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<br />CERTIFICd.AT E OF LIABILITY INSURANCE DATE P%VUD1YYYY)
<br /> 01/23/2013
<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 />IMPORTANT: If the Certificate holder is an ADDITIONAL INSURED, the policy(has) 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 CONTACT
<br />Levine Insurance Group LLC (UNC and). 860 739-4444 FA Her (860) 739.6861
<br />221 Boston Post Road E"MAIL
<br /> s
<br />P.O. Box 339 INSURERS AFFORDING COVERAGE NAICS
<br />East Lyme CT 06333 INSURERA: Travelers Property Casual Co of America
<br />INSURED
<br />INSURER s:
<br />D.S. Saws INSURER C:
<br />11 High Street INSURER O:
<br />
<br /> INS R R E
<br />_ _
<br />
<br />Suffield CT 06078 _
<br />INSURER F: _
<br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<br />THIS IS TO CERTIFYTHAT 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 MAYBE 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 />T TYPE OF INSURANCE ADDL
<br />NAP SUBR
<br />VAIn
<br />i POLICY HUNGER POLICY OFF
<br />11h POLICY EXP
<br />MMIDDYYYYY1 LUfITS
<br /> GENERAL LIABILITY EACH OCCURRENCE 51,999,999
<br />A X COJIMERCIAL GENERAL LIABILITY DAMAGE TO RENTED
<br />EEASE. r
<br />5300,000
<br />
<br /> J CLAIMS-MADE ? OCCUR 1-680-6A854259-TIL-12 11/17/12 11117113 MED EXP An en 55,000
<br /> PERS014AL B. ANY INJURY 51,909,690
<br /> GENERAL AGGREGATE $2,000,000
<br /> GEN' L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMIP/OP AGO 52,000,000
<br /> POLICY PRP LOG S
<br /> AUT OMOBILE LIABILITY COMBINED SINGLE LUHIT
<br />d3CLitlCI]t)
<br /> ANY AUTO BODILY INJURY (Per parson) 5
<br /> ALL OWNED
<br />AUTOS SCHEDULED
<br />AUTOS
<br />BODILY INJURY Per accidenp
<br />3
<br /> NON-OWNED PROPERTY DAMAGE S
<br /> HIRED AUTOS AUTOS °r3ci
<br /> S
<br /> X UMBRELLA LAB X OCCUR EACH OCCURRENCE $2,000,000
<br />A EXCESS LIAB CLAIMS rAAOE CUP-BA854128-12-42 11117112 11/17113 AGGREGATE $2,000,000
<br /> DED X RETENTION -0 3
<br /> WORKERS COMPENSATION
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<br /> ANY PROPRIETOR/PARTNER/E:XECUTIV.
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<br />- E.L. EACH ACCIDENT 51,000,000
<br />A OFFICER/MEMBER EXCLUDED? N/A IJUB-3794
<br />36-1.12
<br />1 11117112 11117113
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<br /> htandatoryIn NH) E.L 01 CEASE- EA EMPLOYEE 31, 000,000
<br /> ryes, describe under
<br />DLscNPn@l OF OPERATIONS helum
<br />E.L]DISEASE - POLICY LIMIT
<br />b1,900,009
<br />
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach FlLOR01a 1, Adtlitlonal Rartlarks SchetlWO, if mom space is,nI,L,IH VJ
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<br />The City of Santa Ana, We officers, employees, agents, and representatives are named as additJ&PPRO
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<br />insureds as per attached form CG D2 47 OS 05
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<br />CERTIFICATE HOLDER CANCELLATION
<br />The 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 ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Santa Ana, GA 92701 AUTHORIZED REPRESENTATIVE <NPJ>
<br />C1Ct L1 ?, Oilutu(
<br />©1988-2010 ACORD CORPORATION. All rights reserved,
<br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
<br />Exhibit C
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