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OP ID: KB <br />`.� CERTIFICATE OF LIABILITY INSURANCE <br />°" 0111`""a "" <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(les) must be endorsed. If SUBROGATION IS WANED, 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 endorsemen s . <br />PRODUCER 626-966-3664 <br />Valley Insurance .Service, Inc. <br />Ucense# 0586246 626.966-3895 <br />800 S. Barrancs Ave, Suite 200 <br />Covina, CA 91723 <br />Gary Champlin <br />COwFA= <br />HAM <br />PHONE I Hal! <br />E4MLaL a: <br />. DECKS -2 <br />INSURER(S) AFFORDING COVERAGE NAIL a <br />Deckside Pool <br />1547 W. Struck, Unit E <br />Orange, CA 92867 <br />— C'z C ' 1 ?51— 1 <br />INSURER A: M9rCIJrY Insurance Company 27553 <br />INSURER a:Alterra Excess & Surplus Ins 33189 <br />INSURER c: The Hartford Insurance Co. 29424 <br />INSURER o: of the Midwest <br />INSURER E <br />INSURER F <br />V UY CRAM W [ JFK , JFK .O , F N� ,MQFO• wC /,w.A...., .�.w�w_ <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 />wsR <br />.6111. <br />TYPE of INSURANCEPam <br />J= <br />wyn <br />POLICY NUMBER <br />Eff <br />MMA <br />POLICY EXIS <br />LBmS <br />GENERAL LIABILITY <br />EACH OCCURRENCE a 1100010 <br />B <br />X COMMERCIAL GENERAL LIABQM <br />X <br />MAX012009000828 <br />09/01111 <br />09101112 <br />S S 100,00 <br />CLAIMS-MADE❑X OCCUR <br />MED one $ 5100 <br />PERSONAL a ADV INJURY a 11000,00 <br />GENERAL AGGREGATE a 2,000,00 <br />GENL AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS-COMPIOP AGG a 2,000,00 <br />POLICY iFcTPRO' LOC <br />a <br />AUTOMOBILE <br />LIASLnY <br />COMBINED SINGLE LIMIT : 1,000,00 <br />A <br />ANY AUTO <br />CCA0007272 <br />02115111 <br />02115/12 <br />(Ea a= da,u) <br />BODILY INJURY (Per perum) s <br />X <br />ALL OWNED AUTOS <br />BODILY INJURY (Per amde v) i <br />X <br />SCHEDULED AUTOS <br />PROPERTY DAMAGE <br />(pw �,y) i <br />HIREDAUTOS <br />NON-OWNEDAUTOS <br />a <br />a <br />UMBRELLA LIAR <br />OCCUR <br />EACH OCCURRENCE S <br />EXCESS LIAR <br />CLAIMS -MADE <br />AGGREGATE _ <br />DEDLICTIBLE <br />S <br />RETENTION Sa <br />WORKERS COMPENSA710N <br />AND P.MPLOYERV LIABILITY <br />VNC STATU OTH <br />C <br />TIN <br />ANY PROPRIETOWARTNEROEXECUTIVE Y f N <br />OFFICERIMEMBER EXCLUDED? <br />N I A <br />34WEOG4050 <br />02119/11 <br />02/19/12 <br />E.L. EACH ACCIDENT S 1,000,00 <br />- EA EMPLOYEES 11000100 <br />KMy;NI" <br />� �E.L.DISEASE <br />OES RIPTIO OPERATIONS below <br />E.LDISEASE - POLICY LWr a 1,000,00 <br />X <br />DESCRIPTDON OF Off -mum I LOCATIONS I vE10CLES (AWeh (CORD 161. Ad iftimal Ramarb SeheduK N mora space b nWj1nd) <br />(SEE ATTACHED FOR ADDITIONAL INSUREDS) <br />f+etlTlttin�Tr uwwww <br />SA A01. <br />City of Santa Ana <br />Parks, Re, i atlan 8 Community: �.C- <br />Services Agency <br />28 Chrk Center Plaza <br />Santa Ana, CA 92701 <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 />AUTROREED REPRESENTATIVE <br />®1988-2009 ACORD CORPORATION. All riahts reserved. <br />AGVRU [O tzuuwuul The ACORD name and logo are registered marks of ACORD <br />