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CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MM 12100//2010 2010 Yp
<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 INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the
<br />terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />AOn Risk Services South, Inc.
<br />Atlanta GA Office
<br />CONTACT
<br />NAME:
<br />AX
<br />(NC. Ne. Eaq, (366) 283 -7122 FAIL (847) 953 -5390
<br />3565 Piedmont Rd NE,B1g1,k700
<br />ESL A 55
<br />Atlanta GA 30305 USA
<br />PRODUCER 570000039630
<br />CUSTOMER ID a:
<br />INSURER(S) AFFORDING COVERAGE
<br />NAICA
<br />INSURED
<br />INSURER A ACE American Insurance Company
<br />22667
<br />Sapphire Technologies, LP
<br />(See Attached Named Insured Schedule)
<br />60 Harvard Mill Square
<br />INSURER B: Indemnity Insurance CO of North America
<br />43575
<br />INSURER C: Zurich American Ins Co
<br />16535
<br />Wakefield MA 01880 USA
<br />INSURER D'
<br />$1,000,000
<br />NSURER E:
<br />CLAIMS -MADE ❑% OCCUR
<br />N9URER F:
<br />COVERAGES CERTIFICATE NUMBER: 570041224784 REVISION NUMBER:
<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 PAID CLAIMS. Limps shown are as requested
<br />LTR
<br />TYPE OF INSURANCE
<br />INSR
<br />IWO
<br />POLICYNIMBER
<br />MMID
<br />MW
<br />LIMITS
<br />GENERAL LIABILITY
<br />GILD
<br />EACHOCCURRENCE
<br />$5,000,000
<br />X COMMERCIAL GENERAL LIABILITY
<br />PREMISES Ea ocounence
<br />$1,000,000
<br />CLAIMS -MADE ❑% OCCUR
<br />MED EXP(My one Vereon)
<br />510,000
<br />X Dor,Iro=al Liability
<br />PERSONAL B ADV INJURY
<br />$5,000,000
<br />GENERAL AGGREGATE
<br />$5,000,000
<br />GEN'L AGGREGATE LIMB APPLIES
<br />PER:
<br />PRODUCTS- COMP /OP AGO
<br />$$,000,000
<br />X POLICY PRO
<br />LOC
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />ISA H0863080A
<br />COMBINED SINGLE LIMIT
<br />Me eccident
<br />$2,000,000
<br />BODILY INJURY (Per paean)
<br />X
<br />ANY AUTO
<br />ALL OWNED AUTOS
<br />BODILY INJURY (Per accaen0
<br />SCHEDULED AUTOS
<br />PROPERTY DAMAGE
<br />(Per ... debt)
<br />HIREDAUTOS
<br />NON OWNED AUTOS
<br />UMBRELLA LIAS
<br />OCCUR
<br />EACH OCCURRENCE
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />AGGREGATE
<br />DEDUCTIBLE
<br />RETENTION
<br />*
<br />A
<br />A
<br />WORKERS COMPENSATION AND
<br />EMPLOYERS' LIABILITY YIN
<br />ANY PROPRIETOR I PARTNER I EXECUTIVE
<br />OFFICERIMEMBER EXCLUDED?
<br />(Mandatary in NH)
<br />NIA
<br />WLRC46139811
<br />WLRC46139793
<br />SCFC4613980A
<br />10 01 2 10
<br />10/01/201010/01
<br />10/01/2010
<br />10/01/2011
<br />/2011
<br />10/01/2011
<br />WC STATU- OTH-
<br />X TORY LIMITS IER
<br />E.L. EACH ACCIDENT
<br />$1,000,000
<br />E. L, DISEASE -EA EMPLOYEE
<br />$1,000,000
<br />I! ym deea,ibe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$1,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Afti ACORD 101, Addiaonal Ramarka 9chadu14, s more apace is required)
<br />THE CITY OF SANTA ANA, 20 CIVIC CENTER PLAZA SANTA ANA, CA 92701, ITS OFFICERS, EMPLOYEES, AGENTS, VOLUNTEERS AND
<br />REPRESENTATIVES ARE NAMED AS ADDITIONAL INSUREDS WITH REGARDS TO LIABILITY AND DEFENSE OF SUITS ARISING FROM THE OPERATIONS AND
<br />USES PERFORMED BY OR ON BEHALF OF THE NAMED INSURED PER ATTACHED CG2010 FORM.
<br />CERTIFICATE HOLDER CANCELLATION
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
<br />EXPIRATION DATE THEREOF, NOTICE WILL BE DELNERED IN ACCORDANCE WITH THE
<br />POLICY PROVISIONS.
<br />CITY OF SANTA ANA I AUTHORIZED REPRESENTATIVE
<br />ATTN: LORI SMITH
<br />1439 S. BROADWAY
<br />SANTA ANA CA 92707 USA Jq�
<br />©1988 -2009 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD
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