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ACORI� CERTIFICATE OF LIABILITY INSURANCE
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
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<br />F9/24/D 24/ 201IDp/Y
<br />2
<br />2
<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(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 endomemen s .
<br />PRODUCER
<br />GLENDALE INSURANCE AGENCY, INC.
<br />601 E GLENOAKS BLVD, SUITE 100
<br />GOO . Julia B. Traughber
<br />PHONE (818) 244 -1149 FAx (818)2 +2-528e
<br />E41111AIL julieQglsndaleins.com
<br />P. O. BOX 831
<br />GLENDALE CA 91209 -0831
<br />INSUR 8 AFFORDING COVERAGE
<br />NAIC#
<br />INSURERA:General Ins. Co. of America
<br />4732
<br />NBURED
<br />INSURER B American States Ins. Co.
<br />9704
<br />Phoenix Group Information Systems
<br />INsuRERc:Ca ital 3 ecialt Ins. Co
<br />0328
<br />2677 N. Main Street, Suite 400
<br />INSURERD.National Union Fire Ins. Co.
<br />9445
<br />INSURER B
<br />Santa Ana CA 92705
<br />1 INSURER F:
<br />PREMIISES (Ea oomnlrence)
<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 />LTR
<br />TYPE OF INSURANCE
<br />CY NUMBER
<br />Y EFF
<br />EXP
<br />LIMITS
<br />GENERALLIABIUTY
<br />EACH OCCURRENCE
<br />111 1,000,000
<br />X COMMERCIAL GENERAL LIABILITY
<br />PREMIISES (Ea oomnlrence)
<br />S 1,000,000
<br />A
<br />CLAIMS -MADE a OCCUR
<br />X
<br />X
<br />24CC29837820
<br />0/1/2012
<br />0/1/2013
<br />MED EXP CAny we parson)
<br />S 5,000
<br />PERSONAL & ADV INJURY
<br />$ 1,000,000
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />PRODUCTS - COMPIOPAGG
<br />S 2,000,000
<br />X1 POLICY 7 PRO- LOC
<br />$
<br />AUTOMOBILE
<br />LIABILITY
<br />{N L LI 1
<br />1,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />A
<br />ANY AUTO
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />X
<br />%�
<br />4CC29837820
<br />10/1/2012
<br />/
<br />0/1/2013
<br />BODILY INJURY (Per accident)
<br />$
<br />X
<br />HIRED AUTOS X AUTOS NED
<br />AUTOS
<br />P DAMAGE
<br />$
<br />$
<br />UMBRELLA LUUB
<br />OCCUR
<br />EACH OCCURRENCE
<br />$
<br />AGGREGATE
<br />$
<br />EXCESS LIAB
<br />CLAMS -MADE
<br />DIED I I RETENTION
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />X
<br />X WC STATU- OTH-
<br />AND EMPLOYERS' LIABILITY YIN
<br />E.L. EACH ACCIDENT
<br />1,000,000
<br />ANY PROPRIETORIPARTNERIEXECUTIVE
<br />OFFICERIMEMBER EXCLUDED? E7
<br />NIA
<br />(Mandatory In NH)
<br />1WC10616070
<br />0/1/2012
<br />0/1/2013
<br />is
<br />If yes, describe under
<br />E. L. DISEASE - EA EMPLOYEd
<br />$ 1,000,000
<br />E.L. DISEASE - POLICY LIMIT 1
<br />$ 1,000,0()o
<br />DESCRIPTION OF OPERATIONS below
<br />C
<br />Error* & Omissions Liab,
<br />110120174703
<br />10/1/2012
<br />10/1/2013
<br />$2.500 DEDUCTIBLE 1,000,000
<br />D
<br />Commercial Crime Coverage
<br />012482318
<br />10/1/2012
<br />0/1/2013
<br />$25,000 DEDUCTIBLE 1,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, K mom space Is re"red)
<br />It is agreed that the City of Santa Ana, its officers, employees, agents, volunteers and representatives
<br />are named Additional Insureds per form CG2026 (07/04) attached. It is also agreed that this insurance is
<br />primary and non - contributory.
<br />..CST. c.A. �� ..... ..�..
<br />City of Santa Ana
<br />Attention: Yolanda Bautista
<br />60 Civic Center Plaza
<br />Santa Ana, CA 92702
<br />ACORD 25 (2010/05)
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />J B. Traughber /0134
<br />®1988-2010 ACORD CORP0RATIeN
<br />INUUZ5(201005).01 L ._ r (eA C r, The AFORD name an o are reoist rso marks of ACORD
<br />
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