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DESMO-1 OP ID: AM <br />CERTIFICATE OF LIABILITY INSURANCE <br />O11/06/201 YY) <br />11/06/2013 <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 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 endorsements). <br />PRODUCER <br />John J. Matsock $ Assoc. Inc. <br />1750 N Washington Street <br />Naperville, IL 60563 <br />Steven L. Monteith <br />CAMEACT Steven L. Monteith <br />PHONE FAN <br />a E# :630-505-7886 'V No): <br />E-MAIL <br />ADDRESS:.._._........._-.-...._._-...-._ <br />GENERAL LIABILITY <br />INSURERIS) AFFORDING COVERAGE NAIC k <br />INSURER A : St Paul Travelers - AMD 25674 <br />INSURED Donna Desmond Associates <br />265 South Beverly Glen Blvd. <br />Los Angeles, CA 90024 <br />INSURER a: <br />INSURER C: <br />INSURER b <br />INSURER E: <br />_ // 7� <br />...............-..-.-_ <br />IINSURER F: <br />�oll - a /'"j LJ <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 />INSR <br />TR <br />OF INSURANCE <br />ADDLTYPE <br />INSRIVWD <br />SU <br />POLICY NUMBER <br />POLICY <br />POLICY DYYYY <br />LIMITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE $ 1,000,00 <br />A <br />X COMMERCIALGENERALLIABILITY <br />CLAIMS -MADE F7x OCCUR <br />X <br />680.1B716605 <br />12/0112013 <br />12/0112014 <br />PREMISESE.o urgncceL__ $ 300,00 <br />MED EXP (Any one person) $ 10,00 <br />PERSONAL &AOV INJURY $ 1,000,00 <br />GENERAL AGGREGATE $ 2,000,00 <br />GENT AGGREGATE <br />LIMIT APPLIES PER: <br />PRODUCTS - COMP/OP AGG $ 2,000,00 <br />$ <br />17 POLICY <br />PRO= LOC <br />IECT <br />AUTOMOBILE LIABILITY <br />COMBINED SINGLE LIMIT 1,000,00 <br />Ea accident $ <br />BODILY INJURY (Per person) $ <br />AANY <br />AUTO <br />680-1 B716505 <br />12/0112013 <br />12/01/2014 <br />BODILY INJURY (Per acciden) $ <br />ALL OWNED SCHEDULED <br />AUTOAUTOS <br />X HIRED SAUTOS j( NOI,OWNED <br />AUTOS <br />PROPERTY DAMAGE $ <br />PER ACCIDENT <br />$ <br />UMBRELLA LIAO <br />EXCESS LIAR <br />OCCUR <br />CLAIMS-MAOE <br />> qC ? <br />,9PPROj ED AS t <br />YaA <br />l yJ <br />) 1 �--/T;'as�A <br />EACH OCCURRENCE $ <br />AGGREGATE $ <br />DE_D RETENTION $ <br />$ <br />WORKERS COMPENSATION <br />ANDEMPLOYERS'LIASILITY YIN <br />ANY PROPRIETORIPARTNERIEXECUTIVE <br />OFFICERIMEEXCLUDED? ❑ <br />NH) <br />NIA <br />YSS15L3n[ ,LjilllJTnfv <br />.. <br />WC STATU- OTH- <br />TORY LIMITS <br />E.L. EACHACCIDENT $ <br />E.L. DIBEASE- EAEMPLOYEE $(Mandawryho <br />E1 DISEASE -_POLICY LIMIT $ <br />Ifyes,describeunder <br />DE8 RIPTION OF OPERATIONS 01.w <br />A <br />Property Section <br />680-18716605 <br />12/01/2013 <br />12/01/2014 <br />DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) <br />ADDITIONAL INSURED WITH RESPECTS TO GENERAL LIABILITY: CITY OF <br />SANTA ANNA,ITS OFFICERS, EMPLOYEES, AGENTS, VOLUTEERS AND <br />REPRESENTATIVES//ADDITIONAL INSURED IS PRIMARY AND NON <br />CONTRIBUTORY//AS REQUIRED BY WRITTEN CONTRACT, CERTIFICATES <br />ARE SUBJECT TO ALL POLICY TERMS AND CONDITIONS. <br />CFRTIFICATE HOLDER CANCELLATION <br />SANTAAN <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />CITY OF SANTA ANA <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />PUBLIC WORKS AGENCY <br />ATTN: JASON GABRIEL <br />20 CIVIC CENTER PLAZA M-36 <br />AUTHORIZED REPRESENTATIVE �. <br />SANTA ANNA, CA 92701 <br />O 1988-2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD <br />