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<br />Client#: 51-.,20 <br />oURETRAC <br /> <br />ACORDn., CERTIFICATE OF LIABILITY INSURANCE <br />IDDl9Y""' <br />° <br />6 <br />106/2 <br />610 612 0 1 3 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER <br />THIS <br />. <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) <br />AUTHORIZED <br />, <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED <br />b <br />t t <br />, su <br />jec <br />o <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not c <br />f <br />i <br />on <br />er r <br />ghts to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />Hub International NAME, Emily Silversparre <br /> <br />HUB Int'I Insurance Serv <br />Inc j'/ q 877 825.2681 <br />No 951 231-2572 <br />E"' ` (uc <br />. <br />. <br />BO N Riverview Or <br />Ste 170 , <br />E-MAIL Cal.CPU@hubinternational.com <br />ADDRESS: @huhinternational.com <br />, <br />Anaheim, CA 92$08 INEURERIa)AFFORDING COVERAGE NAICN <br /> INSURERA:Golden Eagle Insurance Corporal 10836 <br />INSURED <br /> <br />Sure Track, LLC <br />INSURER SPeerless Indemnity Insurance Co <br />: <br />18333 <br />3130 S. Harbor Boulevard <br />Suite 100 INSURER C: <br />, <br />Santa Ana, CA 92704 INSURER O: <br /> INSURER E <br /> <br />COVFR df;F.S rvor,nrnr,-In <br />,.... ?... NSURER F: <br />- --------"' ntvlalVN NU MtlEK: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSU <br />ED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITIONOF ANY CONTRACTOR OTHER DOCUMENT WITH <br />RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO <br />ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS <br />. <br />INSR -ADDLSURR <br />LTR TYPEOFINSURANCE INSR WVO POLICYNUMB ER (MMIDI DIYI'YYY POLICYYVYY LIMITS <br />q GENERAL LIABILITY <br /> <br />X BOP3084809 03126/2013 0312612014 Ea CH OCCURRENCE <br />$1,000,000 <br /> COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED <br /> PREMISES(Ea oxonance $50,0 00 <br /> CLAIMS-MADE OCCUR & MED EXP (Any one person) $ 5,000 <br /> <br /> % PERSONAL &ADV INJURY $1,000,000 <br /> r f <br /> <br />' <br />E ,y <br />: l_ ? <br />GENERAL AGGREGATE <br />$2,000,000 <br /> GEN <br />L AGGR <br />GATE PR IL APPLIES PER: Sr t <br />?„stj Y PRODUCTS - CO,NIPIOP AGG $2,000,000 <br /> POLICY JECT LOG <br />AUTOMOB $ <br /> ILE LIABILITY " ?? i?Q COMBINED SINGLE LIMIT <br /> <br />v GG (??? <br />4 IEa axidenl <br /> ANY AUTO <br />ALL OWNED <br />17 <br />SCHEDULED tN <br />`SP t?•l ! ` <br />t G 1 BODILY INJURY (Per person) $ <br /> AUTOS AUTOS <br />/`I ON OWNED <br />nn55 ? BODILY INJURY (Per accident) $ <br /> HIRED AUTOS !` PROPERTY DAMAGE <br />$ <br /> I Per accident <br /> <br /> <br /> UMBR <br />j OCCUR <br /> <br />EXCE EACH OCCURRENCE $ <br /> CLAINIS MADE <br /> AGGREGATE $ <br /> DEG $ <br />B WORKERS COMPENSATION <br /> <br />AND EMPLOYERS'LIABILITY WC3084610 <br /> <br />03126/2013 <br /> <br />03(26/201 L NC <br />OTH. <br />X <br />$ <br /> YIN <br />ANY P <br />OP i YLe? ER <br /> R <br />RIETORfPARTNER/EXECUTIVE <br /> OFFICER.MIEMB EXCWOEDP <br />d NIA EL EACH ACCIDENT $1 DDD DDD <br /> <br />ory in NH) <br />(Man <br />atory describe under <br />yes, <br />EL. DISEASE - EA EMPLOYEE <br />$1,000,000 <br /> D <br />ESCRIPTI PTION <br />DN OF OPERATIONS below <br />I <br />EL.DISEASE - POLICY LIMIT $1,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if mars space is required) <br />The City of Santa Ana, its officers, employees, agents & representatives are Additional Insured in regard <br />to General Liability per the attached endorsement form 44-148 06/04; Primary and Non-Contributory wording <br />applies per the attached endorsement form 44.231 07110. <br />l`FfJTICIGATC Utni TCD <br />The City of Santa Ana <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />ACORD 25 (2010105) 1 of 1 <br />#S2267723/M2240142 <br />The ACORD name and logo are registered marks of ACORD <br />r <br />v /you-ZU le AUUKU UUKHORATION. All rights reserved. <br />MG42