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PHASIIS -01 HBCT15 <br />`{�_°,ROP CERTIFICATE OF LIABILITY INSURANCE <br />DATE DYYYY) <br />5/3/2013 <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 INSURERS), 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 <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 License # 0564249 <br />(OC) Heffernan Insurance Brokers <br />6 Hutton Centre Drive, Suite 500 <br />Santa Ana, CA 92707 <br />CONTACT <br />NAME: <br />PHONE 1 (714) 361 -7700 FAX ) <br />A/C No Ext : A /C, No): 1 714 361 -7701 <br />E -MAIL <br />ADDRESS: <br />INSURER(S) AFFORDING COVERAGE <br />NAIC # <br />INSURER A: Sentinel Insurance Company Limited <br />11000 <br />TORY LIMITS ER <br />INSURED <br />INSURER B: Lloyd's of London <br />$ <br />INSURER C <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />Phase II Systems dba PARS <br />INSURER D <br />4350 Von Karman Ave, Ste. 100 <br />Newport Beach, CA 92660 <br />INSURER E: <br />E.L. DISEASE - EA EMPLOYE 1 <br />INSURER F: <br />(Mandatory in NH) <br />If yes, describe under <br />UUVtKAUhb CERTIFICATE NUMBER: 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. <br />INSRR TYPE OF INSURANCE I IN SR WVD POLICY NUMBER MM /DDfYYYY ) (MOMIDDIYYYYI LIMITS <br />GENERAL LIABILITY <br />=T=D CE $ 2,000,000 <br />A X COMMERCIAL GENERAL LIABILITY X 72SBAAC2429 5/8/2013 5/8/2014 PREMISES Ea occurrence $ 1,000,000 <br />CLAIMS -MADE � OCCUR MED EXP (Any one person) $ 40,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />POLICY X PE I LOC <br />AUTOMOBILE LIABILITY <br />A ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS L AUT OS <br />X HIRED AUTOS I X AUTO - SWNED <br />UMBRELLA LIAB IH OCCUR <br />EXCESS LIAB CLAIMS -MADE <br />PERSONAL & ADV INJURY $ 2,000, <br />GENERAL AGGREGATE $ 4,000, <br />PRODUCTS - COMP/OP AGG $ 4,000, <br />5/8/2013 5/8/2014 BODILY INJURY (Per person) $ <br />BODILY INJURY (Per accident) $ <br />PROPERTY DAMAGE $ <br />PER ACCIDENT <br />O $ <br />EACH OCCURRENCE $ <br />L � _ AGGREGATE $ <br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) <br />PROJECTS AS ON FILE WITH THE INSURED INCLUDING BUT NOT LIMITED TO THOSE USUAL TO THE INSURED'S OPERATIONS /PARS SUPPLEMENTARY <br />RETIREMENT PLAN. THE CITY OF SANTA ANA, ITS OFFICIALS, EMPLOYEES AND VOLUNTEERS ARE NAMED AS ADDITIONAL INSUREDS ON GENERAL <br />LIABILITY POLICY -SEE ATTACHED ENDORSEMENT. <br />CERTIFICATE HOLDER CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />CITY OF SANTA ANA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ATTN: EXECUTIVE DIRECTOR OF PERSONNEL SERVICES ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 CIVIC CENTER PLAZA <br />SANTA ANA, CA 92701 AUTHORIZED REPRESENTATIVE <br />©1988 -2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD <br />WORKERS COMPENSATION <br />WC STATU- 0TH - <br />AND EMPLOYERS' LIABILITY YIN <br />�aK,a <br />el <br />TORY LIMITS ER <br />E.L. EACH ACCIDENT <br />$ <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />N/A <br />A� or <br />E.L. DISEASE - EA EMPLOYE 1 <br />$ <br />(Mandatory in NH) <br />If yes, describe under <br />A <br />77/30/2012 <br />I <br />E.L. DISEASE - POLICY LIMIT <br />$ <br />�13 <br />DESCRIPTION OF OPERATIONS below <br />PROFESSIONAL <br />LDUSA1204508 <br />7/30/2013 <br />PER CLAIM 2,000,000 <br />B (LIABILITY <br />iLDUSA1204508 <br />7/30/2012 <br />7130/2013 <br />AGGREGATE 2,000,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) <br />PROJECTS AS ON FILE WITH THE INSURED INCLUDING BUT NOT LIMITED TO THOSE USUAL TO THE INSURED'S OPERATIONS /PARS SUPPLEMENTARY <br />RETIREMENT PLAN. THE CITY OF SANTA ANA, ITS OFFICIALS, EMPLOYEES AND VOLUNTEERS ARE NAMED AS ADDITIONAL INSUREDS ON GENERAL <br />LIABILITY POLICY -SEE ATTACHED ENDORSEMENT. <br />CERTIFICATE HOLDER CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />CITY OF SANTA ANA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ATTN: EXECUTIVE DIRECTOR OF PERSONNEL SERVICES ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 CIVIC CENTER PLAZA <br />SANTA ANA, CA 92701 AUTHORIZED REPRESENTATIVE <br />©1988 -2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD <br />