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178564 Servando Varela dba XV Solutions Certificate of Insurance (page 1. of 1) 10/13/2011 09:50:20 AM <br />qp®' DATE Dwwrrl . <br />wM+ <br />CERTIFICATE OF LIABILITY INSURANCE 10,13/2011 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT 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(iss) must be endorsed_ N SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may requdm <br />ra an endorsement- A statement on this certificate does not confer rights to the <br />certificate holder In lieu of such endorses s _ <br />PRODUCER <br />Techlnsuranca <br />1301 Central Expy. South, Suite 115 <br />Allen, TX 75013 <br />PHONE - (800) 668-7020 Np ; (972) 390-8484 <br />- <br />I - <br />ADURESS. <br />EA <br />CUS E43 <br />-M <br />INSURER 9 AFFORDING COVERAGE NAIC e <br />INSURED <br />INEURERA: The Hartford 30104 <br />INSURER B: <br />Servando Varela dba XV Solutions <br />344 Orange Blossom <br />Irvine, CA 92618 <br />INSURER C : --- <br />PR MI ES E7a%=S 300.000CLAIMS-MADE <br />MED EXP (Any one p-.—) S 10,000A <br />INSURER 0: <br />INSURER E: _ <br />INSURERF: <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 />INSR <br />T. <br />AUTHORIZED REPRESENTATIVE <br />LIMITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE S 2.000.000 <br />PR MI ES E7a%=S 300.000CLAIMS-MADE <br />MED EXP (Any one p-.—) S 10,000A <br />TC—"IRCIAL GENERAL LIABILITY <br />OCCUR <br />PERSONAL S ADV INJURY S 2.000.000 <br />Yes <br />413SBMWB4B5 <br />IWINMI1 <br />9/23/'2012 <br />GENERAL AGGREGATE S 4000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />-- <br />PRODUCTS - COMPIOP AGG S 4.000.000 <br />f POLICY i PRO- LOC <br />S <br />AUTOMOBILE <br />LJABILnY <br />ANY AUTO <br />COMBINED SINGLE LIMIT <br />(Ee aea'deny S <br />BODILY INJURY (Per, P---) $ <br />ALL OWNED AUTOS <br />BODILY INJURY (Per a­Iderd) S <br />SCHEDULEDAUTOS <br />PROPERTY DAMAGE s <br />(Per np�enq <br />HIRED AUTOS <br />NON-0NMED AUT05 <br /><\ ]-' i111 f j v E- [� .A -S I <br />T� <br />FOR <br />S <br />UMBRELLA LIAR OCCUR <br />EACH OCCURRENCE S <br />EXCESS tl1B LCLAIMS-MAGE <br />_._.. -_ <br />DEDUCTIBLE <br />RETENTION 5 <br />AGGREGATE S <br />- -- ---- -- <br />• 1.,Lat3t CiLy At <br />Drticy <br />S <br />SATION <br />VLCSTATLL OTR - <br />... NPSCFRS- <br />AND EMPLOYE/ffi' LIAa1LITY Y l N <br />ANY PROPRIETORIPARTNEWEXECUTVE <br />OF FICERIMEMBER EXCLUOED'I <br />NIA <br />CRY, ER <br />E.L. EACH ACCIDENT $ <br />- <br />E.L. DISEASE - EA EMPLOYEE S <br />(MendatorV In NH) <br />If yrs desrflbe trtder <br />DESCRIPTION OF OPERATIONS below <br />E . DISEASE - POLICY LIMIT S <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEMICLE3 (Atte h ACORD 101, AddM.11 IdrrMrYe Sellatlule, V more rpA b raqu w -n <br />C" of Santa Ane end its o1rcVre, e9s^Is. ntpraeenratives. vdumeers. S employees am hs,eby namatl as additi 1 inau w{M -pe b the poneMI IWMIItY eoyarRpe. SrnWd cry a1 Ms above daaotbad Pordne <br />b9 fA nursed before Ms enpiredon date. Rha IHeul V Insurer will entleeyor m mall 30 de wdllan notica (10 tl ys notl¢e It d W nrn-peyment) b Ma oenlNr�le Udder named below, but- fail"M 10 do 60 shall ImpOas nc <br />ob110Mlwt or Ilebrlty pi MrY 01,11 Upon the incurs. lb ega,b pr nrptbantadyo. <br />CI of Santa Ana <br />City <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED'SEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />20 CIVio Center Me— - Ross Annex (M- ) <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Santa Ana, CA 92701 <br />AUTHORIZED REPRESENTATIVE <br />'0'19138-2009 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD <br />