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CERTIFICATE OF LIABILITY INSURANCE °oiATE 27//20 inn <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: K the certificate holder Is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. H SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certiflcate does not confer rights to the <br />certificate holder In lieu of such endonreme s . <br />PRODUCER 1-804-000-0000 CONT= 0. ? <br />NAME <br />ONE Carol Vernier <br />Arthur J. Gallagher Risk ltanagesent Services, Inc. PH <br />804-916-6846 FAx804-916-6897 <br />4860 Cox Road, Snits 200 L <br />ADDRESS: <br />Glen Allen, VA 23059 OM AFFORDING COVERAGE NAICI <br />Carolyn O. Vernier NSURMA: LM INS CORP 33600 <br />INSURED <br />JONES L STOKES ASSOCIATES, INC. NSURBNB: <br />9300 LEE EICNNAY <br />rAIRFRX, VA 22031 <br />COVERAGES CERTIFICATE NUMBER: 21948995 REVISION NUMBER: <br />1 ? ? c <br />ISSUED <br />T <br />INDICATED. NOTWITHSTANDINGvANY REQUIREMENT <br />TERM OR CONDTION OF ANY CONTR <br />I <br />U <br />U <br />L <br />, <br />ACT <br />THER <br />DOC <br />R NT <br />H RESPECT O <br />WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN <br />THE INSURANCE AFFORDED BY <br />O <br />, <br />THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES <br />LIMITS SHOWN MAY HAVE <br />. <br />BEEN REDUCED BY PAID CLAIMS. <br />NsR <br />LTR TYPE OF INSURANCE POLICY NUMa6t <br />:::: !FF POLICY DP <br /> <br />GENERAL LIABILITY Lia na <br /> <br />C <br />7 <br />7 FACFI OCCURRENCE t <br /> OMMERCIAL GENERAL LIABILITY <br /> <br />El 1 <br />?y.T P $ <br /> CLAIMS-MADE <br />OCCUR O <br />'rib/ TO M MEO E%P -------- M s <br /> <br /> PERSONAL 4ADVINJURY f <br /> <br /> <br />G <br />N' GENERALAGOREOATE _ <br /> E <br />?GGR.EGATE LIMIT APPLIES PE : <br />Pao- d? r I I <br />(p PRODUCTS • COMPXW AGG S <br /> <br />AUTOMOBILE LIABILITY $ <br /> red <br /> AUTO <br />SCHEDULED A BOIXLV IwuaY (per IeNOn) s <br /> AUTOS <br />NON-OMED BODILY INJURY (Pr eOCldellq f <br /> <br />AUTOS <br />PR <br />OPE <br />.? DAMAGE <br />: <br /> f <br /> <br />lAB <br />OCCUR $ <br /> EacrloccuaaENCE <br />f <br /> Ch1JMSMADE AGGREGATE S <br /> ErENN ON <br />A WORKERS COWENSATION <br />AND EMPLOY11" LUMUTY NC5-Z31-508381-011 <br />06/25/1 <br />06/25/12 -STATLL oTH• <br />Y s <br /> YIN <br />ANY PROPRIETOR/PARTN <br /> ER/EXECUTIVE <br />OFFICERIMEMBER EXCLUDED? a <br />(Mend <br />l <br />I <br />NM <br />NIA <br />EL. EACH ACCIDENT <br />s 1,000,000 <br /> e <br />ory <br />n <br />I <br />r deualbe under <br />DESCRIPTION OF OP <br />E.L. DISEASE-61 ENf+LOYE <br />i 1 000,000 <br /> ERATIONS babes <br />E.L. dSFJI.9E • POLICY LIMIT <br />s1,000,000 <br /> <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AtlaeM ACORD 101, AddMb/rl Ranurks Schedule, N more .peen Is requited) <br />Re: On-Call Services <br />CERTIFICATE HOLDER ,......?..._ _.. <br />City of Santa Ana <br />Planning and Suildinq Agency <br />20 Civic Center Plaza, Ross Annex K-20 <br />P.O. Sox 1988 <br />Santa Ana, CA 92702 <br />USA <br />ACORD 25 (2010105) <br />carolynvar <br />21948995 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUrNORMD REPRESENTATIVE <br /> <br />®1988-2010 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />3:4