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?--0o/i-a?6::, Acorrv' CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDINYYYY) 01/20/2012 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 endoreement(a). PRODUCER AMTACT Siebe, Bill SL Insurance Associates Inc PIwNE 408-776-8600 FIAIC AX No: 408-776-8602 18181 Butterfield Blvd # 170 EMAIL bi118slinsure.com Morgan Hill, CA 95037 INSURE S AFFORDING COVERAGE NAIC Nt INSURER A ; CNA INSURED INSURERS: The Hartford Pacific Services Inc INSURERC: 1060 Calle Negocio INSURER D: Suite C San Clemente CA 92673 INSURERE: , INSURER F : COVERAGES CERTIFICATE NUMBER: 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. ILTR I TYPE OF INSURANCE ADUL SUER POLICY NUMBER POLICY IMMMOA-YM EFF POLICY EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE - S 2,000,000 A X COMMERCIAL GENERAL LIABILITY 4031343323 01/20/2012 01/20/2013 DAMAGE TO RENTEIF s 300,000 CLAIMS-MADE a OCCUR MEOEXP (Any one wn S 10,000 PERSONAL A ADV INJURY S 2 000 000 , , GENERAL AGGREGATE S 4 000 000 , , GEN,L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG S 4,000,000 X POLICY MR- 17 LOC S AUT OMOBILE LIABILITY Ea deM IN L 11000,000 A ANY AUTO ALL OWNED SCHEDULED 4031343323 01/20/2012 01/20/2013 BODILY INJURY (Per person) S AUTOS AUTOS NON OWNED BODILY INJURY (Per sttident) S X HIRED AUTOS X - APPRGV E ll AS T FUR PROPER DAMAGE Porseddent $ s UMBRELLA LIAO OCCUR EACH OCCURRENCE S EXCESS UAB CLAIMS-MADE - AGGREGATE S DED RETENTIONS r / 1J$t11't1 SCi[t She dy s WORKERS COMPENSATION ' Assistant City [. OTRC ,' WG S TATU- X OTH- AND EMPLOYERS LIABRITY YIN XJ, B ANY PROPRIETORIPARTNERIEXECUTNE OFFICERMEMBER EXCLUDED? NIA 57 WEC FZ5870 01/09/2012 01/09/2013 E.L EACH ACCIDENT $ 1,000,000 (MSndatorylnNN) It ysadsso?bs wdsr E. L. DISEASE - EA EMPLOYE S 1, on, 000 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1 000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ARach ACORD 101, AddlUe"I Rom da Schn&d., N man space in naulnd) As it pertains to its California operations, and where required by contract for any and all locations for that contract, the following is named as additional insured interest. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701 its offciers, employees , agents, volunteers, and representatives with regard to liability and defense of suits i i ar s ng from the operations and uses performed by or on behalf of the named insured. The City of Santa Ana 20 Civic Center Plaza Santa Ana, CA 92701 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 REPRESENTATNE 0198a.201a ACORD CORPORATION. All rights reserved. rtVVr%LJ ca tLU-IWU0) Tne AGURD name and I090 are registered marks of ACORD