ACCURATE PERFORMANCE MACHING, INC. - 2012

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?L•, =,? ; -`'Lco?®® CERTIFICATE OF LIABILITY' INSURANCE DATE (MM/DD/YYW) 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 RG Business Insurance Agency, Inc. CONTACT NAME: An Affiliate of United Agencies PHONE A/C No - - - - 861 S. Oak Park Rd Covina CA 9'1724 E-MAIL ADDRESS: , INSURERS AFFORDING COVERAGE NAIC # License No.: 0555729 INSURERA: INSURED INSURER B - ' Accurate Performance Machining Inc. 2086 S Grand Avenue INSURERC: . Santa Ana CA 92705 INSURER D: INSURER E' INSURER F COVERAGES CERTIFICATE NUMBER: -I ZSa?F;s? 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 ANV 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM/DD POLICY EXP MM/DD/1'YYY LIMITS A GENERAL LIABILITY ? M50-C L-00'10"1'19-1 6/15/20'12 6/15/20'13 EACH OCCURRENCE $ '1,000,000 ? COMMERCIAL GENERAL LIABILITY PR EMIS ES OEe occu ante $ 3QQ•000 CLAIMS-MADE ? OCCUR MED EXP (Any one person) $ 5.000 PERSONAL 8 ADV INJURY $ ? •000.000 GENERAL AGGREGATE $ 2.000.000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $ Excluded ? POLICY PRO LOC $ AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT ' Ea accntlent. S ANY AUTO BODILY INJURY (Par person) g ALL OWNED AUTOS SCHEDULED BODILY INJURY (Per accitlent) $ e NON-OWNED P R O P cR T nl AMAGE HIRED AUTOS AUTOS P e a tl $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE ? $ DED RETENTIONS $ $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY MSOWKOO'10066't 6/15/2072 6/15/20'13 WC STATU- O TORY LIMITS y/ N ANY PROPRIETOR/PARTNER/EXECUTIVE ? N / A E_L. EACH ACCIDENT $ ? OOO QQQ OFFICER/MEMBER EXGLUDED7 (Mentlatory in NH) EL DISEASE - EA EMPLOYEE $ 7 QQQ QQQ If yes, tlescrlbe untler DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 7 ,000,QQQ DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (Attach ACORD '101, Atldltlonel Remarks Sehetlule, If more space Is requl reli) The City of Santa Ana, its officers, employees, agents, and volunteers are named as additional insureds in respects to the general liability policy only per the attached form. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE The City of Santa Ana t ? ®?'lY'?' v `a 2U C C nter Plaza THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE.WITH THE POLICY PROVISIONS. ? . y? ? IVIC e " ?? t. .._- - Santa Ana CA 92702 ?-v _, ??y? ?.r? AUTHORIZED REPRESENTATIVE s-?oRCK ?? /?/t / ` ' i 1sA ?. AttOYney ' - a m lin G Ch v a a f?ssts?u••' ? ©t988-2010 ACORD CORPORATION, All rights reserved- ACORD 25 (20'10/05) The ACORD name nd logo are registered marks of ACORD Exhibit C CERT NO.: 13562652 HaGhezine Hanh ]/5/2012 3:33:20 PM Page 1 0£ 6