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Client#: 1514175 306ALLCITYM <br />DATE (MM/DDlYYYY) <br />•ACORDTM CERTIFICATE OF LIABILITY INSURANCE 3/27/2012 <br />ItIS 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 ADD A IlNSNEDI • <br />e plies) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />.. _ <br />the terms and conditions of the policy, certain policies may require an en Bement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />ACT <br />PRODUCER E: <br />Nysa Gallegos <br />BB&T-Knight Insurance Services IIHONNoe, Ext : 818 662-4234 ?FAX 877 297-9262 <br />C, <br />535 N. Brand Blvd. 10th Floor E-MAIL <br />ADDRESS: NGailegos@bbandt.com <br />Glendale, CA 91203 <br />818 662-4200 I P, -1 10q INSURER(S) AFFORDING COVERAGE NAIC # <br />ff""" INSURER A: Liberty Surplus Insurance Corp 10725 <br />INSURED INSURER B: Interstate Fire 8r Casualty Comp 22829 <br />All City Services Management, Inc. <br />10440 Pioneer Blvd # 5 INSURERC - <br />Santa Fe Springs, CA 90670 INSURER D <br />INSURER E : <br />COVERAGES CERTIFICATE NUMBER RFVISION Nl1MRFR- <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 CONTRACTOR 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 />LTR <br />TYPE OF INSURANCE_ ADDL <br />INSR SUBR <br />WVD <br />POLICY NUMBER POLICY EFF <br />MM/DDlYYYY POLICY EXP <br />MMIDD/YYYY <br />LIMITS <br />A GENERAL LIABILITY X X 100000384002 04/01/2012 04/01/201 EACH OCCURRENCE $1,000,000 <br /> X' COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED <br />50 <br /> PREMISES Ea occurrence ,000 <br />$ <br /> ?] <br />? <br /> CLAIMS-MADE <br />OCCUR <br />? MED EXP (Any one person) $ Excluded <br /> PERSONAL & ADV INJURY $1,000,000 <br /> <br />GENERAL AGGREGATE . _ <br />$2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000 <br /> PRO- <br />XI PO <br />Y - <br />$ <br /> LIC <br />1JECTLOC <br /> AUTOMOBILE LIABILITY <br />Not Applicable COMBINED SINGLE LIMIT <br />Ea accident) - - - <br />$ <br /> ANY AUTO BODILY INJURY (Per person) $ <br /> I ALL OWNED <br />AUTOS SCHEDULED <br />AUTOS <br />BODILY INJURY (Per accident) <br />$ <br /> HIRED AUTOS NON-OWNED <br />AUTOS PROPERTY DAMAGE <br />Per accident <br /> <br />$ <br /> $ <br />B X UMBRELLA LIAR H OCCUR PFX000485747 4/0112012 04/011201 EACH OCCURRENCE $8,000,000 <br /> <br />i <br />EXCESS LIAB <br />CLAIMS-MADE <br />AGGREGATE _ <br />$8 000 000 <br /> DIED X RETENTION $0 _ $ <br /> WORKERS COMPENSATION Not Applicable WC STATU- OTH- <br /> AND EMPLOYERS' LIABILITY TORY LIMITS I R <br /> Y I N <br />ANY PROPRIETOR/PARTNER/EXECUTIVE,? <br />OFFICERIMEMBER EXCLUDED? <br />NIA E.L. EACH ACCIDENT <br />$ <br /> <br />(Mandatory in NH) <br />E.L. DISEASE - EA EMPLOYEE _- <br />$ <br />I <br />- if yes, describe under <br />-DFSCRIPTION OF OPERATIONS below <br />- -_ - -- _ - -- <br /> <br />-- <br />E.L. -DISEASE - POLICY LIMIT <br />- <br />L $ - <br /> ? Not Applicable <br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) <br />As respects General Liability and required by written contract; Certificate Holder is named as additional <br />insured. Insurance is Primary 8r Non-Contributory. Waiver of Subrogation applicable. <br />Certificate Holder Completed to Read; City of Santa Ana, it's officers, employees, agents, volunteers and <br />respresentatives. <br />APPROVED AS TO FORM <br />r' <br />Santa Ana Police Department <br />c/o Linda Flores <br />60 Civic Center Plaza <br />Santa Ana, CA 92702 <br />SHOULD ANY OF-T E AfJ1H <br />THE EXPIRATION Aist <br />ACCORDANCE WITH THE <br />AUTHORIZED REPRESENTATIVE <br />3?EIYKMCIES BE CANCELLED BEFORE <br />,All WILL BE DELIVERED IN <br />PROVISIONS. <br />©1988-2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD <br />#S8369279/M8369173 NNGON v