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unerim: 4ZHAU <br />ACORDTM CERTIFICATE OF LIABILITY INSURANCE <br />DATE <br />_ <br />05/04/M/DD/WYY) <br />5 /04/ 12 <br />PRODUCER <br />Tegner - Miller Insurance <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />License #0466134 <br />2001 Wilshire Blvd., #101 <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />A <br />X <br />Santa Monica, CA 90403 <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />INSURED <br />Blueray Management, LLC <br />P.O. Box 12529 <br />INSURERA: Philadelphia Indemnity <br />$1,000,000 <br />INSURER B: <br />INSURER C: <br />Newport Beach, CA 92658 <br />INSURER D: <br />DAMAGE TO RENTED <br />PREMISES (Ea occurrence) <br />INSURER E: <br />MED EXP (Any one person) <br />$ <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />LTR <br />NSR <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />DATE MM /DDlYY <br />POLICY EXPIRATION <br />DATE MM /DD/YY <br />LIMITS <br />A <br />X <br />GENERAL LIABILITY <br />PHPK687767 <br />03/24/12 <br />03/24/13 <br />EACH OCCURRENCE <br />$1,000,000 <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE OCCUR <br />DAMAGE TO RENTED <br />PREMISES (Ea occurrence) <br />$1 OO OOO <br />MED EXP (Any one person) <br />$ <br />PERSONAL BADV INJURY <br />$1,000,000 <br />GENERAL AGGREGATE <br />s3,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMP /OP AGG <br />s3,000,000 <br />POLICY PRO LOG <br />JECT El <br />A <br />X <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />PHPK687767 <br />03/24/12 <br />03/24113 <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />$1,000,000 <br />X <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />BODILY INJURY <br />(Per person) <br />$ <br />HIRED AUTOS <br />X <br />NON -OWNED AUTOS <br />BODILY INJURY <br />(Per accident) <br />$ <br />X <br />PROPERTY DAMAGE <br />(Per accident) <br />$ <br />GARAGE LIABILITY <br />AUTO ONLY- EAACCIDENT <br />$ <br />OTHER THAN EA ACC <br />$ <br />ANY AUTO <br />$ <br />AUTO ONLY: AGG <br />EXCESS /UMBRELLA LIABILITY <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />OCCUR CLAIMS MADE <br />$ <br />$ <br />DEDUCTIBLE <br />$ <br />RETENTION $ <br />WORKERS COMPENSATION AND <br />WC STATU- OTH- <br />TORY LIMITS I ER <br />EMPLOYERS' LIABILITY <br />E.L. EACH ACCIDENT <br />$ <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />If yes, describe under <br />E.L. DISEASE - EA EMPLOYEE <br />$ <br />E.L. DISEASE -POLICY LIMIT <br />$ <br />SPECIAL PROVISIONS below <br />OTHER <br />DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES/ EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS <br />*EXCEPT 10 DAYS NOTICE OF CANCELLATION FOR NONPAYMENT OF PREMIUM <br />ADDITIONAL INSURED: <br />CITY OF SANTA ANA <br />(See Attached Descriptions) <br /><r 11 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />Evidence of Insurance DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL *1 ( DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />AUTHORIZED REPRESENTATIVE <br />4� ,4uu uvo/ l OT 3 444974 CLF © ACORD CORPORATION 1988 <br />