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<br />CERTIFICATE OF LIABILITY INSURANCE OATr_11-Y1
<br />��- 4/14/20011
<br />THfS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTf FICAI-E 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 cenificata holder is an ADDITIONAL INSURED, than policy(ies) must be endorsed. if SUBROGATION IS WAIVED, subiect 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 if,.
<br />certificate holder in lieu of such endorsement(s}_
<br />Ph'ODUCER CONTACT Jeanie Druabc rt
<br />NAME":
<br />PHONE
<br />Elizabeth Souther Insurance Group (Arc,No. Exol: (S 66)544--5273 IA.; r. N„).
<br />29395---(g----
<br />isec'I sea-.as�G
<br />A our- ad E -MALL druebert @elf zat>c_tkasouther_com
<br />�J ADDness:7
<br />Suit- #202-PRobuc ....
<br />00000923
<br />CUSTOMER p.
<br />Ag.— H1115 CA 91301 INSUP.ER(5)AFFORDING COVERAGE NA -
<br />INSURED INSURER- IF1—tt ME!r —y In£: —Cto L'O1TP—y 10657
<br />PHC Halding Corp Inc; Pacific Building Care - -
<br />INsugER B;Philade 1phia Indetnni _y Ins Co 18058
<br />Inc; PBC Phoenix Inc; PSC Commercial Cleaning INSURER c:National Union Fire Ins Co 19455
<br />Systems Inc; PSC Solution One T--; PBC A&D Ina INSUREn-'X et -1— Prop Cas Co o£ Amer 25674
<br />3080 Airway Avenue, Ste 101 INSURE RE:Hart£ord Fisc insurance Co 1968_
<br />Costa Mesa CA 92626 INSURER IF
<br />COVERAGES CERTIFICATE NUMBER:11-12Gh AU CR 10-11INIC UM REVISION NUMBER=
<br />Tet 1r9 IS TO CE RTIPY TI-IA'r 'i Fit- POLIC IES CF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO -I I iF INSURED NAMED ABOVE FOP -I POLICY PERIOD
<br />iNDiCAI LD. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER
<br />DOCUMENT WITH RESF'F_CT TO V4,10H THIS
<br />CER'TIFICA TE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY TRE POLICIES DESCRIRFD HFREIN 'S SUL.IL1,T TO
<br />ALL I I IE -I'L-
<br />F.XG LIISIONS AND CONLlIT lOIJS CJ f= :iUCH PU LICIES. LIAAITS SHOSti (`I M.AY HAVE BEEN REDIICEU BY PAID CLAIMS.
<br />INSR ADDL SC— - POLICY EFF POLICY E%P
<br />LTRTYPE OFINSUHANC:L INSR WVDPOLICY NUMBER(MM.'ODiYYYYl (MM�DO'YYYY1
<br />- _-
<br />LIMITS _
<br />,ENERAL LIABILITY_
<br />f-Acl-i cccuRneNCF
<br />-1
<br />-.000,000
<br />X COMM r -AL GENAL L1A630TYr
<br />t d\LE TCi F.1TLG ,
<br />r a rn,>L 5: II .c r _ ,,.
<br />9; 50, 000
<br />A CLAIMS MADE X OCCUR X —1024873 3/1/2011 :3/1/2012
<br />rdl l']a [. w=;Ary orns P+,;rano)
<br />9; S, 000
<br />X Errors 6 Omis ,ions
<br />PEr:-.r uan!. s Ai;V IN.n/:civ
<br />Y 1, 00C) :)00
<br />x vicar -r ous
<br />GENER:yI. nr,i;!:1L:am.l 1:
<br />Y; 2, 000, 00()
<br />C- NI <-Cc _i- -1 e 1_I 1,01'1 APPI:L PC i R-
<br />—0-1-rs.-p>.ir•:i .r ,aGc'a
<br />N 2,000, 000
<br />X POU<JY PRC -
<br />:'T LOG
<br />AIJTOM021LE LIABILITY
<br />l->tl}IIJf:U LM1II L1191
<br />1, 000, 0(j0
<br />X NY FJTO
<br />B AUTOS PHPK695636 3/1/2011 3/1/2012
<br />—"L'PJdLII?` tPrr
<br />:.
<br />AL.i..:;b`✓N E.CI
<br />I�tIIlIL1' !IJ,1:-11-"( lPc, :tfn'nrl,Il
<br />-�
<br />-G!—UI. P:D 111, YOti
<br />X NON-O—F13 AUI
<br />U yam_,: �IL,Iill P'[i.gllp
<br />.. 1,006,000
<br />X
<br />i, UCO, UUU
<br />X UMBRELLA LIA.BX- -_-
<br />tx;rl�'R
<br />- -
<br />C�.. 1.-,rUFFrrirE
<br />5,000, 000
<br />EXC ESS LIAB CLAIMS -MADE_
<br />A<ICHI: Gi—
<br />5,000, 000
<br />pp0 •58251200 10/5/2010 10/5/2011
<br />...... 10 000
<br />D WORKERSW^,SiALU-
<br />ANDEIdPLOYERS LIABILIT'V Y, N
<br />TORI LIMITti LH
<br />ANY FNOPn IET )t/PAR'TNC,/EXECUTIVE
<br />IT EAGI-IA 1/CN'I'
<br />.L, 00a, 000
<br />CI rIC -r`.0 u/A
<br />(M d t yNH) V83120T42710 5/4J201.0 5/4/2011
<br />fn 1.
<br />rl pISFASr In@MI"I ! i?
<br />1,066, 000
<br />II y I !br. t h r
<br />[N`'EliAll
<br />L r 3L/._I--PC>!.IIT! It I
<br />,: 1, 000,000
<br />-.
<br />E 1st & 3r1 Party CrTne 92}1.0.25059.3 3/1/2011 3/]/20.12
<br />_„„II
<br />$250,000
<br />Employee Dishonesty
<br />Daa..aii,Ic
<br />$5, 000
<br />DF.SCFlIPTION OF OPF_HAl10Nti / LOCATIOIJS ,VEHICLES' (AIF3ch -CORD t01, AAdI<ional R¢marl<s SCM¢Aul¢, if more spaa:u 1s rqq ulretl)
<br />T? -aa City o£ Santa P.na, its officers, agen:.s, and employees era named as Addi.tlonal,
<br />ensured, bnT_ only a..,
<br />c'r'hcx
<br />respects
<br />Gcaneral 1..3.abil,ity arising out a£ Th operations f the Name¢ Insured P— form CG 20
<br />10 07 04 attactaed
<br />Genoral
<br />Liability po11Ey is P ri.xna ry ,au4}..33;oni Contr tauY',or,v+rth'�, a`ny `dther General. T. a.sb i..I..i.ty Pot-cy
<br />showrng Th. City
<br />o£ Santa Ana
<br />as Named ensured par form [$v]tE=Sb"]"Y (02/2009) attached. Steve Testa is excluded from
<br />WorAasn' Cnmpene-.at:i-on
<br />caverag.x
<br />CERTIFICATE HOLDER / t I GANGELLA I ION
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DAI-E 'I'HER =OF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS -
<br />At Purchasing ment
<br />Depart
<br />20 Civic Center Plaza AUTHORIZED REPRESENTATIVE
<br />Santa Ana, CA 92701
<br />ACORD 25 (2009/09) U 1988-2009 ACORD CORPORATION. All riqhts reserved.
<br />INS025:zo;crlvl The ACORD name and logo are registered nlarKs 01 ACUHU
<br />
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