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mw <br />1,,- 1 0 ., r <br />AC4r->R° CERTIFICATE OF LIABILITY INSURANCE R054 DATE (MM/DD/YYYY) <br />09-08-2010 <br />THIS CERTIFICATES 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 D tIC0155TIkNTEO "TRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICAT HOLDE . <br />IMPORTANT: If the certificate holder is an ADDC}tyALINSURED,the-pollI s must be endorsed. If SUBROGATIONIS WAIVED, subject to <br />the terms and conditions of the policy, certain p ??s s1nay,require are or, A. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). _'! ! <br />PRODUCER NAME: <br />USAA INSURANCE AGENCY INC/PHS <br />: (888)242-1430 (A/C,Not: {877)905-045 <br />MR. FAX <br />812846 P:(888)242-1430 F:(877)905-0437 ADDRESS: <br />PO BOX 33015 <br />SAW ANTONIO TX 7 8 2 6 5 PRODUCE <br />c?oD x' <br /> INSURER(S) AFFORDING COVERAGE NAIC b <br />/N$LWO INSURER A : Hartford Casual{ Ins CO <br />KNOWLEDGE & INTELLIGENCE PROGRAM INSURER B: Hartford Accident & Indemnity C <br />PROFESSIONALS, INC <br />INSURER C <br />4401 ATLANTIC AVE STE 200 <br />LONG BEACH CA 9 0 8 0 7 <br />INSURER D <br /> INSURER E <br /> INSURER F <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> <br />MaR 7R <br />L <br />TYPE Of W$&QUACE <br />vivo <br />POLICY AA/A/8ER <br />(MAdDII?YYYI'1 <br />rMM/OD/YYYY/ <br />WAITS <br /> OENER4LL448KlrY EACH OCCURRENCE 9 1 O O O 000 <br /> COMMERCIAL GENERAL LIABILITY PREMISES =1 I . s 300,000 <br /> CLAIMS-MADE Q OCCUR MED EXP (Any one porson) 1 S 10"000 <br />A X General Liab X 65 SBM PW1830 10/22/2010 10/22/2011 PERSONAL & AOV INJURY is 1 000 000, <br /> GENERAL AGGREGATE 5 2, 0 0 0, 000 <br />1 <br /> GEN*L AGGRE GAIE LIMIT AEELU?S PER: PRODUCTS - COMP/OP AGG <br />O O O O <br />Is 2 00, <br /> POLICY P <br />RO- <br />irr <br />--1 <br />X LOC <br />I <br />S <br /> AVT OWOBRE UABILrrY COMBINED SINGLE LIMIT { <br />(Ea accident) I 000 /? <br />= 1, , O 0 0 <br /> ANYAUTO BODILY INJURY (Per person) j S <br /> ALL OWNED AUTOS <br />BODILY INJURY (PoraerJtlmt) <br />S <br /> <br /> <br />A SCHEDULED AUTOS <br />65 SBM PW1830 <br />10/22/2010 <br />10/22/201,1 <br />PROPERTY DAMAGE <br /> X HIRED AUTOS (Poarr accida acudantl <br /> X NON-OWNED AUTOS S <br /> <br /> UMBRELLA UAB OCCUR EACH OCCURRENCE 5 <br /> EXCESSLlAB H CLAIMS-MADE AGGREGATE I S <br /> DEDUCTIBLE C S <br /> RETENTION 1 5 <br /> WORKERS COAIPE14A"ON WC STATW 0TH. <br />X <br /> AND EMPLOYERS' ""LrrY T R1 I FR I <br /> (Y! N <br />ANY PROPRIETORIPARTNERIEXECUTIVE N/A EL. EACH ACCIDENT S 1, 000,000 <br />B j <br />OFF1 andwwy h NN) EXCLUDED? ? <br />W <br />65 WEC J02464 <br />D4 /22/201C <br />04/22/2011 <br />E.L. DISEASE - EA EMPLOYE <br />S 1 , 0 0 0 , 0 0 0 <br /> If yes. dextri <br />DESCRIPTION OFaOPERATIONS below <br />I <br />I <br />E.L. DISEAM <br />1 0 0 0 0 0 0 <br /> <br />DESCR/Pr10N op oPER4770N5 / LOCA770AL4 / VEMCLW rA11xh ACOAD 101, A0W&b W Rwnmks Sdaaduk, it mao 4"Ca is -Q <br />w; <br />Those usual Lo the Insured's Operations. <br />4P <br />.p? HWAITE <br />A <br />--r- - <br />City of Santa Ana <br />20 CIVIC CENTER PLZ <br />SANTA ANA, CA 92701 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br />BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE <br />DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPPX=ArXAVVE <br /> <br />w 1988-2009 AULJHU GUHI UHA I IUN. All rlgnTs reservea. <br />ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD