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ACOR" CERTIFICATE OF LIABILITY INSURANCE PATE(MM/DD/YYYY) `...?? 12/30/2011 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 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). PRODUCER Spectrum Risk Management CONTACT NAME: Account Manager 74 Discovery PHONE • 949-756-5730 FAX A/c No): 949-756-5740 Irvine CA 92618 , E-MAIL ADDRESS: Office s ectrumrisk.com INSURERS AFFORDING COVERAGE NAIC # www.spectrumdsk.com OC77485 INSURER A: Mt. Hawley Insurance Co. 37974 INSURED INSURER B : American Economy Ins CO 19690 TSCM Corp 17791 J e t n L INSURER c : St. Paul Fire & Marine Ins Co 24767 am s ow ane Huntington Beach CA 92647 INSURER D: Everest National Insurance Co. 10120 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 1905'AEi4? REVISION NUMBER: 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 LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MM/DD POLICY /YYYY /DD/YYYY MM LIMITS A GENERAL LIABILITY MGLO176203 1/1/2012 1/1/2013 EACH OCCURRENCE $ 2,000,000 COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ 50,000 I CLAIMS-MADE a OCCUR MED EXP (Any one person) $ 5,000 $1,000 deductible PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1,000,000 POLICY W PRO- LOC $ B AUT OMOBILE LIABILITY 24-CC-298386-1 1/1/2012 1/1/2013 EO accident) LIMIT $ 0 1,000.00 ANY AUTO BODILY INJURY (Per person) _ $ ALL OWNED AUTOS H SCHEDULED AUTOS BODILY INJURY (Per accident) $ NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Peraccident $ C UMBRELLA LIAB V/ OCCUR ZUP-12P38996-12-NF 1/1/2012 1/1/2013 EACH OCCURRENCE $ 4,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 4 000 00 0 DIED RETENTION $10,000 , , $ D WORKERS COMPENSATION CA10000979111 7/1/2011 7/1/2012 WCSTATU- O T t i - A N D EMPLOYERS' LIABILITY Y I N TORY LIMITS EErc ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ? N I A E.L. EACH ACCIDENT $ 1000000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE 1-000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISE E - C' 1,000,000 0191 PPW - DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) ' All Crr'' SA E' S ? FittO L Re: Parking lot sweeping services. Cant C.ItY i The City its officers, agents, employees are named additional insureds with resepect to the general liability and auto R,fb`Il W per the attached q ^ blanket carrier form. t CERTIFICATE HOLDER CANCELLAT ON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE The City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Community Development Agency ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza M-25 Santa Ana CA 92701 AUTHORIZED REPRESENTATIVE Jim Waterhouse © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD