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ACORO`® CERTIFICATE OF LIABILITY INSURANCE <br />�� <br />DATE (MM /DDmW) <br />7/23/2012 <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 pollcy(las) 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 Ileu of such endorsements . <br />PRODUCER <br />CONTACT Kim HutChin 60n <br />JD Fulwilar � Co. insurance, Inc. <br />PHONE (503)293 -8325 FAX (503)293 -541$ <br />5727 SW Macadam Ave <br />'MnIL .]chu tchinaon ®jdf ulwi lar.com <br />INSURERS AFFORDING COVERAGE <br />NAICM <br />PO BOX 69506 <br />INSURERA:Ameri Can Caau8lt CO <br />EACH OCCURRENCE <br />Portland OR 97239 <br />INSURED <br />INSURER B <br />INSURERC: <br />Cathy Morehead + Associates <br />2409 IS Valencia St N- 2012 -119 <br />INSURER D: <br />$ 300,000 <br />INSURER E <br />CLAIMS -MADE �OCGUR <br />X <br />INS RERF: <br />9023017259 <br />Santa Ana CA 92706 <br />COVERAGES CERTIFICATE NUMBER:2012 to 2013 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 />INSR <br />TYPE OF INSURANCE <br />ADDL <br />SUBR <br />P LILY N MBER <br />POLICY EFF <br />POLICY EXP <br />LIMITS <br />Santa Ana, CA 92702 <br />GENERAL LIABILITY <br />/� <br />Kim Hut chin eon /KIMH �� ' ��/ <br />� / <br />i /��2.vYLC1E3� � <br />EACH OCCURRENCE <br />$ 2.000.000 <br />X COMMERCIAL GENERAL LIABILITY <br />DAMAGE TO RENTED <br />$ 300,000 <br />A <br />CLAIMS -MADE �OCGUR <br />X <br />9023017259 <br />9/1/2012 <br />9/1/2013 <br />MED EXP An one rson <br />$ 10,000 <br />PERSONAL6ADV INJURY <br />$ 2,000,000 <br />GENERAL AGGREGATE <br />$ 4,000,000 <br />GEN'L AGGREGATE <br />LIMIT APPLIES PER: <br />PRODUCTS - COMP /OP AGG <br />$ 4 , O OO , O 00 <br />X POLICY <br />PRO- LOC <br />$ <br />AUTOMOBILE LIABILITY - <br />COMBINED SINGLE LIMIT <br />1 000 000 <br />BODILY INJURY (Per parson) <br />$ <br />A <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />X <br />4023017254 <br />9/1/2012 <br />9/1/2013 <br />BODILY INJURY (Per acdtlen[) <br />$ <br />NON -0WNED <br />X HIRED AUTOS X AUTOS <br />PROPERTY DAMAGE <br />$ <br />$ <br />� <br />V MBRELLA LIAB <br />OCCUR <br />�� �� <br />EACH OCCURRENCE <br />AGGREGATE <br />$ <br />EXCESS LIAB <br />CLAIMS -MADE <br />hh <br />r' <br />V <br />� <br />DED RETENTION <br />$ <br />```�'�� <br />(J <br />// <br />1 -� <br />WORKERS COMPENSATION <br />�� <br />- <br />WC STATU- OTH- <br />AND EMPLOYERS' LIABILITY Y / N <br />OFFICER/MEMBER EXCLUDED EG UTNE � <br />(Mantletory In NH) <br />I1 yes, tlescribe untler <br />DESCRIPTION OF OPERATIONS below <br />N / A <br />� <br />..� � <br />�}C' <br />�,� 1'3 � <br />-C21� <br />__ G v <br />;'.`` S` >"``�T <br />� <br />qty <br />C7 <br />EL. EACH ACCIDENT <br />$ <br />EL. DISEASE - EA EMPLOYE <br />$ <br />E.L. DISEASE - POLICY LIMIT <br />$ <br />DESCRIPTION OF OPERATIONS /LOCATIONS / VEMIC LES (Attach ACORD 101, AAtlttlonal Remarks SehsAUla, If more space k required) <br />Tha City of Santa Ana, 20 Civic Cantor Plaza, Santa Ana, California 92702; it officers, employees. agents <br />and volunteers era named as Additional Inaurad's and defence of suite arising fom ha operations and uses <br />performed by or on behalf of the named insured par SB- 146932- D attached_ Thia insurance is considered <br />primary and non contributing to any bald by the Additional Insured i£ a wrttan contract stating this is <br />in of £act_ <br />CERTIFICATE HOLDER CANCELLATION <br />ACORD 25 (20'10/05) ©'1988 -20'10 ACORD CORPORATION. All rights reserved. <br />INS025 (zot oos >.ot Tha ACORD Hama and logo era registered marks of ACORD <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE <br />WILL BE DELIVERED IN <br />Tha City o£ Santa An8 <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 Civic Cantor Plaza <br />AVTHORIZED REPRESENTATIVE <br />Santa Ana, CA 92702 <br />/� <br />Kim Hut chin eon /KIMH �� ' ��/ <br />� / <br />i /��2.vYLC1E3� � <br />ACORD 25 (20'10/05) ©'1988 -20'10 ACORD CORPORATION. All rights reserved. <br />INS025 (zot oos >.ot Tha ACORD Hama and logo era registered marks of ACORD <br />