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ADLER -1 OP ID: PRTI <br />CERTIFICATE OF LIABILITY INSURANCE °08/27'12013Y' <br />08!2712013 <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 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 endomement(s). <br />PRODUCER CONTACT <br />Phone: 951 - 685 -7478 NAME: Tracey L Prieto <br />Loomis Insurance Services Fax: 951- 685- 0665 PHONE - -- FAx <br />PO BOX 3128 Arc He Ea9 951.665 7478 LAID Nep 951- 685 -0665 <br />Riverside, CA 92519 <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER <br />E -MAIi <br />ADDRESS; tprieto @loomis4lnsurance.com <br />Michael J Runner <br />HEREIN IS SUBJECT TO ALL THE TERMS, <br />_ <br />INSR IADOLTSUMF— T POLICY EFF POLICY EXP <br />T TYPEOFINSURANCE INSIR MD I POLICY NUMBER IMMIDDIYYYYJ MMIOD/YYYYJ <br />INSURER(S) AFFORDING COVERAGE HAD <br />'GENERAL LW BILITY <br />EACH OCCURRENCE 1,00000O <br />_ <br />INSURERA: Northfield Insurance Company <br />INSURED AdierhOrst International, Inc. <br />CLAIMS MADE X j OCCUR I <br />INSURER e: i <br />3951 Vernon Avenue <br />4 <br />Riverside, CA 92509 <br />INSURERC <br />GEN'L AGGREGATE LIMIT APPLIES PER '.. <br />'PRODUCTS - COMPIOP AGG S <br />INSURER D: <br />I._ _._ S —_ __.. <br />. X POLICY LOC <br />INSURER E: <br />ZOO - Irl <br />COM8INED SINGLE LIMIT <br />INSURER <br />CnVFRAGFR CFRTIFIC ATF M I I MPFR- <br />IP=1IIQR -,M kit IARPFO. <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 <br />DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED <br />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 IADOLTSUMF— T POLICY EFF POLICY EXP <br />T TYPEOFINSURANCE INSIR MD I POLICY NUMBER IMMIDDIYYYYJ MMIOD/YYYYJ <br />- - - <br />LIMITS <br />'GENERAL LW BILITY <br />EACH OCCURRENCE 1,00000O <br />I <br />A I x <br />I COMMERCIAL GENERAL LIABILITY , X WS178749 08/08/2013 08/0812014 <br />FS <br />DAMAGE TO REHTEf - -- <br />PREMISES (Ea occunencel S 100 000 <br />CLAIMS MADE X j OCCUR I <br />I <br />MED EXP (Any one porson) $ 5,0()C <br />1 <br />4 <br />PERSONAI d ADV INJURY IS 1,000,000 <br />GENERAL AGGREGATF S 2 ODO,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER '.. <br />'PRODUCTS - COMPIOP AGG S <br />. <br />f i PRO _.� <br />I._ _._ S —_ __.. <br />. X POLICY LOC <br />yAUTOMOBILE LIABILITY <br />COM8INED SINGLE LIMIT <br />[ <br />,.1E acc dent_ 15 _ <br />�ANYAUI'0 - <br />BC9IYINJURY(P p ) E <br />ALL OWNED <br />AUTOS A <br />:., _.. AUEDULED TO <br />BODILY INJURY (Per ecaden) l5 <br />OWNED <br />HIRED AUTOS � AU IOS 1fOS { i '. <br />PROPERTY OAMAGc S <br />I IP wtleVZ <br />UMBRELLA <br />( OCCUR <br />[EACHOCCJRRENCE <br />~— <br />EXCESS LIAB AIMS -MApE <br />_S_ <br />AGGREGATE 5 <br />DELI RETENTION S <br />5 <br />WORKERS COMPENSATION <br />- WC STATU- OiH <br />AND EMPLOYERS' LIABILITY YIN <br />TORY .IMJ_T6 ER I. <br />ANY PROPRIETORIPARTNERICXECU'NE <br />EI FACHACO.OEN' S <br />OFFCERIMEMSER EXCLJDED'+ ❑ NIA <br />-- - -- _- <br />(MandatoryinNH) <br />EL OISEASE FAFMPIOYEEi$ <br />Ryes descrbe undo, <br />-- I - <br />DESCRIPTION OF OPERATIONS below <br />EL DISEASE- POLICY LIMIT S <br />I <br />DESCRIPTION OF OPERATIONS I LOCATIONS) VEHICLES (AHaeh ACORD 101, Additional Remarks Schedule, If more apace Is required) <br />The City of Santa Ana, its officials, officers, employees, agents and <br />volunteers are named as additional insureds. <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />The City f S Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ty Santa ACCORDANCE WITH THE POLICY PROVISIONS, <br />P O Box 1988 <br />Santa Ana, CA 92702 AUTHORIZED REPRESENTATIVE <br />Inc 1ARA -7nin ACnRn CnR PnR ATInu All rir.hrc rocur.•eH <br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD <br />All <br />