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UNION-1 OP ID: TTL <br />n CERTIFICATE OF LIABILITY INSURANCE 0 DAT81278/27DIYYYY) <br />/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 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(les) must be endorsed. If SUBROGATION 16 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 9164844793 NA TA T <br />Builders Advantage Insurance 916.784.9799 <br />107 Main Street PHONE FAX <br />IAIC. N.. 2.6i Arc No : <br />Roseville, CA 95678 E-MAIL <br />ADDRESS: <br />Toni Luker INSURERS AFFORDING COVERAGE NAIC N <br /> INSURER A: Security National Ins Ce <br />INSURED Union Investments, Inc. INSURER e: <br />--- <br />DBA: Stoneshlne <br />211D E. McFadden Ave., Suite G INSURERC: <br />Tustln, CA 92705 INSURER D: <br /> INSURER E : <br /> INSURER COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br /> <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 AN Y 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 ANDCONDITIONS OFSUCH POLICIES. LIMITS SHOWN MAYHAVE BEEN REDUCED BYPAID CLAIMS. <br />INB,R rypE OF INSURANCE ADDL SUER <br />POLICY NUMBER POL YEFF <br />(MMeDOMYrYI MMIDD? LIMITS <br />GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 <br />A X COMMERCIAL GENERAL LIABILITY X NA102594501 06/17113 06117114 PREMISE6 Eaacourw $ 100,00 <br />CLAIMS-MADE ® OCCUR MEDEXP An one ereon $ 5,00 <br /> PERSONAL&ADV INJURY $ 1,000,00 <br /> GENERALAGGREGATE $ 2,000,00 <br />GEN'L AGGREGATELIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ 2,000,00 <br />POLICY PEA LOG $ <br /> AUT OMOBILE LIABILITY COMP NEP N LE IMIT <br />me accident) <br /> ANY AUTO BODI LY INJ URY(Per Parson) $ <br /> ALLOWNED <br />AUTOS SCHEDULED <br />AUTOS <br />BODILY INJURY (Per eccldenp <br />$ <br /> NON-OWNED PROPERTY OHMAGE $ <br /> HIREOAUTO$ AUTOS Par .cant <br /> <br /> UMBRELLAUAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAR CLAIMS-MADE AGGREGATE .$ <br /> <br /> DEO RETENTICNl$ <br />$ <br /> WORKERS COMPENSATION <br />• O <br />WO STATU TH- <br /> AND EMPLOYERS 'LIABILITY TO Y L <br />- _ <br /> YIN <br />ANY PROPRIETORIPARTNERIEXECUTIVE <br />NIA E.L. EACH ACCIDENT <br />- $ <br /> OFFICERIMEMBER EXCLUDED? <br />1MandatoryInNH) E.L. DISEASE-EA EMPLOYE $ <br /> f yes describe under <br />DESCRIPTION Of OPERATIONS below <br />E.L. DISEASE POLICY LIMIT <br />$ <br /> <br />DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more apace Is required) <br />The City of Santa Ana, it's officers, employees, agents and representatives <br />are named as additional Insured under the Commercial General Liability per APPROVED Fl,M.1 TO Z°(}RNI <br />attached endorsement. <br />Re: Various locations throughout the City of Santa Ana, CA <br /> LISA k. STORCK ` , <br /> Assistant City Attorney 3 <br />CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. <br />2D Ci <br />t <br />Pl <br />M <br />16 <br />i <br />C <br />_ <br />v <br />en <br />er <br />aza <br />- <br />c <br />Santa Ana, CA 92702 AUTHORIWO REPRESENTATIVE <br /> Jahn Sslingel' <br />©1088-2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD <br />Exhibit C