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OP ID: RY
<br />.4COR15° DATE (MMIDDNYYY)
<br />CERTIFICATE OF LIABILITY INSURANCE I 01/04/13
<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 />PRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />__ APORTANT: 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 endorsements .
<br />CONTACT
<br />PRODUCER 626-943-2200 NAME:
<br />Narver Insurance 626-299-1010 PHONE FAX
<br />1641 W. Las Tunas Drive o Ext : A/C No):
<br />PO BOX 1509 E-MAIL
<br />ADDRESS:
<br />San Gabriel, CA 91776 P
<br />RODUCER
<br />WESLEY HAMPTON HOUSE CUSTOMER I #; LIEBE-1
<br />INSURERISI AFFORDING COVERAGE NAIC #
<br />INSURED Liebert Cassidy Whitmore
<br />6033 W. Century Boulevard
<br />Los Angeles, CA 90045
<br />INSURER A: Sentinel Insurance Company
<br />INSURER B : Hartford Insurance Company 37478
<br />INSURER C: AsDen SDecialty Insurance 10717
<br />nnVRRAnPR CFRTIFICOTF NI IMRFR- REVISION NIIMRFR!
<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
<br />
<br />LTR TYPE OF INSURANCE
<br />DDL
<br />A
<br />IM
<br />B
<br />WVD
<br />POLICY NUMBER
<br />MM/DDNYYY
<br />
<br />MM/DD/YYYY
<br />
<br />LIMITS
<br /> GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000
<br />A X COMMERCIAL GENERAL LIABILITY X 72SBAAK0318 12114/12 12114113 DAMAGE
<br />PR E Ea occurrence 1,000 000
<br />$
<br /> CLAIMS-MADE F7X OCCUR MED EXP (Any one person) $ 10,000
<br /> PERSONAL & ADV INJURY $ 2,000,000
<br /> GENERAL AGGREGATE $ 4,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 4,000,000
<br /> X POLICY PRO LOC $
<br /> AUT OMOBILE LIABILITY X COMBINED SINGLE LIMIT
<br />(Ea accident) $ 2,000,000
<br />
<br /> ANY AUTO BODILY INJURY (Per person) $
<br /> ALL OWNED AUTOS
<br />BODILY INJURY (Per accident)
<br />$
<br />
<br />A
<br />X SCHEDULED AUTOS
<br />HIRED AUTOS
<br />72SBAAK0318
<br />12114/12
<br />12114113 PROPERTY DAMAGE
<br />(Per accident)
<br />$
<br />A X NON-OWNED AUTOS 72SBAAK0318 12/14/12 12114/13 $
<br />
<br /> UMBRELLA LIAS X OCCUR EACH OCCURRENCE $ 2,000,000
<br /> EXCESS LIAR CLAIMS-MADE AGGREGATE $ 2,000,000
<br />A
<br />DEDUCTIBLE 72SBAAK0318 12114/12 12/14/13 --
<br />$
<br /> X RETENTION $ 10,000 $
<br /> WORKERS COMPENSATION
<br />' X WI STATU- OTH-
<br />ITO ER
<br />B AND EMPLOYERS
<br />LIABILITY
<br />ANY PROPRIETORIPARTNERIEXECUTIVE Y/N 72WEDE1729 04/01/12 04101/13 E.L. EACH ACCIDENT $ 1,000,000
<br /> OFFICER/MEMBER EXCLUDED?
<br />(Mandatory in NH) N/A
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br /> If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE -POLICY LIMIT
<br />$ 1,000,000
<br />C Professional
<br />Liability LRA9AF812
<br />CLAIMS MADE - FULL PRIOR 12/10/12 12110113 Per Claim 3,000,000
<br />Aggregate 3,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Aftach ACORD 101, Additional Remarks Schedule, If more space is required)
<br />Certificate Holder is named as an Additional Insured in regards to attached
<br />General Liability Form SS 00 08 04 05, per written contract or agreement.
<br />CEKTIFIGAI L HULUtK 6tLLA I IUN
<br />CITYSAA
<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 /- < 1 . CORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza Laura S ttt Sheedy
<br />P.O. Box 1988
<br />-Atr,-)rnec AUTHORIZED REPRESENTATIVE ?
<br />Santa Ana, CA 92702 .?.-1-,, 2
<br />I _
<br />©1988-2009 ACORD CORPORATION. All rights reserved.
<br />ACORD 26 (2009109) The ACORD name and logo are registered marks of ACORD
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