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RIOVIST-01 SHME <br />CERTIFICATE OF LIABILITY INSURANCE DATE1 YYJ <br />1201 <br />6/1 V2012 <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 policy(les) 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 lieu of such endorsement(s). <br />PRODUCER (410) 685-4625 <br />Maury. Donnelly &Parr, Inc. <br />Commerce & Water Streets <br />Baltimore, MD 21202 <br />NAME: CT <br />PHONE q'— <br />A! No. Ertl' f�(AJC, N., <br />E-MAIL <br />ADDRESS: <br />_ INSURER(3) AFFORDING COVERAGE NAIC # <br />— ._._. <br />INSURED Rio Vista Universal <br />040 N. Las Palmas Ave. <br />Building 24, Suite 203 <br />Los Angeles, CA 90038 <br />INSURER A: Hartford Insurance Companies 29424 <br />INSURER B: <br />INSURER C: <br />INSURER D: ' <br />INSURER E; <br />COVERAGES <br />INSURER F, <br />CERTIFICATE NUMBER: 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 POLICIES_ LIMITR --"n--4 <br />MAY HAVE ccvla i <br />rZED CE e.. f, <br />City of Santa Ana <br />Parks, Recreation and Community Services Agency <br />PO Box 1988, M-23 <br />Santa Ana, CA 92702- <br />© 1988-201 O ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />4CORD 25 (2010/05) <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 />LTR <br />TYPE OF INSURANCE <br />R <br />I <br />POLICY NUMBER <br />MM/DOIYYYY Y F MIN%../YYVY LIMITS <br />GENERAL LIABILITY <br />A <br />X COMMERCIAL GENERAL <br />I <br />30SBMT0846$ <br />E.CH OCCURRENCE I S 2,000,00 <br />LIABILITY <br />X <br />•. <br />5/4/2012 I 5/4/2013 - q 300,00 <br />PREMISES Ee acpurrencel <br />CLAIMS -MAGE X OCCUR <br />i <br />'( <br />- <br />! MEDE%P (Any one person) lr 5 10,000 <br />--..........__._._. <br />—"- <br />LEN'L <br />PERSONAL R All INJURY S 2,000,00 <br />-- <br />GENERAL AGGREGATE S 4.000,00 <br />AGGREGATE LIMIT APPLIES PER. <br />X POLICY PRO -LOC <br />PRODUCTS - COMP/OP AGG S 4.000.00 <br />S <br />AUTOMOBILE LIABILITY <br />�30SBMT08465 <br />COMBINED SINGLE LIMIT <br />I <br />A <br />ANY AUTO <br />(Ea acddenU S 2,000.00 <br />; BODILY INJURY (Per porson)� S <br />5/4/2012 i 5/4/2013 <br />ALL OWNED �^ SCHEDULED <br />I BODILY INJURY (Per er:c�tlenl) 5 <br />PROPERTY AMAG <br />� S <br />AUTOS AUTOS <br />X HIRED AUTOS X ANONO5WNED <br />i <br />Per aCcitlenl <br />UMBRELLA UAB <br />I <br />--� .00CUR <br />EXCESS 11AB <br />i <br />EACH OCCURRENCE S <br />,AGGREGATE S <br />L CLAIMS-MApE <br />I <br />DED E RETENTIONS <br />_ <br />I <br />WORKERS COMPENSATION <br />S <br />' <br />AND EMPLOYERS' LIABILITY �, 1 N <br />WC STATU- 0TH- <br />Y I IT <br />ANY PROP EMBER/PXCLUDE/EXECUTIVE � I <br />OFFIC ER/MEMBER EXCLUDE 07 <br />N / A <br />E.L EACH ACCIDENT <br />(Mandatory <br />E.L. OISEA9E - EA EMPLOYEE S <br />.1yes, tlescribe antler <br />I <br />DESCRIPTION OF OPERATIONS below <br />A <br />Commercial Inland Marine <br />30MSVX1157 <br />5/4/2012 i 5/4/2013 <br />E.L. DISEASE - POLICY LIMIT I S <br />Rented/Leased Equipn 100,00 <br />A <br />Commercial Inland Marine <br />E <br />�30MSVX1t57 <br />I <br />5/4/2012 5/4/2013 <br />Replacement Cost <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remark. Sch.d.hi. it mora apace ie req of ratl) <br />A.PPRovt�J Asr�� <br />City of Santa Ana <br />Parks, Recreation and Community Services Agency <br />PO Box 1988, M-23 <br />Santa Ana, CA 92702- <br />© 1988-201 O ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />4CORD 25 (2010/05) <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 />