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�- -a o�� --�� -� ® ACORO CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) O1 /20/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER- THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATNELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the eertlfleate holder la an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certifleate does not confer rights to the certlfleate holder In Ileu of such endoreement(a). PRODUCER SL Insurance Associates Inc NAMTACT Siebe, 8111 PNONE 908- 776 -8600 ac No- 908- 776 -8602 q paL bill @slinsure. com 18181 Butterfield Blvd # 170 Morgan Hill, CA 95037 IN8URER 9 AFFORDING COVERAGE NAIC • INSURER A : CNA INSURED INSURER B: The Hart ford pREMI rtence INSURERC: A Pacific Services Inc INSURER D: 1060 Celle Negocio Suite C San Clemente, CA 92673 IN8URER E: MED EXP (An one parson IN8URER F - PERSONAL3ADV INJURY S 2, 000, 000 (_fIVFRAr'�FS CFRTIFICATF NIIMBFRe - REVISION NUMBER- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN9R LTR TYPE OF INSURANCE POLICY NUMBER M�DD/YWY MME Y E7CP LIMIT8 GENERAL LU\BILnY EACH OCCURRENCE S 2, 000, 000 pREMI rtence S 300, 000 A %� COMMERCIAL GENERAL LV\BILITY GLAIMS�rIADE � OCCUR 4031393323 01/20/2012 01/20/2013 MED EXP (An one parson 5 10, 000 PERSONAL3ADV INJURY S 2, 000, 000 GENERAL AGGREGATE S 9.000, 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODVGTS - COMP /OP AGG S 9 , O OO , 000 X POLICY PRO- LOG $ AUTOMOBILE LU\BILn -Y Ea arrJdaM IN LI 1, 0 0 0, 0 0 0 BODILY INJURY (Per person) t A ANY AUTO 4031393323 of /zo /2o12 0l /2o /zo13 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) S X HIRED AUTOS X AIJTOSWNED AS "S't i�vl� PROPER D Per amident $ a APPRpVIr�i� UMBRELLA LIAR EXCE89 LU\B OCCUR CLAIMB -MADE �� � C�_ _ �� SC_`CI S11C - dY -" EACH OCCURRENCE i AGGREGATE E DED RETENTIONS 3 B WORKERS COMPEN8AT10N AND EYPLOYERS'LIABILJTY Y/N ANY PROPRIETOR/PARTNER/E %ECVTIVE OFFIGER/MEMBER EXGLUDEDT � N/A ASSSSCHU.L Clt.y ( 57 WEC FZ 5670 (7TRC_,' 01/09/2012 01/09/2013 WC STATU- X OTH- E.L. EACH ACCIDENT E 1, 000, 000 E.L. DISEASE - EA EMPLOYEE S 1 , O O O , O O O (Mandatory In NN) 1/ a, dasvibe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1 , O O O , O OO DEBCRIPTON OF OPERATK)!18 / LOCATIONB / VENICI -ES (AWeh ACORD 101, AddKlonal Remarb 8chWUle, H mwa apace le nsqulred) As it pertains to its California operations, and where required by contract for any and all locations for that contract, the following is named as additional insured interest. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701 its offciers, employees, agents, volunteers, and representatives with regard to liability and defense of suits arising from the operations and uses performed by or on behalf of the named insured. I�GR 1 Ir'IVA I C r1VLLlCR GAIYGCLLA I IVN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELNERED IN The City o£ Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS - 20 Civic Center Plaza Santa Ana, CA 92701 AUTHORIZED REPREBENTATNE ® 1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/OS) The ACORD name and logo are registBred marks of ACORD / ��