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1 6
<br />AC C>R"" b CERTIFICATE OF LIABILITY INSURANCE
<br />DATE Ifs MY00,IYYYYy
<br />1 Oi2/2015
<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 pohcy(ies) must be endorsed. If SUBROGATION IS WAlVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement, A staternent on this certificate does Inot confer rights to, the
<br />certificate holder in lieu of such endorsement(s).
<br />PRODUCER Venbrook Insurance Services CA Lic OD80832
<br />6320 Canoga Avenue, 12th Floor
<br />Woodland Hills, CA 91367
<br />CONTACT
<br />NAME
<br />PHONE FAX
<br />(AM � NQ, Ems: NDI: 818,-598-8910
<br />E-MAIL
<br />ADDRESS'
<br />..... ........ INSURER(SV AFFORDING COVERAGE
<br />NANO; 0
<br />COMMERCIAL GENERAL LIABILITY
<br />INSURER A Hartford Accident and ldt.rnnify Coni.aDy
<br />22357
<br />wws,,,.venbrock.coal
<br />INSURED
<br />Overland Pacific & Cutler Inc.
<br />INSURER E Hartford Fire Insurance CoLnp- 1
<br />"19682
<br />INSURER C Hartford CaSualt�.12s_urance C2m any
<br />29424
<br />3750 Sdiaufele AvellUe,
<br />INSURER ID Sentinel Insurance Company, Limited
<br />11000
<br />Suite '150
<br />Long Beach CA 90808
<br />INSURER E Twin City Fire Ins uranre Company
<br />29459
<br />INSURERF: Western World Insurance Company
<br />13'196
<br />=1111 a I a rovilli 111MMUS .1tinLififln
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PEMOD
<br />INDICATED, NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMEN"r WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, 'THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 6 SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSIR
<br />LTR
<br />TYPE TYPE OF INSURANCE
<br />ADDLSUBR
<br />RTSD
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />(MWDD1YYYYj
<br />POLICY EXP
<br />(MMiDD/YYYYj
<br />LIMITS
<br />A
<br />COMMERCIAL GENERAL LIABILITY
<br />✓
<br />721JUNTR7859
<br />611/201$
<br />6/1/2016
<br />EACH OCCURRENCE
<br />CLAIMS -MADE OCCUR
<br />—IDAMAG TLL -'D
<br />E , E�� 3
<br />IREIIe 300,000
<br />V
<br />MED EXP (Any one ppr5w) 3 10,000
<br />$10,000 BI&PD Ded.
<br />& ADV INJURY S 1,000,000
<br />Per ClaimPERSONAL
<br />..........
<br />GENERAL AGGRLGATF 5 2,000,000
<br />GFN'L
<br />AGGREGATE LIMIT APPLIES PER
<br />POLICY [7 J,E,(,- ED LOC
<br />,T
<br />PRODUCTS - COMP�01` AGG 5 2,00'O',000
<br />[ETnc Ben. Liab. Occ. S 1,000,'000
<br />OTHER:
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />72UUNTR7859
<br />6/1/2015
<br />6/1 /2016
<br />COMBINED SINGLE IT0,1111 I
<br />fEa acdchrt) 1,000.000
<br />BODILY INJURY (Per pefsm
<br />A iTo
<br />�t L OV �`NED SCHEDULED
<br />JS AUTOS
<br />F30DILY INJURY (Por amai�nt) S
<br />✓
<br />NO� -O�ANED
<br />I IHED AU I O'S V ALH
<br />PROPERTY DANIAOF
<br />WcderiL� $
<br />............
<br />I V
<br />ornp ;x'1,000
<br />1 000 V Coll $1.000
<br />C
<br />UIMERELLA LIAS y OCCUR
<br />72RHIJTR7849
<br />6/12015
<br />6/112016
<br />EACHI OCCURRENCE 2,000,000
<br />00,0
<br />AIE 2,000
<br />EXCESS LTAB CL.?,..........NV.AGGREG
<br />... .... .......ISAIA
<br />DLEDJLE'IEUI-ION3S
<br />D
<br />E
<br />WORKERS COMPENSATION
<br />AND EMPLCYCRS'LIA8[LITY
<br />Y�N
<br />ANY
<br />1:1
<br />imandatory in NH)
<br />NfA
<br />72WED043001
<br />6/1/20'15
<br />6/11270-16
<br />FF
<br />E L. EAC11-1 ACCIDENT S '1,67017,000
<br />L.L. DISEASE- FA EMPLOYEE$ 1,000,000
<br />--
<br />ffyes desutbaundLF
<br />Dr'SCRiiprjoi or OPERATiONS bebw
<br />EL.DOEASE-POLICYUM11 'S 1,000,000
<br />F
<br />Profpssbnal Liab.
<br />DR] -0009 L06
<br />6M/2015
<br />6112016
<br />$2,000,00O Each Claim
<br />clainis Made
<br />$2,000,000 Aggregate
<br />Retro Date: (5/30/03
<br />$50,000 DeduclIbIo
<br />DESCRPTION OF OPERATIONS f LOCATIONS t VEHICLES AC ORD 101, Add i honM Rpmark 5 Schud0a, may ba attach od if nacre space, Is veq WrPd
<br />rF'E:P�-opr,,rtyAcqi.iisitXoii,Rel!oc,gion &Man,,.ageriic-,lit S�i-vice.sAgrraLr7ieii.t A -201:1 -055 -01,A -20,15-162,A-201; -'16;-P
<br />Cty of Santa Ana, its offirers, empIoyo- .,-s agents, vokwitf�,,rsand representatives are riained as additaonal insured on a
<br />prii-nary & rif.-m-contributory basis where reqt&ed by written contract. Subject w Policy temns Conditions and excluskws.
<br />10 Day�s Notice of Cancellation for Non-Payrnent of Preml[jrm 30 Days All Others.
<br />IE TE—�Ll I -: t1 BY: rf)MCE kIEREDIA wc�
<br />CERTIFICATE HOLDER CANCELLATION
<br />Cit of � Santa Aria
<br />RK Box 1988
<br />20, Civic Center Plaza (M-36)
<br />Santa Aria CA 92702
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE VVITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPIRFSENTATNE
<br />(WH',I Wei idy Fifice
<br />(K) 1988-2014 ACORD CORPORATION, All rights reserved
<br />ACORD 25 (2014jor4), ThPACORD name sir' -Id logo are registered marks, of ACORD
<br />
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