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<br />ACORO® CERTIFICATE OF LIABILITY INSURANCE <br />" DATE (MM/DD/YY`!17 <br />?? 04/26/2012 <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(ies) 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 CONTACT <br />Paula Pepe <br />MPX Insurance Services, Inc. PHONE <br />FAX <br /> (949)334-5330 ac No: (949)28'1-2877 <br />27121 Aliso Creek Road, Suite 130 E-MAIL <br /> ADDRESS: service mpxinsurance.com <br />Alisa Viejo, CA 92656 <br /> INSURER 5 AFFORDING COVERAGE NAIC # <br />License #• OH49306 <br />- <br /> INSURERA: WOrldWlde Facilities Inc 12203 <br />INSURED INSURER B: Allied Insurance COT an 23787 <br />California Waters LLC 8r California Waters Develo 1? tnc.National Union Fire Insurance Co 19445 <br />2909 W Warner Ave INSURERD: NorGUARD Insurance COm an 25232 <br />Santa Ana, CA 92704-5332 INSURER E: <br /> INSURER F <br />CC]VFRAr9F4 CFRTI FICATF NIIMRF R- nOnnn Sg6_1i1g6Q0 RFVIRIfIN NI IMRFR- Gt <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 />LTR <br />TYPE OF INSURANCE <br />POLICY NUMBER POLICY EFF <br />MM/DD POLICY EXP <br />MM/DD <br />LIMITS <br />A GENERAL LIABILITY Y N 000310064 04/09/2012 04/09/2013 EACH OCCURRENCE $ 1 OOO OOO <br /> X COMMERCIAL GENERAL LIABILITY PREMISES Ea occuErranca $ 50 000 <br /> _ CLAIMSMADE n OOCUR MED EXP (Any oneperaon) _ $ <br /> PERSONAL 8 ADV INJURY $ 1 OOO 000 <br /> GEN ERAL AGGREGATE $ 2 OOO OOO <br /> GEML AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ <br />2,000,000 <br /> POLICY X PRO LOC _ <br />$ <br />B AUT OMOBILE LIABILITY Y N ACPBA7805368589 11/20/2011 '1'1/20/20'12 ee aacc daDtSINGLE LIMIT ,1 OOO OOO <br /> ANY AUTO BODILY INJURY (Per person) $ <br /> <br />X ALL OVM?IED SCHEDULED <br />AUTOS X AUTOS <br />i BODILY INJURY (Par eccitlan[) $ <br /> NON-OWNED PROPERTY DAMAGE <br />$ <br /> X HIRED AUTOS AUTOS Per accitlent <br /> <br />C X UMBRELLA LIAB X occuR Y '. N BE033077324 04/09/2012 04/09/2013 EACH OCCURRENCE $ 5,000,000 <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ S,000,OOO <br /> DED RETENTION $ $ <br />D AND EMPLOYERS' LIABIILOTY N CAWC240190 04/09/20'12 04/09/20'13 X WC STATU- OTH- <br /> Y / N <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE <br />? <br />N / A I EL EACH ACCIDENT $ 1 ,000,000 <br /> OFFICER/MEMBER EXCLU DED9 <br />(Mantla[ory in NH) E.L. DISEASE- EA EMPLOYE $ 1,000,000 <br /> If yes, describe untler <br />DESCRIPTION OF OPERATIONS below <br />E_L DISEASE- POLICY LIMIT <br />$ 1,000,000 <br /> <br />DESCRIPTON OF OPERATONS / LOCATONS /VEHICLES (AHacM ACORD 101, Adtlitlonal Remarha Schedule, if more apa® is requiratl) <br />Certificate holder, iffi officers, agenffi, and employees are named as Additional Insureds in regards to ?CQ„rtera?i,Li?r <br />7- ?1 V <br />g <br />_ - <br />y. <br />attached form. Ap <br />p" ROVED <br />J <br />' <br />10-days notice of cancellation for nonpayment. ?(- ? t <br />j(//?/???++LISA E. STORCK <br />t City Attorney <br />ssistan <br />CFRTI FICATF Hnl nFR CANCFI 1 ATIrfN <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />City Of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />Attn- Purchasing Department ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 Ci <br />i <br />C <br />Pl <br />t <br />v <br />en <br />er <br />aza <br />c <br />Santa Ana, CA 92702 <br />AUTHORIZED REPRESENTATVE <br /> PAP <br />© 1988-201 O ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD <br />Panted by PAP on ApNI 26, 2012 al 03:16PM