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CERTIFICATE OF
<br />LIABILITY INSURANCE
<br />DATE(MMIDDYYYYY)..
<br />8/6/2015
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY
<br />AND CONFERS NO RIGHTS IPPON THE CERTIFICATE HOLDER. THIS
<br />TYPE OF INSURANCE
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,
<br />EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />POLICY NUMBER
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />(MMIDD1YYYY)
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />GENERAL LIABILITY
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, One
<br />policy(ies) must be endorsed. It SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an
<br />endorsement. Astatement on this certificate does not confer rights to the
<br />EACH OCCURRENCE s2,000,000.
<br />certificate holder in lied of such endorsement(s).
<br />X COMMERCIAL GENERAL LIABILITY
<br />PRODUCER
<br />CONLAM
<br />NAME:
<br />LAURIE BRENNAN HAUCK
<br />9'114 Adams Ave #182
<br />MED EXP (Anyone person) $ 5000
<br />PH4?NE FAx
<br />)629-6700 (AIC,Ndp:(702)629'®6701
<br />CLAIMS -MADE L -- I...00CUR
<br />LArC,Nro,Exl:
<br />,-MAIL
<br />DDRE.5S: brenco@aol.com
<br />Huntington Beach, CA 92646
<br />A
<br />OC98533
<br />INSURER(S) AFFORDING COVERAGE
<br />MAEC#
<br />INSURER A: The
<br />5/24/2016
<br />INSURED Aesco, Inc.
<br />GENEtrRAL. AGGREGATE... $2,0100,000.
<br />INSURER B: Trumbull Insurance Company
<br />19666
<br />17782 Georgetown Lane
<br />INSURER c: Houston Casualty Company
<br />Huntington Beach, Ca 92647
<br />PRODUCTS - COMP/CP AGG s2,000,000.
<br />INSURER D:
<br />PRO-
<br />P'OLICY J OC LOG
<br />(714) 375-3830
<br />INSURER E;,
<br />INSURER F:
<br />S
<br />UUVE,RAUES 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 />INS'.... LTR
<br />TYPE OF INSURANCE
<br />INSR
<br />,V.yo
<br />POLICY NUMBER
<br />(MWDDIYYYY)
<br />(MMIDD1YYYY)
<br />LIMITS
<br />GENERAL LIABILITY
<br />EACH OCCURRENCE s2,000,000.
<br />X COMMERCIAL GENERAL LIABILITY
<br />PREIMIS.S $ 100 000.
<br />ES (Ea occurrerrcey... ,
<br />MED EXP (Anyone person) $ 5000
<br />CLAIMS -MADE L -- I...00CUR
<br />A
<br />x
<br />154BW321.78
<br />6/24/2015
<br />5/24/2016
<br />PERSONAL &ADV INJURY S2,000,000.
<br />GENEtrRAL. AGGREGATE... $2,0100,000.
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />PRODUCTS - COMP/CP AGG s2,000,000.
<br />PRO-
<br />P'OLICY J OC LOG
<br />S
<br />AUTOMOBILE LIABIUT'N
<br />Ea accidentS 1,000,000,
<br />BODILY INJURY (Per person) $
<br />A
<br />X ANYAUTO
<br />ALLOWNEDSCHEDULED
<br />AUTOS AUTOS
<br />X,
<br />x..
<br />72UECTQ'.7770
<br />7/7/2015
<br />7/7/2.016
<br />BODILY INJURY (Per accrdenl) S
<br />NON( -OWNED
<br />%'t HIRED AUTOS AUTOS
<br />PROPERTY DAMAGE.
<br />(Per accident) S
<br />S
<br />UMBRELLA LIAR
<br />OCCUR
<br />EACH OCCURRENCE '$
<br />EXCESS L.JAB
<br />CLAIMS•MADE
<br />AGGREGATE $
<br />DED I I RETENTION 5
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />ANDFMPLOYERIPARTILITY UTiVP
<br />ANY PRalP9MBT4RfPARTUUID?F.C' - YIN ®
<br />IMFICERYMEtv98ER EXCLGICYED?
<br />(¢Mandatory in NH)
<br />NAA
<br />72'fr�dECi<4.T6780
<br />4/11/2015
<br />4/11/2016
<br />X I WC S'rATU- OTH-.
<br />LIMITSNT ER.
<br />ELL_. EACH ACCIDETORY
<br />7 $ 1,(}0'(7, 00�}
<br />E.L. DISEASE- EA EMPLOYEE S1,000,000
<br />If yes., describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE- POLICY LIMIT S1,000,000
<br />C
<br />Professional Liab,
<br />HCC1421080
<br />07/09/15
<br />07/09/16
<br />$2,000,000.per claim
<br />$2,0,00,000, aggregate
<br />DESCRIPTION OF OPERATIONS d LOCATIONS I VEHICLES (Attach ACORD 10,1, Additional Remarks Schedaile,'rf morespace is required)
<br />CONTRACT # A-2011--057
<br />Certificate holder is names as an additional insured per the attached form
<br />Primary/Non Contributory wording applies per the attached form
<br />r�
<br />AE,SCO A-2011057-01 REVIEWED BYt �// � EUNICE HEREMA (P'C 1 OF 7)
<br />CERTIFICATE HOLDER rANr.FI I ATinN
<br />City of Santa Ana.
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />Its Officers, Employees, Agents
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Volunteers and. Representatives
<br />AUTNO PRESENTATIVE
<br />20 Civic Center Plaza
<br />Santa Ana, Ca 92701
<br />N%WfQ 1988-20M ACORD CORPORATION. All rights reserved.
<br />ACORD25 (2010105) The ACORD Blame and IDgo are registered marks of ACORD
<br />
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