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Client#: 1259431 <br />305CORDOCOR <br />ACORDT. CERTIFICATE OF LIABILITY INSURANCEDATE(MM/DDIYYYY) <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 />9/15/2014 <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 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 <br />NCONTACT Christy Mata <br />BB&T Insurance Services <br />PHONE FA <br />(AJC'No, Est): 714 941-2870 AIC, No7 677-297-9247 <br />of Orange County <br />ADDRESS: CMata@bbandt.com <br />2400 Katella Avenue Ste 1100 <br />EACH OCCURRENCE <br />INS)AFFORDING COVERAGE NAIL <br />Anaheim, CA 92806 <br />INSURER A; Lloyds of London FOREIGN <br />INSURED <br />INSURER B: <br />Cordoba Corporation <br />1401 N. Broadway <br />INSURER C <br />Los Angeles, CA 90012 <br />INSURER D: <br />INSURER E: <br />A + <br />7'b <br />r Slvifj-1'p� A.),0I 1Di %, r�3I <br />PrIN <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 />LTR <br />TYPE OF INSURANCE <br />ADDLSUBR <br />NSR <br />WVD <br />POLICY NUMBER <br />MMI�IOIYYYY <br />MMIOIOIYYYYY <br />LIMITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ <br />PREMISES Ea occ11 <br />ance <br />ad. <br />$ <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE [—] OCCUR <br />MED EXP (Any one person) <br />$ <br />PERSONAL B ADV INJURY <br />$ <br />GENERAL AGGREGATE <br />$ <br />GEN'LAGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMP/OP AGS <br />$ <br />POLICY PRO LOC <br />ECT <br />$ <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />Ea accident) <br />$ <br />BODILY INJURY (Per person) <br />$ <br />ANVAUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOG <br />BODILY INJURY (Per accident) <br />$ <br />HIRED AUTOS NAITOSWNED <br />PROPER ntacci)AMAGE <br />$ <br />$ <br />UMBRELLA UAB <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />EXCESS LIAB__ <br />CLAIMS -MADE <br />DED E I RETENTION$ <br />$ <br />WORKERS COMPENSATION <br />WC STATU- <br />EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETORIPARTNERIEXECUTIVE❑ <br />OFFICEWMEMBER EXCLUDED? <br />NIA <br />ROH- <br />ST <br />TORY LIM 5 <br />E.L. EACH ACCIDENT <br />$ <br />E.L. DISEASE - EA EMPLOYEE <br />$ <br />(Mandatory in NH) <br />Ifyes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE -POLICY LIMIT <br />$ <br />A <br />Professional Liab <br />B0621PCOR03214 <br />09/27/2014 <br />0912712015 <br />$3,000,000 PerClaim/Ag <br />Ded: $25,000 Per Claim <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) <br />Verification of Insurance <br />'DeJrgil 5hgr' D/,v Mas —page r Of <br />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, CA 92702.1988 <br />AUTHORIZED REPRESENTATIVE <br />@ 1988-2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD / <br />#S12993581/M12993558 LXMCN '// <br />