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UF' IU' MU <br />'4? °?'?°? CERTIFICATE OF LIABILITY INSURANCE OATE(MM/DDA'1'1'Y) <br /> 10/09/'12 <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 antl 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 endorsements . <br />PRODUCER <br />5'13-745-9200 <br />NAMEACT <br />The Hauser Groupp <br />5'13 <br />745 <br />92'19 <br />n <br />° N <br />ac <br />- <br />- <br />8260 Northcreek Dr. Suite 200 /c <br />o E:t : <br />No <br />Cincinnati <br />OH 45236 E-MAIL <br />, ADDRESS: <br /> PRODUCER MANAG-2 <br />C ST MER ID #: <br /> INSURERS AFFORDING COVERAGE NAIC # <br />INSURED Management Partners, InC. INSURER A:The Hartford Cas Ual Ins. Co. 22357 <br />'1730 Madison Road INSURER B: LIO ds S ndicate 3624 <br />Cincinnati, OH 45206 <br /> INSURER C <br /> INSURER D <br /> INSURER E <br /> INSURER F <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 />I?TR TYPE OF INSURANCE A D UBR <br />POLICY NUMBER POLICY EFF <br />MM/DD/1'YYY POLICY EXP <br />MM/DD/YYYY <br />LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE S 'I ,000,00 <br />A X COMMERCIAL GENERAL LIABILITY X 33SBALU7089 09/28/12 09/28/'13 PREMISES Ea occurrence s 300,00 <br /> <br /> CLAIMS-MADE ? OCCUR MED EXP (Any one person) $ '10,00 <br /> X Contractural PERSONAL 8 ADV INJURY $ 1 .000,00 <br /> Liability GENERAL AGGREGATE 5 2.000.00 <br /> GEN'L AGGREGATE LIMIT APPLIES PER' PRODUCTS -COMP/OP AGG S 2.000.00 <br /> POLICY X PRO- LOC Ltd. EPL s 5,00 <br /> AUT OMOBILE LIABILITY EO M <br />BI <br />N <br />E <br />D <br />SINGLE LIMIT $ '1,000,00 <br />A X 33UECTI2490 09/28/'12 09/28/'13 a <br />C <br />tl <br />e <br />t <br /> ANY AUTO BODILY INJURY (Par par50n) S <br /> <br />X ALL OWNED AUTOS <br />BODILY INJURY (Par accident) <br />S <br /> SCHEDULED AUTOS PROPERTY DAMAGE $ <br /> X HIRED AUTOS (Per accident) <br /> X NON-OWNED AUTOS S <br /> S <br /> UMBRELLA LIAB X OCCUR EACH OCCURRENCE S 3.000.00 <br /> EXCESS LIAB CLAIMS-MADE <br />' <br />' AGGREGATE S 3.000.00 <br />A 33SBALU7089 09/28/ <br />12 09/28/ <br />13 <br /> DEDUCTIBLE S <br /> X RETENTION $ 1O OOO $ <br /> WORKERS COMPENSATON <br />AND EMPLOYERS' LIABILITY X WC STATU- X OTH- <br /> Y / N 335 <br />A ANY PROPRIETOR/PARTNER/EXECUTIVE <br />? <br />N / A BAL UlOB9 OH EMPL LIAB 09/26/'12 09/28/'13 E. L- EACH ACCIDENT $ '1,000,00 <br />A OFFICER/M EMBER EXG LUDED9 <br />(Mantlatory In NH) 33WECRX9356 03/0'1N 2 03/0'1N 3 EL DISEASE - EA EMPLOYEE S '1,000.00 <br /> If yes, tlescn be untler <br />DESCRIPTION OF OPERATIONS below <br />E_L DISEASE -POLICY LIMIT <br />$ '1,000,00 <br />B Professional Liab MPLf 008388 06/20/'12 06/20/'13 Ea. Claim '1,000,00 <br /> $10,000 DEDUCTIBLE Agg '1,000,00 <br />DESCRIPTION OF OPERATONS / LOCATONS /VEHICLES (AHach ACORD 101, Atltlltlonal Ramarka Schedule, If more apace la repulred) <br />The City o£ Santa Ana is named as additional insured with respect to ggeneral <br />liability coverage as evidenced herein as required by written contracE with <br />respect to work par£ormed by the named insured . <br />CERTIFICATE HOLDER ?? / c r? O C 'Tn CANCELLATION <br /> SANTAAN <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />? THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />Clty Of Santa An - <br />?f.it Site y ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 Ci <br />i <br />C <br />t <br />Pl `aura <br />'1 <br />" <br />v <br />c <br />en <br />er <br />aza -3 <br />) <br />, ttorney <br />CltY <br />PO BOX '1988 Asststant AUTHORIZED REPRESENTATVE <br />Santa Ana, CA 92702 ???? <br />©'1985-2009 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD <br />PDF created with pdfFactory trial Version www.pdffactory.com