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H�K V <br />CERTIFICATE OF LIABILITY INSURANCE �'n7 ^111YYT) <br />OP ID: Q8 <br />CERTIFICATE OF LIABILITY <br />DATE 1 07120 <br />07120/111 1 <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 BF,, EN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. "` 1 ,', �( �. C: <br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(ies) must be endorsed. If SUBROGA 10 k 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 endorsement(s). <br />PRODUCER 714 - 997 -8100 <br />(OC)Heffernan Prof. Practices 714- 460 -9935 <br />'11856 W. Katella Ave, #266 <br />NAME: <br />PHONE <br />ac No <br />_ <br />ADDRESS: <br />Orange, CA 82687 <br />ER .PHASE -3 <br />INSURERS AFFORDING COVERAGE <br />HAIG0 <br />EACH OCCURRENCE <br />INSURED Phase II Systems <br />INSURERA:Hartford Casualty Insurance Co <br />29424 <br />dba: PARS <br />INSURER a:LLO d's of London <br />PERSONAL S AOV INJURY <br />4350 Von Karmen Ave., Ste 100 <br />Newport Beach„ CA 92660 <br />INSURER C: <br />INSURER D <br />- <br />INSURER E: <br />PRODUCTS - COMP /OP AGG <br />S 4,000,00 <br />INSURER F : <br />$ - -- <br />A <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 PAID CLAIMS. <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />CITY OF SANTA ANA <br />POLICY NUMBER <br />CY EFF <br />MD <br />POLICY EXP <br />MMIODIYYYY <br />UMITS <br />A <br />GENERAL LIABILITY <br />X COMMERCIALGENERALLIABILITY <br />CLAIMS -MADE OCCUR <br />SANTA ANA, CA 82701 <br />72SBAAC2429 <br />O F <br />pVED <br />05108/11 <br />05/09/12 <br />EACH OCCURRENCE <br />$ 2,000,00 <br />PREMISES (Ee ocwrnmcet <br />$ 1,0_00,00 <br />MED EXP(Any one person) <br />$ 10,00 <br />PERSONAL S AOV INJURY <br />$ 2,OOD,00 <br />GENERAL AGGREGATE <br />S 4,000,00 <br />GEN L AGGREGATE LIMIT APPLIES PER: <br />POLICY X PRO- LOC <br />PRODUCTS - COMP /OP AGG <br />S 4,000,00 <br />$ - -- <br />A <br />AUTOMOBILE <br />LUUHLIW <br />ANY AUTO <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />HIRED AUTOS <br />NON OWNED AUTOS <br />(72SBAAC2429 <br />Pt' Stra a <br />Jose At" <br />A$$IStSRt City <br />ey <br />06108/11 <br />06108/12 <br />COMBINED SINGLE LIMIT <br />S 2,000,00 <br />BODILY <br />BODILY INJURY(Per Parton) <br />-- <br />$ <br />BODILY INJURY (Per accident) <br />3 <br />PROPERTY DAMAGE <br />lPeracddanl) <br />$ <br />X <br />X <br />$ <br />S <br />UMBRELLA LIAB <br />EXCESS LIAR <br />OCCUR <br />CLAIMS -MADE <br />N/A <br />EACH OCCURRENCE <br />S <br />AGGREGATE <br />S <br />DEDUCTIBLE <br />. RETENTION S <br />$ <br />$ <br />WORKERS COMPENSATION <br />ANDEMPLOYERS'UABILITY YIN <br />ANY PROPRIETOFUPARTNERIEXECUTNE <br />OFFICER/MEMBER EXCLUDECT <br />(Mandatary In NH) <br />11 es, descrto,mc it <br />DESCRIPTION OF OPERATIONS tmI <br />NIA <br />NIA <br />0 STATU. OTH- <br />E.L. EACH ACCIDENT <br />$ <br />E.L. DISEASE - EA EMPLOYE <br />S <br />E.L. DISEASE - POLICY LIMB <br />S <br />6 <br />PROFESSIONAL <br />LIABILITY <br />I <br />I <br />�WROD0013L <br />071301T"011 <br />PER CLAIM 2,000,00 <br />AGGREGATE 2,000,00 <br />DESCRIPTION OF OPERATIONS I LOCATIONS l VEHICLES Attach ACORD 101, Additional Remarks Schedule, If mon, pace Is required) <br />PROJECTS AS ON FILE WITH THE INSURE INCLUDING BUT NOT LIMITED TO THOSE <br />USUAL TO THE INSURED'S OPERATIONS /PARS SUPPLEMENTARY RETIREMENT PLAN. THE <br />CITY OF SANTA ANA ITS OFFICIALS, EMPLOYEES AND VOLUNTEERS ARE NAMED AS <br />ADDITIONAL INSUREDS ON GENERALLIABILITY POLICY -SEE ATTACHED ENDORSEMENT. <br />CERTIFICATE HOLDER CANCELLATION <br />®1988.2009 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />CITY OF SANTA ANA <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />ATTN: EXECUTIVE DIRECTOR OF <br />AUTHORIZED REPRESENTATIVE <br />PERSONNEL SERVICES <br />20 CIVIC CENTER PLAZA <br />SANTA ANA, CA 82701 <br />®1988.2009 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD <br />