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<br />Acc?Ata CERTIFICATE OF LIABILITY INSURANCE DATA 1MMI Y,
<br />3/9/2013 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 APPIRMATIVELY 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 bolder Is an ADDITIONAL INSURED, the polleyIks) must he endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and condltlons of the policy, certain policies may require an endorsement, A statement on this certificate does not confer rights to the
<br />certlfioate holder In lieu of such endorsement(s).
<br />PROOUCHR NAME' Comm 9. _
<br />Nickerson Tnaar$noo ServiOea, IRO. O a (310)926-6333
<br />7 Ai n ,(510)926-5416
<br />LTC 40491589 ..MAIL
<br />2106 Went Lomita Blvd. INSURERf§(APPOROING OOVERAGE NNOW
<br />Lomita CA 90717 _,
<br />INSURCRA;3enti ®1 Ineuranoo Company LTD -_T
<br />wsdREO INSURER a jHartford Underwriters Ins Co,
<br />Pigs Tail USA LLC, DSA: Pro-Con Industries i RERC; .
<br />1601-8 West St Andrew Place NSURERO
<br />
<br />Santa Ana CA 92705 _
<br />suRaR P<
<br />COVERAGES CERTIFICATE NUMBERI3-14 BOP 12-13 WC REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OP INSURANCE LISTED. BELOW HAVE BEEN 1550EDTO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM ON 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 19 SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />_
<br />L R TYPE OF INSURANCE ? APO ICY NUMBER P0?E? LIMITS Nee ?Q
<br />GENERAL LIABILITY EACH OCCURRENCE 3 2,000,000
<br />X COMMERCIAL QZNRRAL LIABILITY , BR TtS R"?NT€D
<br />i S(Ea occurtancs, 6 1,000 000
<br />A CLAMS-MADE X? OCCUR 72SBAHR44112 1/18/2019 /16/201+1 MED E%P An ano eRaP) d 10,000
<br />PERSONA4d ADV INJURY 2,000,000
<br />_ OENERALAOCREGATIN $ 2,000,000
<br />GENT. AGGREGATE LIMIT APPLIES PER: PRODUCTS. COMPIOP AGO S 4,000,000
<br />PoUry PRO• LOO S
<br />Ecr __
<br /> AU
<br />_ TOMOBILE LIASUITY p al ;D I G L
<br />1aAT&deJ_,pIl
<br />2 00 ,_QQQ
<br />A ANY AUTO ogeILY INJURY (Per pees ) $
<br /> OWNED
<br />AUTTO$ S SCTEOULEU
<br />AUTOS 72aBA,AN'41Ea 1/18/2013 1/18/1.014 SODILV INJURY Per socldanl)
<br />( $
<br /> X HIREn AUTOS X
<br />II AO,OWNE0
<br />05 ,(E@L96£annll $ ??--
<br />
<br /> UMfiREILA WAS OQCUR EACH gLgURRENQ9 $
<br />F P RXCE5$I,IAD CLAIMS-MADE AGGREOAT'e
<br /> ?T
<br /> DE FTEN71ONS S
<br />B WORKERS COMPENSATION
<br />ANDEMPLOYERWLIASILITY X 'AT'-
<br />I Par I's
<br /> YIN
<br />ANY PROPRIETORfPARTNENIExF.GUTIVE
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<br />CERIMCMaER
<br />CLUQEb9
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<br />E,4. EACHAGCItlENT
<br />.11 _
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<br />a 1 OOQ 000
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<br />Mandalary In Nii) 51wECDA4769 ./3012012
<br />/3012013
<br />E.L. DISEASE - EA EMPLOYE
<br />9 11000,000
<br /> RYYES (Instl{N64tl(16f
<br />D[5GRIPTIONDF OPERATIONS Was -"'"
<br />E.L. DISEASE - PCUOYLIMIT '
<br />5 000 000
<br />
<br />DESORIPTfON OF DPERATIQNS I LOCATION81 VRHICLES (AHati, ACORD 101, AddRlmml Remarks Sehnduln If ntnrn xionae In rnquirotll
<br />City Of Santa Ana its officers, agents, and employeas are 6x coy included as additional insureds On the
<br />liability With respect to claims arising out of the operations and uses performed by or on behalf of the
<br />named insured, such insurance as is afforded by this policy is prJ.wary and is not additional, to or
<br />contributing with ,any other insurance carxiod by or for the baratit of the additional .4noureds 30 days
<br />notice of cancellation subject to 10 days notice for non payment of premium,
<br />CERTIFICATE HOLDER CANCELLATION
<br />
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTION WILL BE DELIVERED IN
<br />City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic C
<br />nter Plaz
<br />e
<br />a
<br />Santa Ana, CA 92701
<br />AUTHORIZED REPR0ENTATIVE
<br /> Sarah Kally/MjF
<br />ACORD 26(2010105) d19SI1-2010/h R. ?AT.dC ,.A6Lrig.Ch$unved,
<br />INSO23roelnnmol Th. Annrin nnma anH lnnnar< eenbsfnrnH mart<nf Art Li lih h?.J
<br />1.1 STORCK
<br />Exhibit C Assisti'arl at . CIPV AtiorllAttarey VV
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