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Client#: 1259431 <br />305CORDOCOR <br />2 0 ( Z (-', 7 <br />ACORD CERTIFICATE OF LIABILITY INSURANCEDAZE"-'a"""") <br />1/18/2013 <br />THIS CERTIFICATE IS ISSUED AS A MATTER -OF.INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDrp.THIS <br />CERTIFICATE DOES NOT AFPIRMATIVELY. 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 policyOOS) must be endorsed. N SUBROGATION IS WAIVED, Subject to <br />are terms and conditlons of the polIcy,.certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder In Ilse of such etidorsement(s):.. <br />PRODUCER <br />6hn$ Mata <br />BUT Insurance Services <br />714 578-7370 AroNo:. <br />ofDrengeCounty <br />D11=013 <br />f Dri2638 Suite 100 <br />Leon, <br />A <br />- <br />Full <br />Fullerton, CA 92831 <br />CA <br />INSURER AFFORDNO COVaRAGE NAICr <br />INSURER A,Travelers Property,Casualty.Cc - - 28674 <br />INSURED <br />Cordoba Corporation <br />INSURER 0: <br />_ <br />1401 N. Broadway <br />INSURER C: <br />Avrduo9lLaLuslury:8106682815113 <br />X <br />X <br />Los Angele , CA 99012 <br />INSURER O: <br />_ <br />- <br />-INSURERS, <br />INSURER F: <br />" SI L $1,000,000 <br />COVERAGES I 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 POUCIES 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 />LSI <br />TYPE OF INSURANCE - <br />POLICY NUMBER <br />A0 l <br />I E"XP <br />Aga <br />UNEIS <br />A <br />O NER^LU^ML <br />X COMMERCAALGENUMLLIABiLnY <br />CWMS-AUOE FX OCCUR <br />-- <br />6306CS2815113- <br />- <br />- <br />D11=013 <br />01/201,207 <br />EACH OCCURRENCE - . $i 000 <br />W?ENhD E3000DO <br />MED EXP IA ms w I £5000 <br />PERSONAL &ADV INJURY- 11,000000 <br />OENERALAGGREGATE .52000000 <br />GENL AGGREGATELwIfAPPUES <br />7X POLICY <br />PER: <br />- <br />M LOC <br />PROOLICTS.Ca1PAIP AGe. 112,000,01(10 <br />S: <br />A <br />Avrduo9lLaLuslury:8106682815113 <br />X <br />X <br />ANVAUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS.. <br />HIRED AUTOS X NON4MWEOAUTOS „ <br />- <br />1/20!2013 <br />01120!201 <br />- <br />- <br />" SI L $1,000,000 <br />BODaYINJURY(Phrpr ) 1 <br />--" <br />BODILY INJURY (Peradd{ I E <br />pROPlRTYI E 1 <br />1 <br />A <br />)( <br />UMBRELLAUA9- <br />EXCEu;Luui <br />X OCCUR <br />CLANS -MADE <br />CUP6C82815113- <br />- - <br />1/20/2013 <br />01f2kI201 <br />- <br />.EACHOOCURRENCE. $10000000 <br />AGGREGATE $10000000 <br />OED I I RETENTION <br />f <br />A <br />ANDEMPLOYEWLIATroN <br />AND FgWpIpLOYETER$'UABiJfT YIN <br />OFYFICENMREMBiR El^R'CLNUERIET EOUTIV� <br />IM.r4.h„ y M N DED {V <br />ry�a, ExcrlbeV�r <br />DESCRIPII N TIONS Ww <br />NIA <br />U66CS7092213 <br />120!201301/201201 <br />- <br />X <br />EL EACH ACCIDENT 119OOWIO <br />E. DISEASE -EA EMPLOYEEYI:000DOO <br />E.L. DISEASE- POLICY LIMIT $1000 DD0 <br />DESCRIPRONOPOPP TIONS/LOCATNNISIVEIRO.ES(AUCh AOORDr01, Addfi n Remef lfthefule ff, svS I Rquked) <br />Certificate Holder is named as Additional Insured, as respect$ General 13abllity, as required by written <br />contract per the attachad form CGD4140408 pg i and 2 of 2. - <br />Additionellnsured amended to Include thefoltowing: The. City of Santa Ana, 20 Civic Center Plaza, Santa <br />Ana, Cetlfomia 92702; Its officers, employees, agents and volunteens are named as additional Insureds with <br />regard to liability and defense of suits arising from the operations and uses preformed by or an behalf of <br />the named Insured. ...-ro FORM <br />City of Santa Ane SH00.D ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />- THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED N <br />20Civic Center Ptam/ aura Stitt ShCCOy ACCORDANCE WITH THE POLICY PROVISIONS. <br />Santa Ana, CA 92702.1988,,ant City At[orne� <br />rights reserved. <br />Awru Xp (m1wos) 1 of 1 The ACORD name and logo are registered marks of ACORD <br />#S9833967/1119833860 LXMCN <br />