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A? KlJ CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 04/02/2012 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 CONTACT NAME: Aon Risk Insurance Services West, Inc. (847) 953-5390 (866) 283-7122 a N LOS An el es CA Office (AIC. No. Ext): C No 707 Wilshire Boulevard E-MAIL Suite 2600 ADDRESS: LOS Angeles CA 90017-0460 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: Federal Insurance Company 20281 Tiburon, Inc. 6200 Stoneridge Mall INSURER B: Great Northern Insurance Co. 20303 Pleasanton CA 94588 USA INSURER C: Pacific Indemnity Co 20346 INSURER D: Continental Casualty Company 20443 INSURER E: Chartis Specialty Insurance Company 26883 INSURER F: v c v 41 O COVERAGES CERTIFICATE NUMBER: 570045789535 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. Limits shown are as requested INSIR LTR TYPE OF INSURANCE INADDL SR SUBR WVD POLICY NUMBER - MPO M DDY (P MMIDD/YYYY LIMITS A GENERAL LIABILITY 35911077 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $1 000 000 PREMISES Ea occurrence , , CLAIMS-MADE X? OCCUR MED EXP (Any one person) $10,000 PERSONAL& ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000 POLICY X PRO X LOC B AUTOMOBILE LIABILITY 73558729 09/01/2011 09/01/2012 COMBINED SINGLE LIMIT $1 000 000 a accident) , , X ANY AUTO BODILY INJURY ( Per person) ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS Per accident D X UMBRELLA LIAB X OCCUR L4030957581 09/01/2011 09/01/2012 EACH OCCURRENCE $10,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE S10,000,000 DED RETENTION C WORKERS COMPENSATION AND 71739717 09/01/2011 09/01/2012 X WC oTH- EMPLOYERS' LIABILITY Y I N CRY TORY LIMITS ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED? F N I A E.L. EACH ACCIDENT $1,000,000 (Mandatory in NH) If yes describe under E.L. DISEASE-EA EMPLOYEE $1,000,000 , DESCRIPTION OF OPERATIONS below E.L. DISEASE-POLICY LIMIT $1,000,000 E E&0-ProfLiabPri 068087729 09/01/2011 09/01/2012 Limit $3,000,000 SIR applies per policy er ns & condi ions SIR/Deductible $250,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) l AS TO Fns, APPRO` CERTIFICATE HOLDER ----- '.p VSA ' t "I "ICANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Santa Ana AUTHORIZED REPRESENTATIVE Attn: Lori Smith 20 Civic Center Plaza Santa Ana CA 92701 USA N M u7 W n °o r` O Z d O r=. r d U y? ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD