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JOSHU-1 OP ID: SW
<br />.4`co?RO- CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYrJ
<br /> 03/01/12
<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 IS$SIINCZ. JN?URE?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, subJact 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 />certiflwte holder In lieu of such endorsement(s). ?-?
<br />PRODUCER 925-866-7050
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<br />License #0381524 Ea
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<br />P. O. BOX SO76 EJNAIL
<br />San Ramon
<br />CA 94583
<br />1328 ADDRESS:
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<br />-
<br />David M. Diamond INSURERS AFFORDING COVERAGE NAIC #
<br /> INSURER A ? Peerless Insurance Company
<br />INSURED EHS International, InC.
<br />2
<br />74 INSURER g ; Goltlan EaBla Inauranca Corp. 10836
<br />6
<br />1 Portola Parkway
<br />Suite 1 E#823 Pretarratl Employes Ina. Co.
<br />INSURER C :
<br />10900
<br />Foothill Ranch, CA 9 261 0-1 7 63 INSURER D : •'tlmiral Inauranca Company
<br /> INSURER E
<br /> INSURER F
<br />COVERAGES CERTIFICATE NUMBER: RFVIC InN NIIM RFR•
<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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />ILTR TYPE OF INSURANCE
<br />POLICY NUMBER POLICY EFF
<br />MM/DD/1'YYY POLICY EXP
<br />MM/DD/Y
<br />LIMITS
<br /> GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br />A X COMMERCIAL GENERAL LIABILITY X CBP9599092 06/01/11 06/01/12 PREMISES Ea occurrence $ 100.000
<br /> CLAIMS-MADE ? OGGUR MED EXP (Any one person) $ 5,000
<br /> PERSONAL 8 ADV INJURY $ 1,000,000
<br /> GENERAL AGGREGATE $ 2.000.000
<br />
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $ 1,000,000
<br /> X POLICY PRO LOC $
<br /> AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT 1
<br />000
<br />000
<br /> Ea accitl¢n[ ,
<br />,
<br />A ANY AUTO CBP9599092 06/01/11 06/01/12 BODILY INJURY (Par person) $
<br /> ALL OW NED
<br />AUTOS SCHEDULED
<br />AUTOS BODILY INJURY Per accitlen[
<br />( ) $
<br /> X HIRED AUTOS )( NON-0WNED
<br />AUTOS PROPERTY DAMAGE
<br />Per accitlen[ $
<br />
<br />
<br /> X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 2,000,000
<br />B EXCESS LIAB CLAIMS-MADE CU8738818 06/01/11 06/01/12 AGGREGATE $ 2,000,000
<br /> DED X RETENTION $ g
<br /> WORKERS COMPENSATION WC STATU- OTH-
<br />X
<br /> AND EMPLOYERS' LIABILITY T RY I R
<br />C ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N
<br />OFFICER/MEMB ER EXGLUDED'I ?
<br />N / A WKN118028-9 06/01/11 06/01/12 E. L. EACH ACCIDENT $ 1,000,000
<br /> (Mantlatory In NH) E.L. DISEASE - EA EMPLOYE $ 1,000,000
<br /> If yes, tlescribe untler
<br /> DESCRIPTION OF OPERATIONS blow E.L. DISEASE -POLICY LIMIT $ 1.000,000
<br />D Professional Llab Eooooootasalo 02/12/12 02/12/13 Ea Occur 1,DDD,Do
<br /> Claims Made RETRO DATE: 2/12/OJ Aggregate O?TI( '1,000,000
<br />F a,?
<br />DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (Attach ACORD 101, Atltlltlonal Remarks Sehatlule, B more space Is required) ?D
<br />The City of Santa Ana, its officers, agents, volunteers and employees are (??
<br />named as Additional Insured with respect to General Liability as required by pp4R -
<br />-
<br />written
<br />contract per the attached. Insured's General Liability coverage is '
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<br />P'THIS CERTIFICATE
<br />VO1DS ANDS SUPERSEDES CERTIFICATE ISSUED ON 2/29/12"'
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<br />I.CK I IF ILiAI C KVLUCK CANCELLATION
<br />CITYSAS
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />Briza Morales THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Risk Management, M28 AUTHORIZED REPRESENTATIVE
<br />20 Civic Center Plaza /?.(.
<br />Santa Ana, CA 92701 ?,K^? :?X?_a:Q,?__r.
<br />© 1988-201 O ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
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