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272295 <br />A CERTIFICATE OF LIABILITY INSURANCE <br />DAT D/YYVY) <br />5/7/2 <br />5/712013 <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.f1i{pp <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(hes) must be endorsed. If SUBROGATI9 N I WAVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statementon.this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />Commercial Lines - (949) 225-6900 <br />Wells Fargo Insurance Services USA, Inc. - CA Lic#: OD08408 <br />CONTACT Debbie Karpuk <br />PRONE Exit <br />f IN949-224-1688 ac No -949-225-6910 <br />E-MAIL o.com k <br />dabble. uk wellsfar <br />ADDRESS: dP @ 9 <br />INSURERS AFFORDING COVERAGE NAIC M <br />2030 Main Street, Suite 200 <br />INSURER A: Philadelphia Insurance Company 23850 <br />Irvine, CA 92614-7253 <br />INSURED <br />INSURER B: Travelers Casualty Ins Cc of America 31194 <br />National University <br />INSURER C: <br />11355 N.Torrey Pines Road <br />INSURER D: <br />INSURER E: <br />LIMIT APPLIES PER: <br />PROJECT X LOC <br />La Jolla, CA 92037-1013 <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 6022681 REVISION NUMBER: See below <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 />R <br />TYPE OF INSURANCE <br />AOOL <br />SUER <br />POLICY NUMBER <br />MMID mYY <br />MMIODYYYY <br />LIMITS <br />A <br />GENERAL LIABILITY <br />COM MERCIAL GENERAL LIABILITY <br />CI -AIMS -MADE OCCUR <br />PHPK927071 <br />09/29/12 <br />09/29/13 <br />EACH OCCURRENCE $ 1,000,000 <br />DAMAX ETORENTED <br />PREMISES RENTED <br />PREMISES $ 100,000 <br />MED EXP (Any one person) $ Included <br />PERSONAL$ ADV INJURY $ 1,000,000 <br />GENERAL AGGREGATE $ 2,000,000 <br />GEHL AGGREGATE <br />POLICY <br />LIMIT APPLIES PER: <br />PROJECT X LOC <br />PRODUCTS-COMPIOPAGG $ 2,000,000 <br />$ <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />HIREDAUTOS AUTTOSWNED <br />PPR <br />CEaOMBINEDIT' INGLE LIMIT <br />BODILY INJURY (Par person) $ <br />BODILY INJURY (Per accidenQ $ <br />Laura A. Rost <br />ini <br />PROPERTY Edam DAMAGE $ <br />UMBRELLA LIAB <br />EXCESS LIAB <br />OCCUR <br />CLAIMS -MAGE <br />EACH OCCURRENCE $ <br />AGGREGATE $ <br />DED RETENTION$ <br />$ <br />B <br />WORKERS COMPENSATIONX <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETORIPARTNERIEXECUTIVEE.L. <br />OFFICER/MEMBER EXCLUDED? F—N] <br />(Mandatory in NH) <br />If yes, describe under <br />OF OPERATIONS below <br />NIA <br />TC2JUB-42426530-12 <br />07/01/12 <br />07/01/13 <br />WC STATU- OTH- <br />EACH ACCIDENT $ 1,000,000 <br />E.L. DISEASE - EA EMPLOYE $ 1,000,000 <br />1,000,000DESCRIPTION <br />E, L. DISEASE - POLICY LIMIT $ <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AUach ACORD 101, Additional Remarks Schedule, if more space is required) <br />City of Santa Ana, its officers, employees, volunteers and agents are included as Additional Insured per form # PI-GLD-VS(01/08). <br />CERTIFICATE HOLDER CANCELLATION <br />City of Santa Ana <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />20 Civic Center Plaza <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Santa Ana, CA 92701 <br />AUTHORIZED REPRESENTATIVE f°'c"` d <br />The ACORD name and logo are registered marks of ACORD © 1988.2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010/05) <br />(Tamaerdi repisaoa -d <br />