MERCHANTS BUILDING MAINTENANCE 1b - 2012

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ir A� D® CERTIFICATE OF LIABILITY INSURANCE DATE(MMlDOM/YY) 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 Bolton & Company 3475 E. Foothill Blvd., Suite 100 Pasadena, CA 91107- CONTACT NAME: _ PHONE INC. No E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A: Travelers www.boltonco.com 0008309 INSURED Merchants Building Maintenance LLC 1190 Monterey Pass Road Monterey Park CA 91754 INSURER B : Safety INSURER C: Federal Insurance Company INSURERD: INSURER E : INSURER F : 1.--I COVERAGES CERTIFICATE NUMBER: 12929958 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 OF INSURANCE ADDLTYPE In& SUER POLICY NUMBER MMIDDYlYYYN MW DDlYYYY LIMITS A GENERAL LIABILITY 6308043N684TIL 6/1/2011 6/1/2012 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES occurrence $ 300 000 COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FvI OCCUR MED EXP (Any one person) $ 5,000 PERSONAL BADVINJURY $ 1,000,000 _ GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPlOP AGG $ 2.000,000 $ POLICY PRO- LOC A AUTOMOBILE LIABILITY 810329D1831TIL 6/1/2011 6/1/2012 Ee acc,,En SINGLE LIMIT $ 11000,000 BODILY INJURY (Per person) $ ANY AUTO ALL OWNED e SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS BODILY INJURY (Per accident) $ PerOPER (DAMAGE $ $ A UMBRELLA LIAB OCCUR CUP8043N684TIL 6/1/2011 6/1/2012 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 EXCESS LIAB CLAIMS -MADE DED RETENTION$0 $ $ B A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PRCPRI'c'OR/PARTNEP✓EXECUTIVE r OFFICERIMEMBER EXCLUDED? u (Mandatory In NH) NIA SP4046075 Excess WC (CA) YUB598M6011'12 (AOS) 4/24/2012 1/1/2012 4/24/2013 1/1/2013 7H WC LATU- OER E.L.EACH ACCIDENT $ 4 B0Q 000 E.L. DISEASE - EA EMPLOYEE $ 1 00,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 C EmplyeeTheft /Forgery 81585028 6/1/2011 6/1/2012 Limit $1 MIUDed. $25,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Workers Comp is Self -Insured under California Certificate of Consent to Self Insure #1793 for California operations. Job: Operations of the Named Insured. Additional Insured(s): City of Santa Ana. CERTIFICATE HOLDER /` + - 'CANCELLATION MBM CA, Operations of the Named Insured SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 CIVIC Center Plaza (M-30 Santa Ana, CA 92702-198a ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE �r "•`" Cheryl Feia ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD CERT NO.: 12929958 CLIENT CODE: MERCH-1 Elizabeth Foster - Direct 626-535-1433 4/25/2012 11:42:26 AM Page 1 of 3