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—� ® DATE(MM /DD /YYW) <br />�`CO'2O CERTIFICATE OF LIABILITY INSURANCE <br />1z/z9 /zo11 <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(les) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the 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 andorsement(s). <br />PRODVCER <br />AOn Ri Sk SerVi Ces South, InC. <br />Atlanta GA Offi Ce <br />CONTACT <br />NAME: <br />PHONE �g66i 283 -]122 FAX (847 953 -5390 <br />(A/C. No. EXy: A/C. No. <br />3563 Piedmont Rd NE, BIgl, #700 <br />Atlanta GA 30303 USA <br />E�1aL <br />ADDRESS: <br />INSU RER(S) AFFORDING COVERAGE <br />NAIC tt <br />INSURED <br />R andstad Technologies <br />CSee Attached Named insured Schedul e� <br />INSURER A: ACE Ame rl Can insurance Company <br />22667 <br />INSURER B: ZU rI Ch American Ins Co <br />16333 <br />INSURER C: <br />'ld3f� 3L'I � <br />60 Harvard Mill Square <br />Wakefield MA 01880 USA <br />INSURER D: <br />bN`d t11NdS �0 <br />.ill <br />INSURER E: <br />PREMISES Ea pccunanca <br />INSURER F: <br />CLAIMS -MADE X� OCCUR <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. Llm its shown era as requested <br />LTR <br />TYPE OF INSURANCE <br />INSR <br />WVD <br />POLICY NUMBER <br />MM /DD <br />MM/DO <br />LIMITS <br />CITY OF SANTA ANA <br />GENERAL LIABILITY <br />gUTHORIZED REPRESENTATIVE <br />GLO <br />EACH OCCURRENCE <br />$ S ,UUU ,UUU <br />'ld3f� 3L'I � <br />X COMMERCIAL GENERAL LIABILITY <br />�`� <br />bN`d t11NdS �0 <br />.ill <br />`��1 `��75 <br />moss `���`�� <br />PREMISES Ea pccunanca <br />$1, UUU' UUU <br />CLAIMS -MADE X� OCCUR <br />ACORD 25 (20'1 O /OS) <br />The ACORD Hama and <br />logo are registered marks of ACORD <br />MED EXP (Any one parson) <br />$10 , 000 <br />X Contractual Liability <br />PERSONAL 8 ADV INJURY <br />$S, 000, 000 <br />GENERAL AGGREGATE <br />$S,000,OOO <br />A app„�� �� _ c r�V\ <br />A��a�V 1'M>• �V <br />GEN'L AGGREGATEPL P APPLIES PER: <br />X POLICY LOC <br />PRODUCTS - COMP /OP AGG <br />S S , OOO , OOO <br />A <br />AUTOMOBILE LIABILITY <br />ISA 1 <br />1 2011 <br />10 O1 2012 <br />COMBINED SINGLE LIMIT <br />$2 , 000 , 000 <br />BODILY INJURY (Par Darson) <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />X HIRED AUTOS X ANON -0WNED <br />BODILY INJURY (Per accident) <br />Cit <br />�Y 7 <br />� <br />PROPERTY DAMAGE <br />Per accident <br />UMBRELLA LIA6 <br />OCCUR <br />EACH OCCURRENCE <br />EXCESS LU1B <br />CLAIMS -MADE <br />AGGREGATE <br />DED <br />RETENTION <br />A <br />a' <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILRY <br />ANY PROPRIETOR /PARTNER /EXECUTIVE Y/N <br />OFFICER/MEMBER E %CLUDED? � <br />N / A <br />WLRC46770894 <br />All other States <br />SC FC4677U9UU <br />10 O1 201110 <br />10/01/2011 <br />O1 2012 <br />10/01/2012 <br />WC STATU- OTH- <br />X TORY LIMITS <br />E.L. EACH ACCIDENT <br />$1 ,UUU, UUU <br />E.L. DISEASE -EA EMPLOYEE <br />$1, UUU, UUU <br />(Mandatory In NH) <br />Wl SCOnSI n <br />IT yea, tlescriba untler <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT; <br />$1 , 000, 000 <br />J <br />DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (Attach ACORD 1 Ot, Atltlhlonal Ramarka Schedule, H more apace la requlreli) <br />THE CITY OF SANTA ANA, 20 CIVIC CENTER PLAZA SANTA ANA, CA 92701, ITS OFFICERS, EMPLOYEES, AGENTS, VOLUNTEERS ANL� ,, <br />REPRESENTATIVES ARE NAMED AS ADDITIONAL INSUREDS WITH REGARDS TO LIABILITY AND DEFENSE OF SUITS ARISING FROM'THE l7VERATION3 AND <br />USES PERFORMED BY OR ON BEHALF OF THE NAMED INSURED PER ATTACHED CG2010 FORM. <br />_;:3 <br />1aJ <br />' e_•a <br />CERTIFICATE HOLDER <br />CANCELLATION "� <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />R 7 � �' ��� <br />�'� <br />EXPIRATION GATE THEREOF, NOTICE WILL BE DELNERED IN ACCORDANCE WRH THE <br />CITY OF SANTA ANA <br />`�' `�' �� <br />gUTHORIZED REPRESENTATIVE <br />ATTN: LORI SMITH <br />1439 S. BROADWAY <br />SANTA ANA CA 92707 USA <br />'ld3f� 3L'I � <br />�`� <br />bN`d t11NdS �0 <br />.ill <br />`��1 `��75 <br />moss `���`�� <br />©'1988 -20'1 O ACORD CORPORATION. All rights reserved. <br />ACORD 25 (20'1 O /OS) <br />The ACORD Hama and <br />logo are registered marks of ACORD <br />d <br />_� <br />c <br />m <br />O <br />S <br />0 <br />m <br />t` <br />u� <br />Z <br />�q <br />Gl <br />m <br />v <br />