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Uliento: 1z59431 305CORDOCO ACORD- CERTIFICATE OF LIABILITY INSURANCE DA TE (MM/DDIYYYY) 1/19/2012 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION BUT Insurance Services ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE of Orange County HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 680 Langsdorf Drive Suite 100 Fullerton, CA 92831 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Sentinel Insurance Company, Ltd 11000 Cordoba Corporation INSURER B: Everest National insurance Co 10120 1401 N. Broadway INSURER C: Property & Casualty Ins CO of H 34690 Los Angeles, CA 90012 INSURER D: INSURER E; COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LTR DDy NSR DATE MM/DD DATE M D LIMITS JA GENERALLIABILITY 72SBACP3130 01/20/2012 01/20/2013 EACH OCCURRENCE $1000000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RMISES (E.ENTED -1$1.000.000 CLAIMS MADE � OCCUR - MED EXP (Any one person) 1$10,000 PERSONAL & ADV INJURY $1 000 OOQ GENERAL AGGREGATE I s2.000.000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG 1$2.000000 X POLICY PRO- LOC C AUTOMOBILE LIABILITY 72UECUS9769 01/20/2012 01/20/2013 COMBINED SINGLE'LIMIT X ANY AUTO (Ea accident) $1,000,000 ALL OWNED AUTOS �PDrso SCHEDULED AUTOS X 1>0 A3- TO FORM (Per person) $ X HIRED AUTOS X NON -OWNED AUTOS�... ��" T-- (erraccide )RY $ Lau a 5 t . (.S11--- -� PROPERTY er dent] AMAGE $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT NY AUTO $ A OTHER THAN EA ACC $ AUTO ONLY: AGG $ A EXCESS/ UMBRELLA LIABILITY 72SBACP3130 01/20/2012 01/20/2013 EACH OCCURRENCE I s5.000.000 X OCCUR CLAIMS MADE AGGREGATE 1$5.000.000 DEDUCTIBLE Is $ X RETENTION $ 10000 Is B WORKERS COMPENSATION AND CA20011117121 01/20/2012 01/20/2013 X WC STATU-ET EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE � E.L. EACH ACCIDE$1000000 QFFI5.E,"EMfifiR EXCLUDED? nN ((MMan story In 11 If yes, describe under E.L. DISEASE - EA 000 000 SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIM,000,000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Per form SS0008 04105 pages 11-13 of 24 attached, the following are named as Additional Insureds, as respects to General Liability, as required by written contract. Additional Insureds: The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92702; its officers, employees, agents and volunteers are named as additional insureds with regard to liability and (See Attached Descriptions) I`COTICIP'ATC U^t MVn SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Santa Ana DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL -'Afl_ DAYS WRITTEN Transportation $ Traffic Engineer Public NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Works Agency M-93 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Attn: David Biondolillo; 20 Civic Center Plaza REPRESENTATIVES. Santa Ana, CA 92702 AUTHORIZED REPRESENTATIVE ACORD 25 (2009/01) 1 of 3 #S8070501/M8064223 0 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD LXMCN