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Client: 1514175 <br />306ALLCITYM <br />ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE (MMID01YYYY) <br /> 1/29/2013 <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 />------------__._._ <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 NAMEA Nysa Gallegos <br />BB&T-Knight Insurance Services PHONE y <br />818 662 <br />877 <br />297 <br />9262 <br />4234 1 <br /> - <br />?c No , <br />- <br />- <br />Ext : <br />535 N. Brand Blvd. 10th Floor F-MAIL <br />ADDRESS: NGallegos@bbandt.com <br />Glendale, CA 91203 <br /> INSURER(S) AFFORDING COVERAGE NAIC # <br />818 662-4200 <br /> INSURER A: Liberty Surplus Insurance Corp 110725 <br />INSURED INSURERS: Interstate Fire & Casualty Comp 122629 <br />All City Management Services Inc INSURER C, Nationwide Mutual Insurance Corn 23787 <br />10440 Pioneer Blvd # 5 - -- -- - ---- <br />--- <br /> <br />S INSURER 0: <br />- <br />Fe Springs, CA 90670 <br />anta ----- ------------- -__.__. <br /> INSURER E : <br /> INSURER F : <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 CONTRACTOR 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 ADDS UBR t OLICYEXP <br />LTR TYPE OF INSURANCE IN R POLICYEFF P <br />WVO POLICY NUMSeF v MMIODIYYYY?-`(MMIDD?- ----- ^___. - ----- -- "--LIMITS <br />A GENERALLIABILITY X X 100000384002 4101/2012 041011201 A <br />E <br />O <br />C <br />0 <br />0R <br />RENCE 1 000 000 <br />CCH <br /> X COMMERCIAL GENERAL LIABILITY E <br />A <br />? <br />E <br />? <br />C <br />0 <br />i PREMISES tEa oc?curcenc?I 550>000 <br /> CLAIMS-MADE Al OCCUR i MED EXP (Any one person) $ 5,000 <br /> PERSONAL & ADV INJURY 1$1,000,000 <br /> <br /> 1 GENERAL AGGREGATE 1$2,000,000 <br /> <br /> GEN'LAGGREGATELIMIT APPLIES PER: PROOUCTS-COMP/OP AGG $2,000,000 <br />-i <br /> XI POLICY LOC <br /> <br />C <br />AUT <br />OMOBILE LIABILITY <br /> <br />X <br /> <br />ACP7805954504 - - <br />1 <br />2/21/2012 - <br /> <br />112/21/201 <br />EaeBtclbEaOrtjINGLE -LIMIT '-'- <br />1 $1,000,000 <br /> X ANY I <br /> AUTO BODILY <br />NJURY (Per person) S <br /> ALL OWNED <br /> <br />AUTOS SCHEDULED <br /> <br />AUTOS 1 <br /> <br />j BODILY INJURY Per accident <br />$ <br /> <br />? <br />I ( ) <br /> <br />X <br />HIRED AUTOS NON-OWNED <br />X AUTOS PROPERTY DAMAGE <br />i S <br />P <br />id <br /> I I er acc <br />ent <br />iS <br /> <br />B ! <br />X <br />UMBRELLA L1A8 <br />X <br />OCCUR <br />PFX00048574727 <br />4/01/201 -- I <br />04/01/201 <br />EACH OCCURRENCE S4,000,000 <br /> EXCESS LIAB <br />_ <br />CLAIMS-MADE 2 <br />AGGREGATE <br />! s4 <br />000 <br /> <br />1 <br />DED X RETENTION SO - ,-.t____ ------_----- <br />.-- <br />?' <br /> <br /> <br />i <br /> <br />WO <br />WORKERS COMPENSATION <br />' <br />?------ -- ?? ----- <br /> <br />Not Applicable <br />----- - <br />? ?---- ---- <br /> <br />_ <br />? (WC STATU-?j" -I - - <br />OTH <br /> AND EMPLOYERS <br />LIABILITY Y/ N <br />ANY PROPRIETORIPARTNERIEXECUTIVE ....1ZOBY.LI)xt(T,S„L,_1 ._-..___ _. ___._....... <br /> OFFICERIMEMBER EXCLUDED? N/A E.L. EACH ACCIDENT S <br /> (Mandatory In NH) <br />If <br />ib <br />d <br />d E.L. DISEASE - EA EMPLOYEE $ <br /> yes. <br />esa <br />e un <br />er <br />DESCRIPTION OF OPERATIONS below [ <br />[ --- <br />E.L. DISEASE - POLICY LIMIT $ <br /> Not Applicable <br />I I <br />DESCRIPTION OF OPERATIONS/ LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more apace ""squired) <br />As respects General Liability and required by written contract; Certificate Holder Is named as additional <br />insured. Insurance is Primary & Non-Contributory. Waiver of Subrogation applicable. <br />City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />20 Civic Center Plaza, M29 ACCORDANCE WITH THE POLICY PROVISIONS. <br />Santa Ana, CA 92702 <br />AUTHORIZED REPRESENTATIVE <br />®1988-2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD <br />#S9882513/M9860483 NNGON <br />?r