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mw <br />.__ 7 * <br />A? ° CERTIFICATE OF LIABILITY INSURANCE 111S4 DATE tMM/DD/YYYY) <br />09-08-2010 <br />THIS CERTIFICATEIS 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 ,JCAIf6T1kNT0 "TRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICAT HOLDE . <br />IMPORTANT: If the certificate holder is an ADD} CMLINSURED,the-policy i s must be endorsed. If SUBROGATIONIS WAIVED, subject to <br />the terms and conditions of the policy, certain p tnay:require ar orAc A. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). ' `• "' <br />PRODUCER <br />USAA INSURANCE AGENCY INC/PHS PHONE FAX <br />" Ewt): (888)242-1430 (AiC.Nol: (877)905-045 <br />" <br />812846 P:(888)242-1430 F:(877)905-0457 <br />PO BOX 33015 . <br />ADDRESS <br /> <br />SAN ANTONIO TX 7 8 2 6 5 PRODUCER <br />cySTOMER l <br /> INSURER(S) AFFORDING COVERAGE NAIC 0 <br />ff4uwD INSURER A : Hartford Casualty Ins CO <br />KNOWLEDGE & INTELLIGENCE PROGRAM INSURER B: Hartford Accident & indemnity C <br />PROFESSIONALS, INC <br />4401 ATLANTIC AVE STE 200 <br /> <br />INSURER C <br />LONG BEACH CA 9 0 8 0 7 INSURER D <br /> INSURER E <br /> INSURER F : <br />COVERAGES CERTIFICATE NUMBER: 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 />vs T•YPf OF pYSLBtAMCE POLICY AIANNER dHMMO/YYYY) 7MM/DOIYYYY! uhm <br /> GENERAL LlABLLLrY EACH OCCURRENCE <br />00 O 000 <br />21 <br />1 <br /> COMMERCIAL GENERAL UABIUTY _ <br />- <br />- <br />PREMISES Ea oeeu"MM S 300, 000 <br /> CLAIMS-MADE I OCCUR MED EXP (Arty one person) : 10" 000 <br />A X General Liab X 65 SBM PW1830 10/22/2010 10/22/2011 PERSONAL & ADV INJURY 1$ 1 000,000 <br /> GENERAL AGGREGATE 8 2,000,000 <br /> GEN'L AGGR LIMIT AEFL[ES PER: PRODUCTS - COMP7OP AGG 1$ 2 000,000 <br /> POLICY PRO- X LOC IS <br /> AV rOMOB2E L4 WL7TY COMBINED SINGLE LIMIT I <br />s <br /> (Ea accidettl 11 0 0 0, 0 0 0 <br /> ANYAUTO BODILY INJURY (Par person) S <br /> ALL OWNED AUTOS <br />BODILY INJURY (PoroeeitlonU <br />S <br /> <br />A SCHEDULED AUTOS <br />65 SBM PW1830 <br />10/22/2010 <br />10/22/2011 <br />PROPERTY DAMAGE <br /> X HIRED AUTOS (Poracc{dont) <br /> X NON-OWNED AUTOS a <br /> <br /> UMBRELLA LAB <br />H OCCUR EACH OCCURRENCE 5 <br /> EXCESSLL4B CLAIMS-MADE AGGREGATE <br /> DEDUCTIBLE <br /> RETENTION I <br />' S <br /> WORKERSCOMPENSA770N X WCSTATII- OTH- <br /> AND J MAUW YERs' LAWL7'Y R <br /> ANY PROPRIETOR7PARTNEWEXECUTIV YIN <br />NSA <br />E.L. EACH ACCIDENT <br />5 1, 0 0 0, 0 0 0 <br />B IMFandatf" h NH7 EXCLUDEDi 65 WEC J02464 04/22/201C 04/22/2011 E.L. DISEASE - EA EMPLOYE $ 1, 0 0 0, 0 0 0 <br /> DESCRIPTION OFdOPERATIONS below I i E.L. DISEASE 1,000,000 <br /> <br /> <br />i AM <br />? Jw <br />7/ <br />DESCR/PTION OP OPERA770NS I LOCAT70NS I VEM6LES !Attach AGORD 101, AoW/Ywraf Rpnorto< Schadrrb, lrarar? Q a . & ,eon <br />Those usual to the Insured's Operations. <br />P <br />_ <br />?p gWAITE <br />14 <br />A <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 />AUTHOPOED RFPRESENTAr1VE <br /> <br />,coo ?nnn nnnon rncononrrnnr nn ....?.,. .,,?e..,e.r <br />ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD