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CERTIFICATE OF LIABILITY INSURANCE page 1 of a o6�`oiiaoll 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 pollcy(ies)must be endorsed. If SUBROGATION IS WAIVED, 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 lieu of such endorsement(s). RODUCER T Willie Insurance Services of California, Inc. 26 Century Blvd. P. O. Sox 305191 877-995-7 7 FAx 888-467-2 7 certifi llis IINSURERA: Nashville, TN 37230-5191 INSURER(S)AFFORDINGCOVERAGE NAICO National Union Fire Ins Cc of Pittsburgh 19445-100 ISURED ORS Corporation dba UR8 Corporation AmeAINSURERF: RB:Zurich American Insurance Company 16535-100 National Insurance Co. 23817-001 2020 R. First Street, Suite 400RC:Illinois Santa Ana, CA 92705 RD;Ineuranc• Company of the state of PA 19429-100 RE;Lexington Insurance Company 19437-000 Lloyd's of London a British Companies 15792-004 OVERAGES CERTIFICATE NUMBER.16028973 REVISION NUMBER:See Remarks 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. SR TYPE OFINSURANCE � SUB POLICYNUMBER POLICY EFF POLICYE7(P LIMITS GENERAL LIABILITY Y GL48704829 5/1/2011 6/1/2012 EACHOCCURRENCE S 2,000,000 p PR MI E RENTED S 1,000,000 ]( COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR MEDEXP (Any oneperson) $ 10,000 PERSONAL& ADV INJURY S 2,000,000 X XCU, BFFD X Contractual Liability GENERAL AGGREGATE S 2 000 0 0 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO S 2,000,000 $ POLICY X PRO- LOC AUTOMOBILE LIABILITY BAP938521 / 2012 GOBeBBIdeDSINGLELIMIT ( $ 2,000,000 BODILY INJURY(Perperson) $ X ANYAUTO ALL OWNED SCHEOULED AUTOS AUTOS HIREDAUTOS NON -OWNED AUTOS 19 BODILY INJURY(Peraccident) $ A A (Pereccidenl S S UMBRELLALIAB OCCUR Cky A EACHOCCURRENCE S AGGREGATE S EXCE89 LIAR CLAIMS -MADE DED I IRETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARtNER/EXECUTIVEYa NIA WC20635052 WC20635051 l/l/2011 1/1/2011 1/1/2012 1/1/2012 X E.L. EACH ACCIDENT s 2,000.000 E.L. DISEASE - EA EMPLOYEE S 2,000 000 OFFICER/MEMBER EXCLUDED? IMandetory In under lift yes, desmbe under DESCRIPTION OF OPERATIONS below WC20635053 WC20635054/wc20635055 1/1/2011 1/1/2011 1/1/2012 1/1/2012 E.L. DISEASE -POLICY LIMIT S 2,000,000 015438088 5 1 2011 6 1 2012 Professional Liability PZ11051501P1RI105490 5/1/2011 6/l/2012 $1.000,000 Each Claim w/Limited Contractual - $1,000.000 Aggregate Claims Made Policy ESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES (Atgch Acord 101, Addltonal Remarks Schedule, Nmore space Is required) 3IS VOIDS AND REPLACES PREVIOUSLY ISSUED CERTIFICATE DATED: 5/31/2011 WITH ID: 16021742 me Workers' Compensation coverage shown above does not apply in monopolistic states. In the tates of ND, OH, WA and WY, Workers' Compensation coverage is provided by the State Fund. In nose States, the above -referenced policies provide Stop -Gap Employers' Liability only. 3Z ATTACHED 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 REPRESENTATIVE City of Santa Ana 20 Civic Center Plaza - Ross Annex (M-36) Santa Ana, CA 92701h Coll:3376174 Tpl:1261289 Cert:16028973 C1988-2010 .CORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD TION. All rights reserved.