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* IFN <br />AI "® CERTIFICATE OF LIABILITY <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />INSURANCE Page 1 of 1 <br />08/21/2012 <br />THIS CERTIFICATE IS ISSUED ASA 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(les)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 lieu of such endorsement(s). <br />PRODUCER <br />CONTACT <br />Willis Insurance Services of California, Inc. <br />c/o 26 Century Blvd. <br />P. O. Box 305191 <br />Nashville, TN 37230-5191 <br />PHONE <br />877_945-7378 FAx 888-467-2378 <br />E-MAIL certificates@willis.com <br />EG6439324 <br />INSURER(S)AFFORDING COVERAGE NAIC # <br />INSURERA:Chartis Specialty Insurance Company 26883-900 <br />EACH OCCURRENCE $ 11000,000 <br />INSURED <br />Athena Services <br />INSURERS: Arch Insurance Company 11150-001 <br />INSURERC: <br />14048 Valley Blvd. <br />City of Industry, CA 91746 <br />INSURER D: <br />INSURER E: <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 18358703 RFVI-RIC)N NIIMRFIRcaa Ramarkn <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 I TR <br />TYPE OF INSURANCE <br />DD' <br />SUB <br />POLICY NUMBER <br />POLICY EFF <br />.. <br />POLICY EXP <br />tuiuminryYYYi. <br />LIMITS <br />A <br />GENERAL LIABILITY <br />Y <br />EG6439324 <br />3/1/2012 <br />3/1/2013 <br />EACH OCCURRENCE $ 11000,000 <br />PDAMIETO RENTED <br />PREMISES Ea occur $ 300,000 <br />X ! COMMERCIAL GENERAL LIABILITY <br />MED EXP (Any one person) $ 2-9,000 <br />CLAIMS -MADE OCCUR <br />PERSONAL &ADV INJURY $ 11000,000 <br />GENERALAGGREGATE $ 2,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS -COMP/OPAGG $ 2,000,000 <br />X POLICY PRO LOC <br />B <br />AUTOMOBILE LIABILITY <br />71CAB4941504 <br />3/1/2012 <br />13/1/2013 <br />COMBINED SINGLE LIMIT <br />(Ea accident) $ 2,000,000 <br />X ANYAUTO <br />BODILY INJURY(Per person) $ <br />AOSCHEDULED <br />AUTOS AUTOS <br />BODILY INJURYaccident $ <br />( ) <br />HIRED AUTOS NON -OWNED <br />AUTOS <br />PROPERTY DAMAGE <br />(Per accident) $ <br />$ <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE Is <br />AGGREGATE $ <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED I I RETENTION $ <br />Is <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS'LIABILITY Y/N <br />ANY <br />OFFICER/MEMBER EXCLUDED ECU TIVE❑ <br />N/A <br />71WCI4941604 <br />�j exzJ �, ,,, _ <br />13/1/2012 <br />tl :r, <br />3/1/2013 <br />Yr <br />X W TA- TH- <br />E.L. EACH ACCIDENT $ 11000,000 <br />E.L. DISEASE - EA EMPLOYEE $ 1,000,000 <br />(andatory in NH) <br />!fMyes, describe under <br />E.L. DISEASE -POLICY LIMIT $ 1,000,000 <br />DESCRIPTIONOFOPERATIONS below <br />- <br />DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (Attach Acord 101, Additonal Remarks Schedule, if more space is required) <br />THIS VOIDS AND REPLACES PREVIOUSLY ISSUED CERTIFICATE DATED: 7/17/2012 WITH ID: 18249116 <br />The City of Santa Ana, it's officers, employees, agents, and representative are included as <br />Additional Insureds as respects to General Liability as required by written contract. <br />General Liability policy shall be Primary and Non-contributory with any other insurance in force <br />for or which may be purchased by Additional Insureds. <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. <br />Finance & Management Services Agency <br />Attn: Purchasing Division AUTHORIZED REPRESENTATIVE <br />20 Civic Center Plaza M-16 <br />P.O. Box 1988 <br />Santa Ana, CA 92702 <br />Coll:3833810 Tpl:1410903 Cert:18358'/03 ©1988 20100-ACORDCORPORATION. All riahts reserved <br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD <br />