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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 <br />�"� <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 apace Is required) <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 reoistarso marks of ACORD <br />