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R� CERTIFICATE OF LIABILITY INSURANCE OPID Gx- DATI(MMDomyY) <br />OS 19 12 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATNELY OR NEGATIVELY AMPND, EXTEND OR ALTER TH! 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 />IMPO t cafe holdwrTs an AIDDITIO19AL INUURED, the po D ea mua a on onto . sU fact to <br />the terms and conditions of the polloy, certain Policies may require an ondoraZnenkt A statement on this cortlficate does not confer rights to the <br />certificate holder in Ileu of such andorsemen a . <br />PRODUCER <br />Tho Waoditah Company :rnauranco <br />Services, Ina. <br />1 PaxIc Pia¢a, Suits 400 <br />Irvine CA 92614 <br />phono:949-553-9800 Fax:949-583-0670 <br />Ne e><i : NO: <br />_ <br />-DRESS: <br />eusTOMERw 1 PAVL1U-1 - <br />INSURER(S)AFFORDINOCOVERAGE <br />ewCa <br />INSURED $$]]}} gg QQ <br />297 Vga $C3:ca Qingtz,=- <br />An ®im, CA 92�t)6 <br />�j <br />-."j009 — 121-1 <br />,7 ✓� L/LJ O <br />INSURER A: Old w 110 Qener.L ins- co>•P <br />24139 <br />INSURER B: <br />NSUReRC, <br />USURER D 1 <br />1NSURPRE: <br />WSUgER F i <br />caJv�Rlacies CERTIFICATE NUMBER: REVISION NUMBER - <br />THIS *TO CERTIFY THAT THE POLICIES OF WSURAIAGE 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 MAYBE ISSUEO OR MAY PERTAIN, THE INSURANCEAFFOROED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERIILS. <br />EXCLUSIONS AHD CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />TR <br />TYPE OF INSURANCE <br />1 <br />POLICY NUMBER <br />LIMITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE <br />S 1 OOO 000 <br />A <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMU^-MADE occuR <br />%ICG94841202 <br />oe/o1/11 <br />06/01/12 <br />R <br />pEMISFS Eiooielr'rerloe <br />S 100 000 <br />MeD EXP wily one Peraan) <br />S 5 000 <br />PERSONAL a ACV IMURY <br />$3 000 000 <br />X <br />_ <br />GENERAL AGGREGATE <br />42,000,000 <br />GENL AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS-COMW/OP AGO <br />a2 000 000 <br />POLICY X LOL <br />a <br />A <br />AUTOMOBILE L41BRrIY <br />AMYAUTo <br />A1CA94843102 <br />OS/01/11 <br />06/et/12 <br />COMBINED SINGLE LIMIT <br />(Ea ecadenl) <br />41,000,000 <br />BODILY INJURY(PW Person) <br />- <br />a <br />ALLOWNEDAUTOS <br />BODILY INJURY(PW—dd-11 <br />S <br />SCHEDULED AUTOS <br />JX <br />HIRED AUTOS <br />DAMAGE <br />(PP—eoddenl <br />a <br />S <br />NON -OWNED AUTOS <br />S <br />UMBAELLJ LUAB <br />OCCUR <br />EACH OCCURRENCE <br />S <br />aXCE99 LIAB <br />CLAIMS -MADE <br />AGGREGATE <br />S <br />DEDUCTIBLE <br />a <br />a <br />RETENTION S <br />A <br />wo <br />AND EMPLOYE 0.S'LIABILITY YIN <br />ANYPROPRIETOWPAitTNERMXECUTN <br />OFFICERILIEMBER EXCLVDEO7 <br />(M-weloryln NK) <br />11 yyeess describe under <br />DES(1, MPTION OF OPERATIONS hero- <br />IA <br />ox <br />on/O1JIi <br />os/Ol/12 <br />X - <br />TIULQ— <br />E.L. EACH ACCIDENT <br />41,000,000 <br />E.L. DISEASE -EA EMPLOYEE <br />a 3 000 000 <br />E.L. DISEASE -POLICY LIMIT <br />s1,000,000 <br />OESCMPTION OF OPERATIONS I LOCATIONS I VEHICLES (AIMeh <br />*Exaeppt 10 Days; Notice o! CanaellaRtiqn <br />City Or Santa Ana, its ogglioera <br />r Tpax�@ap ntativea Sara Named as AdHitizaaal <br />L�7sb11ity par AEtachad HaSrmNnO <br />ACO D 101. Ad Illond Remerb Sehed.Fq N more a — M ne U d) <br />or Nos -Pa o t a Pr�tum. <br />e�i�alo sea, aq ntb volunteara sad <br />2naurAa a>b Tea rota Geaeral <br />tSRE: Santa a Emorlgnay Kor <br />glaip <br />4 CRI1r11.A1 C AUWCR 4AIYLiGLLA1IVN <br />1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES Be CANCELLED BEFORE <br />SANTAAl THE EXPIRATION DATB THEREOF, NOTICE MALL aE DSLNERBD M <br />ACCORDANCE MATH THE POLICY PROVISIONS. <br />Lau 6KSt.itt Slieedy <br />City O! Santa AnAssist, IIt City Attorney AUTHORIZED REPRESSNTATNE <br />220 . I)aiay AV:., M-85 <br />ant:SAna CA 92702 <br />D CORPORATION. All rights reserved. <br />ACORD 25 (10OW09) The ACORO name and logo are registered marks of ACORD <br />