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av �'w CERTIFICATE OF LIABILITY INSURANCE <br />°0913 MO11 <br />09f3012074 <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 dose not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER ARSH RISK& INSURANCE SERVICES <br />345 CALIFORNIA STREET, SUITE 1300 <br />CALIFORNIA LICENSE NO. 0437153 <br />SAN FRANCISCO, CA 9410 <br />Attn: Gene Williams (415)743.8320 <br />19025- BLX- WG14-15 <br />CONTACT <br />PHONE —' IFAX <br />A No c : Alc No: <br />__,; <br />E4,l <br />a D S: <br />INSURER(S) AFFORDING COVERAGE ! NAIC# <br />INSURER A: Twin Gty Fire Insurance Go ;29459 <br />INSURED <br />BLX Group, LLC <br />T77 South Flguaroa Street, Suite 3200 <br />Las Angeles, CA 90017 <br />INSURER 9 : Hartford Awrissra & Indemnity Co. 122357 <br />HaRfoN Casue Ins Go 129424 <br />INSURER C: M _ — <br />INSURER D: Sen inei Insurance ComPany <br />INSURERS: <br />PRODUCTS- CQMPlOPAGG $ <br />_ <br />MSURER F: I <br />COVERAGES CERTIFICATE NUMBER: SEA- W2187505 -95 REVISION NUMBER: 18 <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY 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 />Well I 70-o['XQaR <br />LTR TYPE OF INSURANCE HNSRImarn <br />POLICY NUh16ER <br />POLICY EFF j POLICY EXP LIMITS <br />pmsucIDIYY ) lfiwm (YVY <br />GENERAL LIABIU'IY <br />EACH OCCURRENCE 1 S <br />" GGM AERCIAL GENERAL LIABILITY ll <br />DAMAGET RENTED <br />PREMISES (Eaomurtenca S <br />GLAIMS -MADE I�OCCUR <br />I MEDEXP(AOY One Person} �5 <br />of Marsh Risk & ineuranre Services <br />i `PERSONAL &ADV INJURY S <br />Gene Williams <br />�I GENERAL AGGREGATE 8 <br />I OEN1AGGREGATE LIMIT APPLIES PER: I, <br />PRODUCTS- CQMPlOPAGG $ <br />1� PRO. ✓- -{ LOC i 1 <br />s <br />POLICY <br />COMBINE SINGLE LIMB <br />MOILELIABILITY <br />BODILY INdUR`.'(Perperson) & <br />ANYAUTO ',,. <br />7',OALL <br />! <br />OWNED —1 SCHEDULED <br />IBDDILYINJURY (Per acdtlent) S <br />AUTOS AUTO$ NON -AWNED 1 <br />,PROPERTY DAMAGE s <br />MIRED AUTOS AUTO§ <br />Pe aoaaaf <br />S <br />UMBRE LA 4 9 OCCUR <br />1 EACH OCCURRENCE 5 <br />j EXCESS LIAR I CLAIMS -MADEI <br />AGGREGATE 3 <br />! S <br />i DEC I RETENTIONS <br />A {WORKERS COMPENSATION <br />157 WE DZ7249(AOS)TL,NK,WA) 110!0172014 1010112016 1 TWCSTA'Jy- �OTIT ER <br />AND EMPLOYERS' LIABILITY YIN <br />B ' ANV PRGPRIETORIPABTNER/Ex€cunvE <br />❑N N l A <br />! 57 WE DZ7249 (CO,DC,DR,MA,MN,WVJ 10/01/2014 10101(291 EL. EACH ACCIDENT , s 1,009'00 <br />C tMandatory in NHj EXCw°em <br />'157 WE DZ7249 TX and AZ) 10I01I2014 1Cl07/20'6 1,000,000 <br />( ! E.L. DISEASE -EA EMPLOYED S <br />IfYa5 dsscnhe under <br />D I DESCRIFTIDN OF OPERATIONS below I <br />157 VJE UZ7249 (GA} �1N01Y2014 10/01 @015 i 1,000'00 <br />t E.L. DISEASE • POLICY LIMIT 3 <br />I <br />I I <br />DESCRIPnONOFOPERATION $1600ATIONS (VEHICLES (Attach ACORD 101, Additional Remarks Schedula, HI opinion IS requund) <br />Professional Services Central <br />l:AN(:F) I GPt7N <br />ACORD 26 (2010 105) <br />{m 1988.2030 ACORD CORPORATION, ION, A)1 rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />f��Irl� wed b�. +Ah �a <br />)� e <br />atyof Santa Ana <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />AtIn: Rich Ta <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />20 C'lvic Center Plan, M -2 5 <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Santa Ana, CA 92701 <br />AUTHORIZED REPRESENTATIVE <br />of Marsh Risk & ineuranre Services <br />Gene Williams <br />ACORD 26 (2010 105) <br />{m 1988.2030 ACORD CORPORATION, ION, A)1 rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />f��Irl� wed b�. +Ah �a <br />)� e <br />