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Policy Number: Date Entered: 10/6/2010 ACORO? CERTIFICATE OF LIABILITY INSURANCE 1 DATE 10 10 6 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 CONTACT NAME Cindi 07 Adams Avenue Insurance Agency ONE FAX PH # IAC. I No EX1: (877) 250-8397 A/c No: (866) 832-4186 License 0756665 E-MAIL cindi@AdamsAveIns.com ADDRESS: 9114 Adams Ave, #144 PRODUCER CUSTOMER ID Huntington Beach, CA 92646 INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURERA:Sequoia Insurance Company WRJ-GT LLC, dba Essergy Consulting INSURERB:United States Liability Insurance Co Jill Dominguez INSURER C 235 E Broadway #520 INSURER D: Long Beach, CA 90802 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 ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MM/DOIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1 QQQ 00,000 DAMAGE TO RENTED A COMMERCIAL GENERAL LIABILITY SBP212192-3 9/1/2010 9/1/ Oll PREMISES Ea occurrence S 300,000 CLAIMS-MADE Ix OCCUR F RM M ED EXP (Anyone person) S 1Q 000 ED ? S TO PERSONAL &ADV INJURY $ Included R All O GENERAL AGGREGATE $2,000,00 GEN'LAGGREGATE LIMITAPPLIES PER / ?+ PRODUCTS - COMP/OP AGG $2,000,000 POLICY PRO- LOC G -?r S i 0 v? $ AUT OMOBILE LIABILITY Pttorv -,Y COMBINED SINGLE LIMIT taut s`S City (Ea accident) $1,000,000 A ANY AUTO X BODILY N RY P I ( er person) JU $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULEDAUTOS PROPERTY DAMAGE $ HIRED AUTOS SBP21219201 9/1/2010 9/1/2011 (Per accident) NON-OWNED AUTOS SBP21219201 9/1/2010 9/1/2011 $ UMBRELLA LIAB H OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DEDUCTIBLE S RETENTION $ $ WORKERS COMPENSATION W STATU- OTH- C AND EMPLOYERS' LIABILITY T RY LIMIT ER Y J N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER ME ? N / A E.L. EACH ACCIDENT $ I MBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ B Professional SPI018037 7/13/2010 7/13/2011 Each Claim 1,000,000 Liability Aggregate 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate holder is additional insured, see attached CERTiFIGAlt HULUEK CANCELLATION City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 Civic Center Plaza ACCORDANCE WITH THE POLICY PROVISIONS. Santa Ana, CA 92702 AUTHORIZED REPRESENTATIVE ACORD 25 (2009/09) © 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Producedusing Forms Boss Plus software.www.FormsBoss.comlmpressivePublishing 800-208-1977