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INTEHOU -01 PATRA3 <br />CERTIFI ATE OF LIABILITY INSURANCE <br />DATE 12 <br />2/1!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 License # 0522024 CONTACT <br />Chapman PHONE - FAX <br />PO Box 5455 j c, No, Eml1. (626) 405 -8031 _ _ tArc, No), 1 (626) 405 -0585 <br />Pasadena, CA 91117 -0455 E-MAIL _DRESS:_ - -. INSURER(S) AFFORDING COVERAGE -T NAIC # <br />INSURER A:RIverport Insurance Company 36684 <br />!INSURED <br />INSURER e: New York Marine and General 16608 <br />Interval House li NSURERC: _ <br />P.O. Box 3356 INSURER D: <br />Seal Beach, CA 90740 INSURER E <br />,NZIUKLK r <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <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 />INSREXCLUSIONS AND CONDITIONS GENERAL LIABILITY - - - -I INSR WVD POLICY NUMBER PAID CLAIMS. - -�' <br />------ ADDL SUER, - POLICY EFF CY EXP <br />LTR TYPE OF INSURANCE 1 <br />F SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY <br />_ i �MM /DD/YYYY _ MM /DD/YYYY�`_ _ LIMITS <br />(EACH OCCURRENCE <br />i A X COMMERCIAL GENERAL LIABILITY X RIC0012016 10/112011 1011/2012 —MAG -- PRE_MISES (Ea occurrence + $ 100,000 <br />CLAIMS -MADE X OCCUR MEP EXP (Any one person) _ $ -_ 5,000 <br />— —_ <br />X PrOfeSSlOnal Llab - 1 PERSONAL& ADV INJURY $ 1,000,000 <br />X Sexual Abuse Liab <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRO - <br />POLICY JECT LOC <br />AUTOMOBILE LIABILITY - <br />r_ -. <br />� I <br />ANY AUTO <br />ALL OWNED -- - SCHEDULED <br />AUTOS _ _ AUTOS <br />NON -OWNED <br />-_ HIREDAUTOS AUTOS <br />_ --- UMBRELLA LIAB <br />_ <br />- - -- <br />OCCUR <br />A <br />IX <br />_X_ <br />li EXCESS LAB <br />CLAIMS -MADEi <br />RELOO12017 <br />DED X RETENTION <br />_$_ <br />WO E S COMPENSATION <br />_ <br />AND EMPLOYERS' LIABILITY <br />B ANY PROPRIETOR /PARTNER /EXECUTIVE Y , N <br />X WC201200000946 <br />N/A <br />OFFICER /MEMBER EXCLUDED? <br />(Mandatory in NH) <br />�, <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS <br />below <br />A Property Coverage <br />RIC0012016 <br />GENERAL AGGREGATE <br />PRODUCTS- COMP /OPAGG $ <br />BODILY INJURY (Per person) $ <br />BODILY INJURY (Per accident) 1 $ <br />EACH OCCURRENCE $ - 2,000,000, <br />10/1/2011 10/1/2012 I 'GGREGATE- — — $ - <br />Aggregate !$ 2,000,0001 <br />�( WC STATU- I OTH- <br />YLIMITSL -ER I _ <br />2/112012 211/2013 E.L. EACH ACCIDENT '$ 1,000,000 <br />E.L. DISEASE - EA EMPLOYEE _$ 1,000,000 <br />E.L. DISEASE -POLICY LIMIT . $ 1,000,000 <br />10/1/2011 10/1/2012 Blkt Cont 425,000 <br />A Crime RIC0012016 10/1/2011 1 10/1/2012 Empl.Dishonesty 200,000'' <br />DESCRIPTION OF OPERATIONS LOCATIONS VEHICLES (Attach Additional if $ required) <br />Re: Cont act #A 20 O061- 002A -2009 -133A 2009133A. City of Santa Ana, its officers, employees, agents, and representatives are named <br />additional Insured with respect to the General Liability policy of the named insured - CG 2026 endorsement to follow. Such insurance is primary and <br />non- contributory per the attached endorsement. Waiver of Subrogation for Workers Compensation policy applies in favor of certificate holder - endorsement <br />to follow. <br />CERTIFICATE HOLDER <br />CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />City of Santa Ana Community Dev. Agency (M -25) THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />Attn: Frank Hernandez <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 Civic Center Plaza, M -25 <br />Santa And, CA 92701 <br />AUTHORIZED REPRESENTATIVE <br />©1988 -2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD <br />