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<br />,4 " CERTIFICATE OF LIABILITY INSURANCE DATE <br />( <br />YYVY) <br /> <br />12012 <br />01,0 120,2 <br />, <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 <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not cpnfer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER CONTACT <br />Marsh RISI & Insurance Services _NAME__ <br />CA License #1)437153 PHONE FAX <br />Ext): A/C No : <br />A <br />E- <br />777 South Figueroa Mreet M <br />iIL <br />L <br />A <br />l <br />CA 90017 ADDRESS: <br />- -- -- "? <br />os <br />nge <br />es, ------ - ----- <br /> INSURER(S) AFFORDING COVERAGE NAIC # <br /> <br />502512-FINPR-F&012-13 _ <br />: Nautilus Insurance Company <br />INSURER A _ <br />17370 <br />INSURED <br />Richards <br />Watson & Gershon _ <br />INSURER B : AXIS Surplus Insurance Company <br />-- - -- 26620 <br />, ---- --- <br />355 South Grand Avenue INSURER C : <br />-- ----- - - <br />40th Floor - -- ----- --- <br />L <br />CA 90071 <br />3101 <br />A <br />l _INSURER D : <br />os <br />- <br />nge <br />es, <br /> INSURER E : <br /> INSURER F : <br />COVERAGES CERTIFICATE NUMBER: LOS-001448649-24 - REVISION NUMBER- 1 <br />THIS IS TO CERTIFY 1HAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUE HE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY NJArT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY TH ICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN ViffrED B PAID CLAIMS. <br />INSR ADDL SUBR---- <br />LTR TYPE OF INSURANCE INS R POLICY NUMBER MM/ DY 'MM/ D/YYYY LIMITS <br /> GENERAL LIABILITY <br />? _ EACH OCCURRENCE $ <br /> <br />1 COMMERCIAL GENERAL LIABILITY 1. <br />C. ' DAMAGE TO RENTED <br />PREMISES Ea occurrence <br /> CLAIMS-MADE lI OCCUR MED EXP (Anyone person) $ <br /> PERSONAL & ADV INJURY $ <br /> <br /> GENERAL AGGREGATE $ <br /> <br />GEN'L AGGREGATE LIMIT APPLIES PER _ <br />PRODUCTS - COMP/OP AGG _ <br />$ <br /> POLICY PRO- LOC $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> Ea accident <br /> ANY AUTO BODILY' INJURY' (Per person) I $ <br /> ALL OWNED <br />AUTOS SCHEDULED <br />AUTOS <br />BODILY INJURY (Per accident) <br />$ <br /> AUTOS <br />- NON-OWNED <br />AUTOS PROPERTY DAMAGE <br />Per accident-- <br />$ <br /> <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB - L CLAIMS-MADE AGGREGATE $ <br /> <br /> DED RETENTION $ $ <br /> WORKERS COMPENSATION WC STATU- OTH- <br /> AND EMPLOYERS' LIABILITY <br />I ER <br />TORYLtMiLS-L ___ <br /> Y / N <br />ANY PROPRIETOR/PART NEH/EXECUTIVE E <br />L <br />EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? ? N N / A . <br />. <br /> (Mandatory in NH) <br />If <br />d <br />ib .L. DISEASE - EA EMPLOYEE <br />[E $ <br /> yes, <br />escr <br />e under <br />DESCRIPTION OF OPERATIONS below .L <br />. DISEASE -POLICY LIMIT $ <br />A Lawyers Professional Liability PLP 1600238 P-2 10i0812012 10108/2013 Limit of I lability 5,000,000 <br />B Lawyers Professional Liability EGN721261/01/2012 1 1010812012 10108/2013 $250,000 Retention Claims Made Policy <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is require <br />T"PUVLll A <br />1 <br />S TO FORM <br />w <br />Laura Stitt Szt/Kdy <br />Assistant City Atlornev <br />• • •• •••• • •? • •........-• • l.N1YL.CLLA I IUIV <br />CITY OF SAN FA ANA <br />OFFICE OF THE CITY ATTORNEY <br />TWENTY CIVIC CENIER PLAZA <br />SAN FA ANA, CA 92702 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />of Marsh Risk 8 Insurance Services <br />Pat Fritcher <br /> <br />©1988-2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD