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GRAFF-2 OP ID: HU <br />° CERTIFICATE OF LIABILITY INSURANCE <br />'` OAT <br />DIYYYYI <br />I <br />-- 06114 <br />6!14/12 <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 poiicy(ies) 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 endorsements . <br />PRODUCER 916-630-8643 CONTACT <br />NAME. <br /> <br />Powers and Company <br />800-783.0083 . __ ..._ ,_ <br />PHONE ] <br />A- <br />Insurance Agents and Brokers _INc No. SKI); ....... .No): <br />A <br />Ac, <br />P. O. Box 619043 Lic #OH38004 EMAIL <br />ADDRESS: <br />Roseville, CA 96661.8043 <br /> INSURERISi AFFORdNG COVERAGE NAID# <br /> INSURERA James Riverlnsurance Comp !!y 12203 <br />INSURED Graffiti Protect Coatings Inc INSURER B Companion Property & Casualty 12167 <br />419 N. Larchmont Blvd #264 ""`" - -- <br /> <br />Los Angeles, CA 90004 wIsuREfl c. <br /> INSURER D <br /> INSURER E <br /> INSURER F <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <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 />1NSR`. , _ __ .._`.... ADDLi8U0. , _... _._ POLICY EFF pOUCYEXP ....`.. _...... .. .__.__ _. _......__ .___. <br /> <br />LTR OF INSURANCE POLICY NUMBER M DO%YYY MIOMYYYY LIMITS <br />T <br />I GENERAL LASE-MY EACH OCCURRENCE S 1r000,OO <br />I <br />A ..... <br />MMERCIAL GENERAL LIABILITY <br />X _ C <br />X ?. <br />000437302 <br />06/16/12 <br />00116113 <br />roAVAGETO RENTED <br />pREMI5ESAaaccunebce) - .._... <br /> <br />5 60,00 <br /> O <br />CLAIMS-MADE ?X OCCUR ! MCP_q PIAAV ono PaeooL S EXCLUDE <br /> PERSONAL S ADV IN41URY <br />, <br />. $ 11000,00 <br />_.... <br /> _. .__.. -.., j GENERAL AGGREGATE 2,000,000 <br />S <br /> GENT. AGGREGATE LIMIT APPLIES PER: <br />. PROOUOS COMPMP AGO <br />... 5 2,000,00 <br /> ...i LOC <br />X:• POLICY PRO- S <br /> AUTOMOBILE LIABILITY <br /> <br />Ao r OM 8 D OLELMIT <br />i€eaalgemL <br /> <br />ANY AUTO U ?+y <br />? <br />" BODILY INJURY IP#r pmoonl E <br /> ALL OWNED SCHEDULED AL <br />I BODILY INJURYIPorocod rdI $ <br /> AUTOS __._ AUTOS ; <br />N <br />GD <br />PROPERTY DAMAGE - <br />$ <br /> UTOS <br />_ HIRED AUTOS ... AUTOS <br />SY - ,1?@r Pa!Wnll, ,. _. ,..., <br />S <br /> i \l. t <br /> UMORELLA UM3 <br />OCCUR L C ty EACH OCCURRENCE <br />... $ <br />. _ <br /> -_ scan <br />ABd .__. ..... <br /> EXCESS LIAa CLAIMSMAOE AGGREGATE _ S <br /> Oro I RETENT'ION$ i t <br /> WORKERS COMPENSATION i WC TATU- OTH <br />-I <br />TGRYSLIMITS . _ER <br />B AND EMPLOYERS' LIABILITY <br />ANY PROPHIETORIPARTNERRXECUTIVE Y CPCA14601 01101112 OIID1113 . <br />EL EACH ACCIDENT <br />'- $ 1,000,00 <br /> OFFICERIMEMBER EXCLUDED? <br />(Mandatory In NMI NIA E .L D15_EASE -EA EMPL_GYEE <br />1 000,00 <br />11 <br />? <br /> If YYees describe under <br />DESCRIPTION F OPERATIONS below E.L. DISEASE POLICY LIMIT E 1,OD0,00 <br /> <br />OESCRIP710N OF OPERATIONS I LOCATIONSI VEHICLES IAHach ACORD Tot, Additional Remarks Schedule, if more apace 4donlool <br />The Cil of Santa Ana, Its officers, agents ampbyees and representatives <br />are Inc uded as en Additional Insured un er Commercial General Liability <br />policy per andorsement CG 20 10 07 04 and CG 20 37 07 04, sub Oct to a <br />I <br />nsured. <br />written contract between the Named Insured and the Additional <br />Endorsements attached. "Subject to company approval. (see attached notepad) <br />THECITY <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />The City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 AUTRORMED REPRESENTATIVE <br />0 1988-2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010196) The ACORD name and logo am registered marks of ACORD