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.,_4.,v.zu TM. CERTIFICATE OF LIABILITY INSURANCE . JUN'24,3 " PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION MARK JACKSON INSURANCE AGENCY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.O. BOX 775 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR YORBA LINDA CA 92885-0775 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PHONE: 714-779-2629 _ FAX: 714-779.1170 A enc Lick 067323 _; .)NSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: U.S. Liability Insurance Company j 25895 ACIRE, INC. 'INSURER B: 211 SIMPLICITY IRVINE, CA 92620 -INSURER C. INSURER D: INSURER E: fRT�TT13.7TN Y-R THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IxsR TYPE OF INSURANCE POLICY NUMBER LTR POLICY FFFFCTNE GATE YIN00 POLICYEXPIRATION DATE MWO LIMITS GENERAL LIABILITY PPP100653SE JUL 6 12 JUL 6 13 EACH OCCURRENCE $ 1,000,000 DAMAGE TD RENTED PREMISES Ea oaursm $ $0,000 X COMMERCIAL GENERAL LIA8ILITY _ II CLAIMS MADE �. X OCCUR MED. UP Gno Parson) g 5,000 A PERSONAL B ADV INJURY $ 1,000,000 GENERALAGGREGATE $ 2,000,000 PRODUCTS-COMP/OP AGG. $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: POLICY AUTOMOBILE LIABILITY PPP1006536E ANY AUTO JUL 6 12 JUL 6 13 COMBINED SINGLE LIMIT HER accident) $ 1,000,000 ALL OWNED AUTOS BODILY INJURY (Per parson) $ X X _ A SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS I BODILY INJURY (Per accident) $ OPERTY DAMAGE $ GARAGE LIABILITY TO ) AUTO ONLY: EA ACCIDENT $ HAN EA ACC '$ ANYAUTO r�f1 S*'- 4 V YY OONLY. AGG $ EXCESS I UMBERELLA LIABILITY G EACH OCCURRENCE $ OCCUR �� CLAIMS MADE L, 10Tie to AGGREGATE $ __ $ DEDUCTIBLE PSS`c�t3 $ $ i RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY WCa LIMITS TORY L u- OTHER _ EL EACHACCIOENT $ ANY PROPRIETO W PARTNER/EXECUTIVE E.L DISEASE -EA EMPLOYEE Is OFFICEWWMBER EXCEDEDi H Yu, Gmi- -a— sPECML PROVISIONS W. E.L. DISEASE -POLICY LIMIT $ OTHER: PROFESSIONAL LIABILITY PPP1006536E JUL 612 JUL 613 $1,000,000 EACH OCCURRENCE A ERRORS AND OMMISSIONS $2,000,000 ANNUAL AGGREGATE RETRO DATE: 07/06/2007 DESCRIPTION OF OPERATIONSILOCATIONIVEHICLES/EXCLUSIONS ADDED ENDORSEMENT/ SPECIAL PROVISIONS CONSULTING PROFESSIONAL THE CITY OF SANTA ANA ARE ADDED AS ADDITIONAL INSURED PER END CG 20 26 07 04. THE INSURANCE IS NON-CONTRIBUTORY AND PRIMARY END# L722 (02109) TO ALL OTHER INSURANCE OF THE CITY IN RESPECT TO THE OPERATIONS OF THE NAMED INSURED. 10 DAYS NOTICE OF CANCELLATION FOR NON-PAYMENT OF PREMIUM CERTIFICATE HUI L.PIIYL.CLLAI IVIN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT CITY OF SANTA ANA FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE 20 CIVIC CENTER PLAZA, M-36 INSURER, II AGENTS OR REPRESENTATIVES. SANTA ANA, CA 92701 AUTHORIZED REPRESENTATIVE A��\ " V r Attention: MARILYN BOOTHE Arnon nI r, miHnm Codifrato 9 19M72 Mark Jackson 0673236 J