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BRODE3 OR ID: NO <br />CERTIFICATE OF LIABILITY INSURANCE <br />° 101101mn <br />THIS 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, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INI AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, <br />IMPORTANT: N the cedificate holder is an ADDITIONAL INSURED, $a policXiesl must be endorsed, If SUBROGATION IS WAIVED, suhjecfto <br />the terms and wndPoens of $e policy, cedaln policies may require an endorsement. A statement on this ceNficate does noteonfer rlghlste the <br />certificate holderin lieu of such endarsemenQs. <br />PRODUCER <br />Xylem Group Inc -Toledo 419255 -0020 <br />811 Madison Ave 419.255.7557 <br />COMA" <br />NAMF. <br />MxNO En: uc NO <br />Toledo, OH 43604 <br />Jeaonie Y. Nyland <br />EMAL <br />ADDRESS <br />NSUREeP AFFORDING COVERAGE NAZI <br />)SURER A :Philadel hla Indeormly Ins Co <br />18058 <br />INSURED Jay Broderick dha Mad Science <br />of West Orange County <br />3501 W Moore Ave, Ste J <br />INSURERS <br />WsuRmc. <br />INSUeaeo, <br />Santa Ana, CIIA927014,,I <br />INSURER E: <br />�J I�OVIyDIPY <br />USURER F: <br />COVERAGES CERTIFICATE NUMBER: REVISIONNUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR 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 REDUCED BY PRO CLAIMS. <br />Ill <br />nttoFINSUmNLE <br />KUCYNUMEER <br />NMIOpW <br />MMI�OnYYY <br />LIES <br />I GENERAL MAPoWY <br />EACH OCCURRENCE <br />IS 11000,00 <br />A <br />IX cot SPIKE Ersm[UmDm I X <br />CINMPME �GCCLR <br />PHPK772381 <br />10116111 <br />10MV12 <br />PaEMISm7rnzt��: <br />300,00 <br />MEOEYPVnM6,00 <br />X PLPHPK772381 <br />10115111 <br />I M6112 <br />PERSONAL&1,000,00 <br />GENERA. AE21000,00 <br />GENLAGGPECPIE.MITAPPLIESPEP'. <br />FPOOWTS- <br />2,000,00 <br />POUCri °xo me <br />I <br />ABM <br />s 500,00 <br />AUTOMONLEUAEILIIY <br />I <br />EeMx:NemSINGIELIMn <br />'E 1,000,00 <br />acORYINSUarryOlPaxcl <br />a <br />A <br />durwrO <br />I <br />PHPK7123B1 <br />iN16111 <br />10115112 <br />� <br />euowuao aCNEOUreo <br />Auros Au3os <br />� <br />aom.vlN✓<mY M,Omaml <br />I <br />I s <br />X <br />HIREDemOS X NONOVUNEO <br />AUTOS <br />' <br />PeaEerrDANACE <br />Pa,:md„I <br />s <br />r <br />UMEREI.AIIAS <br />DCGGA <br />EACH OCLGRAENCE <br />a <br />EXCE96UAS <br />CWMSAWOE <br />AWPEGATE <br />OEO FOFENTION} <br />� <br />IS <br />� <br />WoRXERSWMPENSAnON <br />ANDENPWYEPS'IIAPoLIry YIN <br />'ANYmOPPofi[ARARINEPhXECINNE <br />OFF[EGMENSEAExCLUCEG? � <br />NIP <br />I <br />WC BTAie' OTNt <br />T ' <br />EL.EACHACCIOENT <br />8 <br />ELOISEASEEAEMPLOYEES <br />INanaaoryio NH <br />N amloeMre, <br />o�alPnouaraPEexnoasMloN <br />' <br />IEL.DISEasEraucY.Mn <br />s <br />I <br />I <br />I <br />i <br />I <br />DESCPoPmaorovERanousrLwnauslvEN ¢TES pdun ACCxorDt Aaetloral PemmuseMamANmoremrela,pwlwl <br />CIN of Sanh Roe PerXa, Recreation, 6 Community Services Agan�, iN <br />o mers, agenh, employees, represenbfives and veluotcere are inO Utled es <br />an AddNonal lnauretl per Form CG2010. ' /wn �// <br />CERTIFICATE HOLDER CANCELLATION <br />SHOULD PNY OF 1HE ABOVE OEBCRIBEO POLI CIE$ BE CANCELLED BEFORE <br />THE EXPIRATION GATE iNEREOF, NOTICE WILL BE DELIVERED IN <br />DItyOTSanhAna <br />ACCOAOANCEWITHiHEPOLICYPRON90Na, <br />AMn: Silvia Cuevas <br />AmHaRUEOeaveESENTansE <br />Jeannie Y.Nylanf <br />26 CivicCen�rPlaza <br />SanWAna,CA92101 <br />©1995.2010 ACORD CORPORATION. All dghis reserved. <br />ACORD 25 �20f010S� The ACORD name and logo are regphred make ofACORO <br />