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HUMAOPT-04 HBCT09 D CERTIFICATE OF LIABILITY INSURANCE 5/24/2 DAT12412012 12 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 License # 0564249 CONTACT NAME: (OC) Heffernan Insurance Brokers PHONE - --- -- -- FAX Hutton Centre Drive, Suite 500 ac No Exf :1 (714) 361-7700 'C No): 1 (714)361- 1 Santa Ana, CA 92707 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC ## INSURER A: New York Marine & General Insurance INSURED INSURER B : Human Options INSURER C : Mindy Weinheimer 5540-A Trabuco Road INSURER D: - -- - 1 - Irvine, CA 92620 INSURER E 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. IN R_R I NSR POLICY EFF POLICY EXP LT - TYPE OF INSURANCE ADDIL UBRWVD, LIMITS _ POLICY NUMBER _ fMM/DD/YYYY MM/DD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ OAMAGETO RENTED - - -PREMISES COMMERCIAL GENERAL LIABILITY MED EXP (Any one CLAIMS-MADE OCCUR (Ey occurrence) person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE ± $ GEN L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ --I PRO- i --I POLICY! _ JECT LOC $ -- COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY Ea accident _$ ANY AUTO BODILY INJURY (Perperson) $ - ALL OWNED -- , SCHEDULED BODILY INJURY (Per accident) $ H REDSAUTOS _ AUTOS - - - NON-OWNED TYDAMAGE $ AUTOS PROPER Per accidentl _ 1 - ----? ---- -- --- - --- $ UMBRELLA LIAR 'OCCUR EACH OCCURRENCE i EXCESS LIAB -' CLAIMS-MADE li AGGREGATE $ II - -.___ - --- -_ - __- ?? DED_ RETENTION$ -- __. _. ------? - __.----- - --. . _-------' ---- $ WORKERS COMPENSATION -I WC STATU OTH- AND EMPLOYERS' LIABILITY OFFICER/ RI TOR EXCLUDED? /PARTNER/EXECUTIVE Y / N I N / A - E. TORY LIMITS - -..ER A ANY PROPRIETOR WC201200001245 4!112012 4/1/2013 E. L. EACH ACCIDENT I $ 1,000,000{ (Mandatory In NH) E. L. DISEASE - EA EMPLOYEE $ 1,000,000 If as, describe under - - D E.L DISEASE - POLICY LIMIT $ 1,000,000. SCRIPTION OF OPERATIONS below -- ----r - -I._----- - -?--- ----......- _ _--_ -__ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Project: As on file with the insured. CERTIFICATE HOLDER City of Santa Ana Attn: Frank Hernandez 20 Civic Center Plaza Santa Ana, CA 92701 ACORD 25 (2010/05) CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. rAUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD