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PARMICILL PARTNERS A...2011 -036.-(7'I REVIEWED BY'
<br />EUNICE HE.REDIA (PG. 1 Of 23) OP ID: SN
<br />CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MM/DD/YYYY)
<br />01/13/2015
<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: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />The Dougherty Company, Inc.
<br />P.O. BOX 7277(A/C,
<br />Long Beach, CA 90807
<br />Richard Lindgren
<br />CONTACT
<br />NAME: Sylvia N@ISOs
<br />PHONE FAX
<br />No Ext): A/C, No:
<br />E-MAIL
<br />ADDRESS: Sylvia@doughertyins.com
<br />PRODUCER PARAG-3
<br />CUSTOMER ID #:
<br />INSURER(S) AFFORDING COVERAGE MAIC #
<br />INSURED Paragon Partners Ltd.
<br />INSURER A: Hartford Insurance Company 29424
<br />5762 Bolsa Avenue, Suite 201
<br />Huntington Beach, CA 92649
<br />INSURER B: Lloyds of London 112300
<br />---
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE ® OCCUR
<br />INSURER C
<br />INSURER D
<br />72UUNPR1964
<br />INSURER E :
<br />01/01/2016
<br />INSURER F
<br />MED EXP (Any one person) $ 10,000
<br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />1CY
<br />�TR
<br />TYPE OF INSURANCE
<br />AD
<br />WVD UBR
<br />POLICY NUMBER
<br />EFF
<br />MM% POLIDIYYYY
<br />POLICY EXP
<br />MMI D/YYYY
<br />LIMITS
<br />GENERAL LIABILITY
<br />EACH OCCURRENCE $ 1,000,00
<br />A
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE ® OCCUR
<br />X
<br />72UUNPR1964
<br />01/01/2015
<br />01/01/2016
<br />DA AGE TOR
<br />PREMISES Ea occurrence $ 300,00
<br />MED EXP (Any one person) $ 10,000
<br />PERSONAL &ADV INJURY $ 1,000,00
<br />X Contractual _ _
<br />Deductible -0-
<br />GENERAL AGGREGATE $ 2,000,00
<br />GENI AGGREGATE LIMIT APPLIES PER:
<br />PRODUCTS - COMP/OPAGG $ 2,000,00
<br />PE LOC
<br />X POLICY Ll
<br />$
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />ANYAUTO
<br />X
<br />72UUNPR1964
<br />01/01/2015
<br />01/01/2016
<br />COMBINED SINGLE LIMIT
<br />(Ea accident) $ 1,000,000
<br />—
<br />BODILY INJURY (Per person) $
<br />ALL OWNED AUTOS
<br />BODILY INJURY (Per accident) $
<br />X
<br />SCHEDULED AUTOS
<br />HIRED AUTOS
<br />PROPERTY DAMAGE $
<br />(PERACCIDENT)
<br />X
<br />NON -OWNED AUTOS
<br />$
<br />X
<br />I Deductible -0-
<br />INSD OWNS -0- AUTOS
<br />$
<br />X
<br />UMBRELLA LAB
<br />X
<br />OCCUR
<br />EACH OCCURRENCE $ 10,000,000
<br />AGGREGATE $ 10,000,000
<br />A
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />72RHUPR1858
<br />01/01/2015
<br />01/01/2016
<br />DEDUCTIBLE
<br />$
<br />X
<br />RETENTION $ 10,000
<br />$
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE Y/ N
<br />OFFICER/MEMBER EXCLUDED? r --1N
<br />(MandatoryinNH)
<br />/ A
<br />72WENG6914 ALL STATES
<br />EMPLOYERS LIA STOP GAP
<br />01/01/2015
<br />01/0112016
<br />X I WC STATU- OTH-
<br />TORY LIMITS I I ER
<br />E.L. EACH ACCIDENT $ 1,000,00
<br />—
<br />E.L. DISEASE - EA EMPLOYE $ 1,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT I $ 1,000,000
<br />B
<br />Real Estate
<br />MPLK102807414
<br />05/22/2014
<br />05/22/2015
<br />Claim: 2,000,000
<br />Errors & Omissions
<br />CLMS MADE:$25K RETENTION
<br />Aggregate 2,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
<br />The City of Santa Ana, its officers, employees, agents, volunteers and
<br />representatives are named Additional Insured for Auto and General Liability
<br />as respects operations of the Named Insured. Coverage is primary and non-
<br />contributory. ENDORSEMENTS ATTACHED. 30 days written notice of
<br />cancellation applies except 10 days notice for nonpayment of premium.
<br />t t—K 111 -I -A I t NULLJtK L;AN(;tLLA I IUN
<br />SANTAA2
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />The City of Santa Ana, et al ACCORDANCE WITH THE POLICY PROVISIONS.
<br />per Written contract
<br />20 Civic Center Plaza AUTHORIZED REPRESENTATIVE
<br />Santa Ana, CA 92701
<br />O 1988-2009 ACORD CORPORATION. All rights reserved.
<br />
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