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AI? ,. /? ` --- CERTIFICATE OF LIABILITY INSURA NICE GATE (htAVDO/Yl"r`O 0 310 6/2 01 2 THIS CERTIFICATE IS ISSUED A3 A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER 7HE COVERAGE AFFORDED BY THE POLICIES BELOW. 7HIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holdsr Is an ADDITIONAL INSURED, Ehe policy(les) must be endorsetl. If SUBROGATION IS WAIVED, subject to the forms and conditions of the policy, certain pollcfes may require an endorsement- A statement on this certl0cate does not confer rlgh[s to Die ce rtificaLe ITOlder in Ileu of such enders am ent(s). PRODUCER C Ni CT Levine Insurance Group LLC PRONE SSO) 739-4444 ? 860 739-6861 221 Boston Post Road "'". a P.O- Box 339 INSURERS AFF RDING COVERAGE NAfC q East Lyme CT 06333 wsuRER A; Travele re Pro )ert Casual Co of America INS Urzeo IN _ U.S. Sa WS IJS RERC- ii High Street INSURER O: _ _ _ E Suffieltl CT 06078 INSURER F: COVERAGES GE RT1FiCATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANV REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER OOC UMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY TIiE- POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _ INSR L TYPE OFINSURANCE ADDL SUB POLICY NUMBER POLICY EFF ,VOD POLICY EXP LIRUTS GENERAL LIABILITY FACH OCCURRENCE 1.000,000 A X COIAIAERCIAI GENERAL UABIIITY DAMAGE TO RENTED ?a1=eusPe IF, „<.,,i s 300,000 culMS?nwoe 0 occuR I-680-6A8547.69-TIL-1 i 11/17/11 11/17112 MED ExP An o a rson 5,000 PERSONAL &ADV INJURY 51 000,000 OENERAI AGGREGATE 5 2.000,000 GEN'L gGGREGATE LIMIT APPLIES PER: PRO CTS- +. POLICY PRO lOC S A V TOh10BIL E LIABILITY COLA BINED SINGLE ULIIT E ___. ANY AVTO BODILY INJURY (Per person) 5 AUTOS NED SA?OES ULED BODILY INJURY (Pet ecrldenl) S HIRED AUTOS NON-0WNED AUTOS PROPERTY DAI.wGE S 5 X VMBRELLA lwO X OCCVR EACH OCCURRENCE 2000000 A E%CE55 LUiH ClAlh15-I?wOE CUP-6A 854128-11-42 11117!11 11/17/12 AGGREGATE _ 62.000 OOO DD X EE O - VlORKERS COMPENSATION ' WC STATU- ?( OTH? AND EMPLOYERS LIABILITY Y? 000 1 000 O EcvrIVE? o I ° XCiuo ? EL EACH ACCIDENT . , s A FF ICER/IA E MB eR E E ?1 NIA IJUB-3794T3G-i-11 11 P17/11 11/17/12 (I.i a ndalPry In NH) E.L. OfSEASE - EA E+APLOYE 5 1 .000,000 y DF_S?RIPT ON OF OPERATIO 5 I x E.I. DISEASE-POLICY LILT IT 51,0?0,?00 . f r?(v DESCRIPTION OF OPERATIONS /LOCATIONS l VEHICLES (Atla ch ACORD 101, Addlllon al Remarks Sche dole, Ir more space Is regvlrcrl) ?a r•Hc"??TY.?. , ???,? / .... sisiant / ps s..cn nrwra r c nvl_ucr< a..vrv... ca-???r vrv City Of Santa Ana SHOULD ANY OF 7HE ABOVE DESCRIE EO POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Finance & Management Services Agency ACCORDANCE WITH THE POLICY PROVISIONS. 20 Clvlc Center Plaza M-16, PO Box 1958 Santa Ana, CA 92702 AUTHORIZED REPRESENTATIVE \ r? <NPJ7 Phone: ? tCL?{? r ?(i????(???C..? Fax• © 1986-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105} The ACORD name and Ingo are reglsfe red marks of ACORD Exhibit c