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nil oM D,YYY„) <br />ACORN CERTIFICATE OF LIABILITY INSURANCE3/] <br />/2012 I 1 / 1/2011 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER_ THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELYj�O¢R NEGATIVELY �AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF REPRESENTATIVE OR PRODUCER. TFfE CERT�I4�AT� HCyLDl41IL�5A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollcy(iss) must be endorsed. If SUBROGATION 13 WANED, subject to <br />the terms and conditions of the policy, c1: IiIales may rat uity a np�Qrsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorse ( - -` <br />PROoucE Lockton Companies, LLC Denver - - -- • °- +N <br />8110 E. Union Avenue <br />Suite 700 <br />Denver 80237 <br />Ac <br />PHONE <br />woo s: <br />INSu S AFFORDING COVERAGE NAICS <br />(303)414-6000 <br />INSURERI.SuRA : First Mer Insurance Com 10657 <br />if-del-hi, Tndem,i an <br />INSURER B <br />PC SolutionOne, Inc. <br />1345 D B <br />1345255 dba Cornmercial Cleaning Systems <br />2695 N. Fowler, Suite 1 1 OA <br />Fresno, CA 93727 <br />/ <br />_�� <br />INsuRER c : St_ Paul Surplus Lines Insurance CornDany 30481 <br />INSURER D: Em to ers Compensation Insurance Company1 1512 <br />INSURERS: <br />INSURER F <br />•� <br />THISIS 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 />LTR <br />TYPE OF INSURANCE <br />ADDR <br />$UBR <br />POLICY NUMBER <br />1 jy%p� �F <br />POI.JCY El(P <br />LROTS <br />A <br />GENERAL LIASILRY <br />Y <br />N <br />FMMI024873 <br />3/1/2011 <br />3/1/2012 <br />N <br />DAMAGE TO RENTED <br />PREMISES (Ea om,— E 5Q 000 <br />GENERgL.L�BIL(TY <br />CLAIMS -MADE II _X_ IOCOUR <br />$5,000 Deductible <br />MED EXP one nwn#1"-"C— <br />PERSONAL SADVIWURY S 1,000,000 <br />GENERALAGGREGATE E 2-000-000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />X POLICY 1 PRO- LOC <br />Jr <br />PRODUCTS - COMP/OP AIsG S 2-000-000 <br />E <br />AUTOMOBILE LIABILrrY <br />N <br />N <br />PHPK695636 <br />3/12011 <br />3/1/2012(Eaa <br />d—t) S 1-000-000ANY <br />AUTO <br />BODILY INJURY (Per Parson) EALL <br />[33 <br />OWNED ASC UTOS LED <br />AUTOS AUTOS <br />BODLYINJURY Pera�dam SHIRED <br />AUTOS AUTOS NEDPROPERTYDAMAGE <br />S <br />E Xx—"O XX <br />UMBRELLA Luc X occuR <br />N <br />N <br />QZ08300059 <br />10/312011 <br />10/31/2012 <br />EACH OCCURRENCE E 5,000,000 <br />E][Cc« LUIS CLA[Ma E <br />AGGREGATE E 5,000-000 <br />DED I X I RETENTIONS $0 <br />E <br />D <br />AND EMPSCOMPENSATON <br />AND EMPLOYERS• LUBILT' �, / N <br />ANY CMOMEMB R/PACLUD /EJ[ECUTNE <br />OFFICER/MEMBER EXCLUDED? � <br />N / A <br />N <br />E1G-1342236-00 (CA Only) <br />5/42011 <br />5/42012 <br />X TORY LIMrr ER <br />E.L. EACH ACCIDENT S <br />1-000-000 <br />E.L. DISEASE - EA EMPLOYE E 1,000,000 <br />WDIMMI m NN] <br />rc yea aeealbe L,DCBr <br />DESCRIPTION OF OPERATIONS bNoar <br />E.L. DISEASE - POLICY LIMIT S <br />D Ref t. An—hd w ONS / L A A(( {V�jI1Ft.F$ IALttarJL q-1gy AtlpN�galjf r� SdroWle, 0 mora epaca is npul�tl) <br />!'�1 j lel) �/_� -F� 1 ll i' ll is lVl <br />C�j <br />ZAZ <br />❑u.a 5t:tt G�' �c y <br />A—I1 Lai1L CIL_y ALLOrney <br />It7N. All nghts reserved <br />J� <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED En BEFORE <br />THE DXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS_ <br />11492388 <br />ALI N —REPRESENTATIVE <br />City of Santa Ana <br />c/o Public Works Agency/SAP-TC <br />20 Civic Center Plaza, M-21 <br />Santa Ana, CA 92701 <br />C J <br />aele <br />It7N. All nghts reserved <br />J� <br />