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<br />A C H CERTIFICATE OF LIABILITY INSURANCE 7E(MM/DD1YYYY) 6/11/2012
<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 endorsement(s).
<br />PRODUCER Tech Serve Alliance Services Corp. CONTACT NAME:
<br />1420 King Street; Suite 610 PHONE (A/C- No. Ext)* 703,838,2050 FAX A/C No): 703,997,7727
<br />Alexandria, VA 22314
<br />www.tecnserveaiiiance.org
<br />INSURED
<br />The Comdyn Group Inc.
<br />100 E. Thousand Oaks, Blvd., Suite 233
<br />Thousand Oaks CA 91360
<br />I _ INSURER(S) AFFORDING COVERAGE NAIC # I
<br />CCfVFRAr:FC r=0 r1C1r?A'rc \rr IaAOOO.
<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 />,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />ILTR TYPE OF INSURANCE ADDL SUBR
<br />POLICY NUMBER POLICY EFF
<br />MM/DD POLICY EXP
<br />MWDDIYYYY
<br />LIMITS
<br />A GENERAL LIABILITY 711011971 6/15/2012 6/15/2013 EACH OCCURRENCE $ $1,000,000
<br /> ? COMMERCIAL GENERAL LIABILITY DAMA? E TO RENTED
<br />$1
<br />000
<br />000
<br /> PREMISES Ea occurrence ,
<br />,
<br />$
<br /> CLAIMS-MADE ?? OCCUR MED EXP (Any one person) $ $10,000
<br /> PERSONAL & ADV INJURY $ $1,000,000
<br />
<br /> GENERAL AGGREGATE 000
<br />000
<br />$ $2
<br /> ,
<br />,
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ $2,000000
<br />
<br />POLICY PRO-
<br />? LOC
<br />JECT
<br />A AUT OMOBILE LIABILITY 711011971 6/15/2012 6/15/2013 (Ea. ocideDtSINGLE LIMIT $ $1
<br />000
<br />000
<br /> ,
<br />,
<br /> ANY AUTO BODILY INJURY (Per person) $
<br /> ALL OWNED SCHEDULED
<br />
<br />AUTOS
<br />AUTOS BODILY INJURY Per accident
<br />( )
<br />$
<br />
<br />?
<br />HIREDAUTOS
<br />? NON-OWNED
<br />AUTOS PROPERTY DAMAGE
<br />Peraccident
<br />$
<br />
<br />
<br />
<br />
<br />A ? UMBRELLA LIAB OCCUR 711011971 6/15/2012 6/15/2013 EACH OCCURRENCE $ $5,000,000
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE
<br /> $ $5,000,000
<br /> DED ? RETENTION $0 $
<br />
<br /> $
<br />A WORKERS COMPENSATION
<br />AND EMPLOYERS' 406034890 6/15/2012 6/15/2013 7H
<br />O
<br />Y
<br />
<br />LIABILITY-
<br />Y/ N ER
<br />TOR
<br />LIMITS
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICER/MEMBER EXCLUDED?
<br />N/A (CA, NC, SC & TN)
<br />E.L. EACH ACCIDENT
<br />$ $1,000,000
<br /> (Mandatory in NH)
<br />
<br />If yes
<br />describe under
<br />E.L. DISEASE - EA EMPLOYEE
<br />$
<br />$1,000.00
<br />0
<br /> ,
<br />DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ $1,000,000
<br />A E&O/Professional Liab Claims Made 711011971 6/15/2012 6/15/2013 $2,000,000 Ea Claim/$2
<br />000
<br />000 Aggregate
<br />B ERISA Bond 105021689 10/1/2011 10/1/2013 ,
<br />,
<br />$350,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is require
<br />City of Santa Ana, is Additional Insured as respects to General Liability
<br />per attached CG2010 1185 Additional Insured Endorsement
<br />. F---
<br />Laura Stitt eedy
<br />CERTIFICATE HOLDER CANCELLATION -ey
<br />Client
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />20 Civic Center Plaza ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Santa Ana CA 92702
<br /> AUTHORIZED REPRESENTATIVE
<br />
<br /> Mark B. Roberts
<br />W 1atW-[U1U AGORU CORPORATION. All rights reserved.
<br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
<br />CERT No.: 13296403 Chris Pettyjohn 6/11/2012 8:18:30 AM Page 1 of 2
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