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.�acoRO• CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MMIDD /YYYV)
<br />05/37 /207 2
<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: It 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 Phone: (626) 300 -9000 Fax: (626) b]0 -0908
<br />NEW CENTURY INS SERVICES, INC.
<br />76 N. 2ND ST.
<br />ALHAM BRA CA 97807
<br />CONTACT NEW CENTURY INS SERVICES, INC.
<br />NAME:
<br />PHONE (626) 300 -9000 n/o No: (626) 570 -0908
<br />ac N Ext:
<br />E -MAIL info @usnci.com
<br />ADDRE
<br />PRODUCER 75724
<br />T MER ID'
<br />INSURERS) AFFORDING COVERAGE
<br />NAIC #
<br />Agency Lic #: 0007085
<br />INSURED
<br />AVT, INC.
<br />347 BONNIE CIRCLE, SUITE 707A & 702
<br />CORONA, CA 92880
<br />INSURERA GOLDEN EAGLE INSURANCE CORP
<br />$ 500,000
<br />INSURERe NATIONAL UNION FIRE INS COMPANY
<br />$ 70,000
<br />INSURER c ZURICH INSURANCE COMPANY
<br />$ I,000,OOO
<br />INSURER D:
<br />GENERAL AGGREGATE
<br />INSURER E
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICY PRO LOC
<br />PRODUCTS - COMP /OP AGG
<br />INSURER F
<br />$
<br />COVERAGES CERTIFICATE NUMBER: 97972 REVISION NUMBER:
<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 ANV REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAV BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />ADD'L
<br />IN R
<br />SUER
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />N DD YY
<br />POLICY E %P
<br />M DD YY
<br />LIMITS
<br />A
<br />GENERAL LIABILITY
<br />X COMMERCIAL GENER�AL LIABILITY
<br />CLAIMS -MADE I ^ OCCUR
<br />CBP8283936
<br />D5/37/72
<br />05/31/73
<br />EACH OCCURRENCE
<br />$ 7,D0D,D00
<br />AMA N en
<br />PREMI E E
<br />$ 500,000
<br />MED. EXP (Any one person)
<br />$ 70,000
<br />PERSONAL 8 ADV INJURY
<br />$ I,000,OOO
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICY PRO LOC
<br />PRODUCTS - COMP /OP AGG
<br />$ 2,000,000
<br />$
<br />A
<br />AUTOMOBILE
<br />LIA6ILITV
<br />ANY AUTO
<br />ALL OWNED AUTOS
<br />SCHEDULED AUTOS
<br />HIRED AUTOS
<br />NON -OWNED AUTOS
<br />BA2442759
<br />02/22/72
<br />02/2.1/73
<br />COMBINED SINGLE LIMIT
<br />(Ea accident)
<br />$ 1,000,000
<br />X
<br />BODILY INJURY (Per person)
<br />$
<br />BODILY INJURY (Par accident)
<br />$
<br />PROPERTY DAMAGE
<br />(Par accident)
<br />$
<br />$
<br />B
<br />X
<br />UMBRELLA LIAe
<br />E %CESS LIA6
<br />X
<br />OCCUR
<br />CLAIMS -MADE
<br />EBU074764659
<br />77/04/77
<br />77/04/72
<br />EACH OCCURRENCE
<br />$ 4,000,000
<br />AGGREGATE
<br />$ 4,000,000
<br />DEDUCTIBLE
<br />RETENTION $
<br />$
<br />$
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY y/N
<br />ANV PROPRIETOR/PARTNER/EXECUTIVE �
<br />OFFICER/MEMBER E %CLUDEDT
<br />(Mandatory In NH)
<br />II yes. describe urWer
<br />DESCRIPTION OF OPERATIONS below
<br />N/A
<br />400774!0
<br />D2/D6/72
<br />02/06/73
<br />X W $TATU-OTH
<br />RY MI
<br />$
<br />E.L. EACH ACCIDENT
<br />$ 7,DDD,DDD
<br />E.L. DISEASE -EA EMPLOYEE
<br />$ 7,000,000
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 7,000,000
<br />DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (Attach ACORD 101, AOtlitional Remarks SeheAUle, II more space Is requiretl)
<br />THE CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS, VOLUNTEERS AND REPRESENTATIVES ARE NAMED AS ADDITIONAL
<br />INSURED- VENDOR PER POLICY FORM NUMBER: GECG602 09 -02. THIS CERTIFICATE IS VALID ONLY IF THE CERTIFICATE HOLDER REQUIRES IN
<br />WRITTEN CONTRACT TO BE NAMED AS ADDITIONAL INSURED. THIS POLICY IS PRIMARY &N0N- CONTRIBUTORY. 70 DAYS NOTICE OF
<br />CERTIFICATE HOLDER CANCELLATION
<br />The City of Santa Ana :-, F't�42(J O/ i�11 �� r0 FORM SHOULD ANV OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />Parks, Recreation and Community Services Agency THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />26 Civic Center Plaza ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Santa Ana, CA 92707 -_.. ��i..l. -. —e �
<br />1.311 rii 51 iil �, f)ef; Cty AUTHORIZED REPRESENTATIVE
<br />.4 snis tans Cily Attorney
<br />Attention: Silvia Cuevas
<br />.. RD 25 (2009/09) c 1988 -2009 A RD R RATI N. All rights reserved.
<br />Tha ACr]RI] name and Innn arw rwnistored marKs of ACORD
<br />
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