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<br />AC'C3.K L:1 <br />( <br />-? ? CERTIFICATE OF LIABILITY INSURANCE DATE(MM,DD/YYYY) <br /> <br />t0/t4/20tt <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 CONTACT <br /> NAME: <br />Aon Risk Se rvi Ces Cen Lral ZnC. PHONE <br />FnX <br /> <br />Chi CagO IL OPfi Ce (g66) 283-2122 <br /><842J 953-5390 <br />(A/C. No. E%[j: A/0. No. <br />200 East Rand Ol ph E-MAIL <br />Chicago IL 60601 USA ADDRESS: <br /> <br /> INSURER(S) AFFORDING COVERAGE NAIC # <br />INSURED INSURER A: COntl nOntal CaS Ual ty Company 20443 <br />AOn COrpOraLl On <br />(See Subsidiar <br />Information Bel owl INSURER B: ARIerl Can CaSUal ty CO. Of Reddl ng PA 20422 <br />y <br />200 E. Randolph INSURER C: Transportati On Insurance Co. 20494 <br />Chicago IL 60601 USA <br /> INSURER O: <br /> INSURER E: <br /> INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 570044'138800 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 BV 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. Limits shown are as requested <br />ILTR TYPE OF INSURANCE NSR WVD POLICY NUMBER MM/OO/YYYY MM/DO/YYYY LIMITS <br />A GENERAL LIABILITY GL EACH OCCURRENCE $1,000,000 <br /> X COMMERCIAL GENERAL LIABILITY DAMA ET RENTE <br />PREMISES Ea o $1,000,000 <br /> CLAIMS-MADE ? OCCUR MED EXP (Any one person) $ lO , 000 <br /> PERSONAL 8 ADV INJURY $1, 000, 000 <br /> GENERAL AGGREGATE $2.000.000 <br /> G EN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $2 , 000 , 000 <br /> POLICY PRO X LOC <br />A' AUTOMOBILE LIABILITY BUA 4U 141U476U O6 O1 2011 O6 O1 2012 COMBINED BINGLE LIMIT $1 <br />UOU <br />OOO <br /> Ea accitlent , <br />. <br /> X ANY AUTO BODILY INJURY (Per person) <br /> ALL OWNED SCHEDULED <br />AUTOS BODILY INJURY (Per accitlent) <br /> AUTOS <br />HIRED AUTOS NON-OWNED PROPERTY DAMAGE <br /> AUTOS Per accitlent <br /> <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE <br /> DED RETENTION <br />C WORKERS COMPENSATION AND WC4014104449 06 O1 2011 06 O1 2012 WC STATU- OTH- <br />X <br /> EMPLOYERS' LIABILITY TORY LIMIT$ <br />H <br />B y / ry <br />ANV PROPRIETOR/PARTNER/E%ECUTIVE <br />OFFICER/MEMBER Excw oe D2 ? <br />N / A WC4O141O4 S47 <br />WC4014104497 O6/O1/2011 <br />06/01/2011 06/01/2012 <br />06/01/2012 E.L-EACII ACCIDENT $1,000,000 <br /> (Mantla[ory In NH) EL- DISEASE-EA EMPLOYEE $1, OOO , 000 <br /> If yes, tlescribe untler <br />DESCRIPTION OF OPERATIONS below <br />E.I._ DISEASE-POLICY LIMIT <br />$1, 000 , 000 <br /> <br />DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (AttacM1 ACORD 101. A,i Bltlonal Remarks ScM1etlule, If more apace Is raquirs,i) <br />RE: AOn Risk COnSUILanLS, 1901 MAIN STREET, IRVINE, CA 92614-0513. THE CITY OF SANTA ANA IS ADDITIONAL INSURED ON THE GENERAL <br />LIABILITY POLICY AS REQUIRED BY WRITTEN CONTRACT AND SUBJECT TO POLICY TERMS ANG CONDITIONS. <br />A_PPRO V F3 i? A S TO FORM <br />.?? ?? <br />`a <br />c <br />d <br />77 <br />2 <br />0 <br />0 <br />m <br />°o <br />O <br />Z <br />a <br />m <br />U <br />d <br />V <br />?? <br />?? <br />_?- <br />.? <br />CERTIFICATE HOLDER CANCELLATION """ Y'"""'"' <br /> .? <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE ?' <br /> NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE <br />EXPIRATION DATE THEREOF <br /> , <br />POLICY PROVISIONS. <br />CITY OF SANTA ANA AUTHORIZED REPRESENTATIVE k? <br />Attn: Bri za Morales, M-28 <br /> <br />20 CIVIC CENTER PLAZA <br />SANTA ANA CA 92701 USA - A <br />e?P? `C r, ? <br />j%JL/)'L.i'?Gpc??/ <br />?- ^???yg? <br />,CJ?O/ <br />?? <br /> <br />©'1988-20'10 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (20'10/05) The ACORD name and logo are registered marks of ACORD