90807 INSURER D INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 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. IN R LTRTYPE OF INSURANCE ADDLSUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EX MM/DD/YYYY LIMITS A ,. GENERAL LIABILITY 72SBACU6245 102/11/2011 02/11/2012 EACH OCCURRENCE___ $1 OOO OOO COMMERCIAL GENERAL LIABILITY. CLAIMS -MADE I X I OCCUR PREMISES (Ea occurrDe nce) MED EXP (Any one person) $300,000 $10,000 PERSONAL B ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000 POLICY PRO LOC $ A AUTOMOBILE LIABILITY 72SBACU6245 02/11/2011 02/11/2012 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS ',, _ _ _. _ _ BODILY INJURY (Per accitlent) $ SCHEDULED AUTOS HIRED AUTOS APPROVED AS TO FORM - R--- - - - PPROPERTY a ET itlentDAMAGE — $ X X $ NON -OWNED AUTOS ) 71 $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ Laura SLUL Assistant CiLy hce. tt( 1' CN AGGREGATE $ DEDUCTIBLE $ RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) NIA WKNIO81971 O 10/06/201 O 10/06/2011 X WC STATU- OTH- TORY LIMITS ER_.. E.L. EACH ACCIDENT EL DISEASE - EA EMPLOYEE $1,000,000 $1,000,000 IT yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1 OOO O00 C Prof Liability I EKS3028791 12/01/2010 12/01/2011 $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) The City of Santa Ana, its officers, agents, employees, consultants, special counsel, and representatives are named as additional insureds with respects to General Liability as per form SS00080405. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Ron Ono;Parks, Recreation 8. Community Services AUTHORIZED REPRESENTATIVE 26 Civic Center Plaza © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) 1 of 1 The ACORD name and logo are registered marks of ACORD #S5215574/M5215416 - JMWJB