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OG/Y2/2012 13:20 FAX 7142471031 <br />I /?r?f 1d11 w??__-_ - _ <br />CF7J 001/001 <br />v.rA_ • /? ?{?/?? ? I? ??? ????r??L? ? Y INSURAII'JCE PATE (MM/DOIYYYY) <br />?RDDUCeR 06/12/12 <br />OH INSURANCE AGENCY TH13 CERTIFICATE I: ? IS3VED q3 A MATTER OF INFORMATIOr <br />ONLY AND CONFEF S NO RIGHTS VPON THE CERTIF=KATE <br />1421 WARNER AVE. $TE_ D ALOTLER RTHEHCOYEFZ4 GE AFFORDED BYO 7HE POLDIGE STE9EOLOW <br />TUSTIN, CA 92780 <br />INSUREp _-. _... INSURERS AFFORDING COVERAGE NAIC _#_ <br />JANET J. OH INSURER A ALLSTATE I(` SURANC;E COMPANY <br />DBA OH INSURANCE AGENCY INSURER B: F D I VSLIRAN? ? ' <br />T421 WARNER AV E. STE_ d ENSURER C: -- <br />TUSTIN, CA 92780 INSURER D: -?- -" ?••- <br />COVERAGES INSURER E: ? -` <br />I THE POLlGIES OF INSURANCE LISTED BELOW HgVE 6EEN ISSUED TO 7HE INSURED NAMED ABOVE FOR TH c POLICY PERIOD IN DICATEO. NO7WITHS7ANDING <br />ANY REOUIREMEN7. TERM OR CONDITION OF ANY CONTRACT OR OTHER ?OCUMENT WITH RESPECT 7 ? WHICH -rNIS CERTIFICATE MAY 6E ISSUED OR <br />MAY PERTAIN, 7HE INSURANCE AFFORDED E)Y THE POLICIES AESCRI6ED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE OEEN REDUCED BY PAID CLAIMS, <br />NaR Dri• <br />POLICY NUMBER PO ICY EFFECTIVE POLICY EXPIAL rIO1V -? <br />GENERAL LViBILIry LIMITS <br />X COMMERCIAL GENERAL LIABILITY 50661033 EACH OCCURRENCE § 2,000,000 <br />06/16/2012 06/16/207:: A?T67SEArED- <br />A K CLAIMS MADE O pCCVR P ISES (Eno -euron S 2,000,QQQ <br />MED F_XP (Any one Pernen, q, 7,000,QQQ <br />I'L AGGREGATE LIMIT APPLIES PER; GENERAL AGGREGATE 3 <br />POLICY PRO LOC PRODUCTS -COMP/OP AGG § <br />OM091LE LIABILITY <br />ANY AUTQ COMBINED SINGLE LIMIT <br /> <br />ALL OWNED gV709 (Ea accitlenl) § <br />._ ___ <br />SCHEDULED AVTOS BODILY INJURY <br /> y <br />(Per pE?reon) <br />HIRED AUTOS _.._? <br />NON-p MM ED AUTOS F30DILY INJVRY <br /> <br />' (Per accidvnl) y <br />PROPERTY DAMAGE <br /> fPer eccldenl) § <br />GA RAGE uABILITY <br /> ANY AUTO <br />AUTO IJNLY • EA ACCIDENT _ $ <br /> OTHER THAN EA_ACC S <br /> <br />EXCES8/UMHRELI-,q LIABILITY AU70 ONLY: qGG § <br /> <br />OCCUR CLAIMS MADE EACH OCCVRRENC6 <br />§ -._ <br /> AGGREGATE y <br /> OEDUCnBLE _` § <br /> RETENTIOIJ -....-. $ <br />WORKERS COMPENSATON AND § <br />EMPLOYERS'l1ABILITY 83 WEC JZ6626 <br />B WC STATV- OTI.1- <br />@,Y IwrG I <br />1 O/13/i l <br /> <br />ANY PRpPRIETOR/PARTNER/E%EGVTIVE <br />OFFICER/MEMBER EXCLU DEDT -._. <br />10/13/12 <br />E.L. EA(:H ACCIDENT § 1,OC <br />It yVea, doscnbe under <br />pECIAL PROVISIONS bPIDW EL DISEASE - EA EMPLOYEE $ 1 ,OC <br />OTHER E. L. DISEASE-POLICY LIMIT S 1 OC <br />DESCRIPTION OF OPERATIONS/ LOGATONS /VEHICLES / EXCLVSIONg ADDED BY ENpORSEMENT / SPECIAL PROVISIONS <br />CertificatQ holder, its officers, agents, and employees a ra Warned as Additional Insured i <br /> <br />CG 2015 11/88 n regard: to General Liability per a ed <br />?' <br />10 d TO FQ <br />ays notice of cancellation for nonpayment. AS <br /> AppR,pV£D <br />:ERTIFICATe HOLDER X ADDI"T"IONAL TIVS?URED X CANCELLATION ``,, -? <br />CITY OF SANTA ANA SNOULpgNYOFTNEA C21BE.p_t aLYIC?iE`??A LED 6EFORE THE EXPIRATION <br />ATTN: PURCHASING DEPARTMENT GATE THEREOF, THE ISSUING INSVBBAx?EL'ENOEAVOR TO MAIL 9O DAYS WRITTEN <br />20 CIVIC CENTER PLAZA NOTICE TO THE CERTIFICATE HOLIF'??E?R''N_AMED TO THE LEFT, BUT FAILURE Tp DD SO SHALL <br />SANTA ANA, GA 92701 IMPOSE NO OBLIQATION OR LIABI _ITY OF ANY K)NO UPON THE INSURER, 179 AGENT9 OR <br />REPRESENTATIVES. <br />AUTHORIZED REPRESENT VE <br />CORD 25 (2007/08) <br />m ACORD CORPORATION 1988 <br />OH INS AGENCY-ALLSTATE <br />Exhibit C