RICHARDS, WATSON & GERSHON (2011) 3

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RICHWAT-01 JCAMOMILE DATE (MM/DD/YYYY) F CERTIFICATE OF LIABILITY INSURANCE 10/25/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Peter C. Foy & Associates Insurance Services Inc. 21650 Oxnard St. Suite 1900 Woodland Hills, CA 91367 INSURED I inc"nie. E:n (818) 703-8057 IA c_ N„h (818) 703-0935 ADDRESS: Richards, Watson & Gershon 355 S. Grand Avenue, 40th Floor Los Angeles, CA 90072-3101 INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: _ REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE AD L INSR UBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY ? EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY X 35293250 10/1/2012 10/1/2013 PREMISES (Ea KLNI occurrence) $ 1,000,000 CLAIMS-MADE ? OCCUR MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 _ GENERAL AGGREGATE $ 2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OPAGG $ Included POLICY M X LOC $ AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 B ANY AUTO 74967929 1011/2012 10/1/2013 BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X HIRED AUTOS X NON-OWNED AUTOS PROPERTY DAMAGE PERACCIDENT $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ ? r DED RETENTION $ $ WORKERS COMPENSATION - WC STATU- OTH- X AND EMPLOYERS' LIABILITY Y / N TORY LIMITS ER B ANY PROPRIETOR/PARTNER/EXECUTIVE 71726476 10/1/2012 1011/2013 E L EACH ACCIDENT 1 000 000 OFFICER./MEMBER EXCLUDED9 ? N /A . . , $ , (Mandatory in NH) L-J If es describe under E.L. DISEASE - EA EMPLOYEE; $ 1,000,000 - y , DESCRIPTION OF OPERATIONS below _ E.L. DISEASE - POLICY LIMIT $ 1,000,000 i DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate Holder is named as Additional Insured as their interest may appear. Subject to policy terms, conditions and exclusions. Coverage is considered primary & non-contributory. 10 days notice of cancellation applies for non-payment of premium. Fop CERTIFICATE HOLDER E? Sisl , CANCELLATION City of Santa Ana Office of the City Attorney Twenty Civic Center Plaza Santa Ana, CA 92701 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Chubb Insurance Company 41386 _ g4 INSURER B : Federal Insurance Company 0281 INSURER C INSURER D SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUT?HORIIZE,D' REPRESENTATIVE © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD