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'``` °? °® CERTIFICATE OF LIABILITY INSURANCE 6i2;;2o1' 2 "' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must ba endorsed. If SUBROGATION IS WANED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In Ifeu of such endorsemerrt(si. PRODUCER CONTACT Teresa Cr112 2NSIIRANCE 30LIIT10NS PNONE (949) 346-7400 F'0`X (949)348-2373 License #0746539 E?uIAIL .t:erQSaC®].aB-SOlut].OaB.COm D 33302 va 110 Rd, Su1te: 200 INSURERS AFFORDING COVERAGE NA San Juan Capistrano CA 92675 INSURERA AIILCO Snsur anca Co 19: INSURED INSURER B DR GARY A L2NNIIKANN 1!?SD INSURER C 1534 E WATZ>v>.R AVE STE A INSURER D - INSURER E - SANTA ANA CA 92705-5475 INSURERF- COVERAGES CFRTIFICATG IJI IMCe Cta-l 2 /T i THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TR TYPE OF INSURANCE POLICY NUMBER POLIp EFF POLICY EXP LIMITS GENERAL LULBILITY EACH OCCURRENCE $ 1, 000, 000 X COMMERCIAL GENERAL LIABILITY p I N g 300. 000 A CLAIMS-MADE X?OCCVR CP7671675916 /6/2012 6/6/2013 MED EXP (An one person) $ 5,000 PERSONALS ADV INJURY $ Sr 000, 000 GENERAL AGGREGATE $ 2, 000 r 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $ 2 r 0 0 O , 0 00 X POLICY PRO LOC $ AUT OMOBILE LIABILRY COMBINtlEDISINGLE LIMI 1 000 000 A ANV AUTO BODILY INJURY (Par person) $ ALL OWNED AUTOS SCHEDULED AUTOS CP7671H 75918 6/6/2012 6/6/2013 BODILY INJURY Per accident ( ) $ X HIRED AUTOS X NON-0WNED AUTOS PROPERTY DAMAGE P r accld t $ UMBRELLA LIAB OGCVR EACH OCCURRENCE $ EXG E33 LIAB CLAIMS-MADE ? v?? AGGREGATE $ ?I DED RETENTION $ g WO RKERS COMPENSATON WG STATU- OTH- AND EMPLOYERS' IJABILJTY ?? Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE a t? OFFICER/MEMBER EXCLUDED'! ? N / A b ?? EL. EACH ACCIDENT $ M nd t M NH ?ep ? ? ( a a ory ) ? E.L. DISEASE - EA EMPLOYE $ If 3, tlascTiba Untlef d DESCRIPTION OF OPERATIONS below ta E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (Attach ACORD 101, Adtlitlonal Remarks Schedule, R more space Is required) The City o£ Santa Aaa, its ot:ficara, amployaea, agents and voluateara era named as additional insured par the Comtnarcial General Liability Coverage Form CG 00 OS 12 07 attached to the policy. MICelleyc?s ante-ann. org City o£ Santa Ana 20 Civic Center Plaza Santa Ana, CA 92702 25 (2010/05) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRE3ENTATVE T Alassaadra/PHTERS ? ?- _ ©'1988-20'10 ACORD CORPORATION- All rights reserved. r.??- 1' r? V\ INSn2s Inn,nnc, n, The erriwn .,?...e and L.r. r, ire ror?:vte.erl m?r?a n4 AC!-ll?ll