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SEEMELE-01 SHMF <br />L�N'c &-" CERTIFICATE OF LIABILITY INSURANCE <br />DATE11412 D/YYYY) <br />/4/20, 2 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 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 certificate holder is an ADDITIONAL INSURED, the Pol(cy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject 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 the <br />certificate holder in Ileu of such endorsement(s). <br />PRODUCER (410) 685-4625 <br />Maury, Donnelly & Parr, Inc. <br />Commerce & Water Streets <br />Baltimore, MD 21202 N-2011-032-001 <br />CONTACT <br />PHONE <br />E NC NO, <br />E-MA-- <br />ILe <br />ADDRESS: <br />INSURERS AFFORDING COVERAOE NAIC K <br />INSURER A; Hartford Insurance Companies 111000 <br />INSURED See Me Learn <br />4900 California Avenue, Tower 8210 <br />Bakersfield, CA 93309 -INSURER <br />INSURER B: <br />INSURERC: <br />D .......... <br />_ <br />INSURER E <br />— <br />INSURER F <br />CLAIMS -MADE Q OCCUR <br />-- -—•-^--�- w. m. aFv At E ii UM.pCK: 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 POI Ir.IFS 1 IMIT4 CHrI\nrM Lnnv u.,v� e��.. e�'.... <br />ILTq <br />TYPE OF INSURANCEINSR <br />POLICY NUMBER <br />POLIC <br />MM/DD/YYYY <br />P ICY EXP <br />MM/DDIYY <br />LIMITS <br />A <br />GENERAL LIABILITY <br />X COMMERCIAL GENERAL LIABILITY <br />X <br />30SBMBR3766 <br />7/22/2011 <br />7/22/20112 <br />EACH OCCURRENCE $ 1.000.00 <br />PREMISE Sc rancu s 1.000,00 <br />MED EXP (Any one arson) $ 10.00 <br />CLAIMS -MADE Q OCCUR <br />PERSONAL & ADV INJURY $ 1,000.00 <br />GENERAL AGGREGATE $ 2,000,00 <br />- <br />GEN'L AGGREGATE LIMITAPPLIES PER' <br />X POLICY PRO- COC <br />PRODUCTS - COMP/OP AGG $ 2.000.00 <br />y <br />AUTOMOBILE LIABILITY <br />COMBINED SINGLE LIMIT <br />Ee accident <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />HIRED AUTOS NON -OWNED <br />BODILY INJURY (Pur person) $ <br />BODILY INJURY (Per accident) $ <br />PROAUTOSRTY DAMA $ <br />Per ac dent <br />$ <br />UMBRELLA LIAB <br />EXCESS LIAB <br />OCCUR <br />CLAIMS -MADE <br />N / A <br />EACH OCCURRENCE $ <br />AGGREGATE $ <br />? OED RETENTION $ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y / N <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />$ <br />WC STATU- OTH- <br />_ <br />E.L. EACH ACCIDENT $ <br />(Mandatory In NH) <br />It yes, dasulbe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - A EMPLOYEE $ <br />E <br />E.L. DISEASE - POLICY LIMIT $ <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101. Additional Remark. Schadula, If more apace Is required) <br />rhe City of Santa Ana Its officers, agents, and employees are additional Insured. 30 -day notice of cancellation applies. <br />A Gala(:]11! ti'iiy Attor,ie <br />City of Santa Ana <br />Donna Schultze <br />Parks, Recreation and Community Services Agency <br />1825 W. Civic Center <br />Santa Ana, CA 92701 - <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />® 1988-2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD <br />