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OP ID: 9Z <br />14� °REX CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MMIDD/YYYY) <br />05124/11 <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 confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER 734- 741 -0044 <br />Hylant Group Inc - Ann Arbor 734- 741 -1850 <br />24 Frank Lloyd Wright Dr J4100 <br />Ann Arbor, MI 48105 <br />JPaul Dixon <br />CONTACT <br />NAME: <br />PHONE 'FAX No <br />Alc Ext <br />IL <br />ADDRESS: <br />PRODUCER FAACI -1 <br />CUSTOMER ID #: <br />INSURER(S) AFFORDING COVERAGE <br />NAIC # <br />INSURED FAAC, Inc.; IES Interactive <br />INSURER A: Travelers Indemnity Company <br />025658_ _ <br />INSURER B: <br />$ 1,000,000 <br />Training, a division of FAAC; <br />INSURER c <br />Realtime Technologies, Inc. <br />1229 Oak Valley Drive <br />Ann Arbor, MI 48108 <br />Santa Ana, CA 927 <br />INSURER D: <br />05/01/11 <br />INSURER E <br />—0—AM—AGE—TO-RENTED <br />PREMISES Ea occurrence <br />INSURER F: <br />MED EXP (Any one person) <br />$ 10,000 <br />.,.—A - 0 r=oTlclrerc nll Mr -tER: 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 />INSR <br />LTR <br />TYPE OF INSURANCE <br />INSR <br />UBR <br />POLICY NUMBER <br />MMIDDfYYYY <br />MM /DDIIYYYY <br />LIMITS <br />FOjRM <br />GENERAL LIABILITY <br />City of Santa Ana <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />P.O. Box 1988 <br />EACH OCCURRENCE <br />$ 1,000,000 <br />• <br />X COMMERCIAL GENERAL LIABILITY <br />X <br />Santa Ana, CA 927 <br />6309237P921 <br />05/01/11 <br />05/01/12 <br />—0—AM—AGE—TO-RENTED <br />PREMISES Ea occurrence <br />$ 300,00 <br />MED EXP (Any one person) <br />$ 10,000 <br />CLAIMS -MADE I •• 'OCCUR <br />PERSONAL & ADV INJURY <br />$ 1,000,000 <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER <br />PRODUCTS - COMP /OP AGG <br />$ 2,000,000 <br />$ <br />POLICY PRO LOC i <br />• <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />BA9237P921 <br />05/01/11 <br />05/01/12 <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />$ 1,000,000 <br />X <br />BODILY INJURY (Per person) <br />$ <br />ALL OWNED AUTOS <br />BODILY INJURY (Per accident) <br />$ <br />-. <br />SCHEDULED AUTOS <br />HIRED AUTOS <br />PROPERTY DAMAGE <br />(Per accident) <br />$ <br />$ <br />NON - OWNEDAUTOS <br />_ <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE <br />$ 10,000,000 <br />AGGREGATE <br />$ 10,000,000 <br />-- — <br />A <br />EXCESS LIAB JX <br />CLAIMS -MADE <br />CUP9237P921 <br />05/01/11 <br />05/01/12 <br />- <br />- -- <br />DEDUCTIBLE <br />$ <br />X <br />RETENTION $ 10,000 <br />$ <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETOR /PARTNER /EXECUTIVE <br />UB9237P921 <br />05/01/11 <br />05/01/12 <br />X WC STATU- OTH- <br />TORY LIMITS ER <br />E.L. EACH ACCIDENT <br />$ 500,000 <br />E.L. DISEASE - EA EMPLOYEE <br />$ 500,00 <br />OFFICER /MEMBER EXCLUDED? ❑ <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />N / A <br />E.L. DISEASE - POLICY LIMIT <br />_ <br />$ 500,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) <br />The City of Snata Ana, its officers, employees, agents, volunteers and <br />representatives, is added as additional insured as respects operations of <br />the named insured performed under contract with the City of Santa Ana for <br />the General Liability. <br />CERTIFICATE HOLDER CANCELLATION <br />` my Anof71ey © 1988 -2009 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD <br />CITSA11 <br />APPROVED <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />_ ED AS TO <br />FOjRM <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />City of Santa Ana <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />P.O. Box 1988 <br />t <br />AUTHORIZED REPRESENTATIVE <br />20 Civic Center PI l a <br />Santa Ana, CA 927 <br />ERESA <br />i- <br />L <br />` my Anof71ey © 1988 -2009 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD <br />