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Client#: 1259431 <br />305CORDOCOR <br />ACORD,. CERTIFICATE OF LIABILITY INSURANCE <br />OAODIYYYY) <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />9/125/22512013 <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(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 endorsement(s). <br />PRODUCER <br />CONTACT Christy Mata <br />BB&T Insurance Services <br />PHONE 714 578.7370 <br />E ANo,Ext: AIC, No: <br />of Orange County <br />ADDRESS: CMata@bbandt.com <br />680 Langsdorf Drive Suite 100IL <br />EACH OCCURRENCE <br />$ <br />INSURERS) AFFORDING COVERAGE <br />NAIC# <br />Fullerton, CA 92831 <br />INSURER A: Lloyds of London <br />FOREGN <br />INSURED <br />INSURER B: <br />Cordoba Corporation -aoOy_0��. <br />INSURER C: <br />CLAIMS -MADE F—I OCCUR <br />1401 N'Broadway <br />Los Angeles, CA 90012'/-aGe�l3?� <br />INSURER D: <br />INSURER E: <br />/.dam <br />$ <br />PERSONAL &ADV INJURY <br />$ <br />I INSURER F: <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br />THIS IS TO CERTIFY TRA1"THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE INSURED NAMEDABOVE FORTHE 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 />ITR <br />TYPE OF INS11pANCE <br />NSRADDLSUSR <br />MID <br />POLICY NUMBER <br />MMIDIOIYYYV <br />MMI�I�IYYYY <br />LIMITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ <br />PREMISES Eaoccurrence <br />$ <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE F—I OCCUR <br />MED EXP (Any one person) <br />$ <br />PERSONAL &ADV INJURY <br />$ <br />GENERAL AGGREGATE <br />$ <br />GEN'L AGGREGATE LI MIT APPLIES PER: <br />PRODUCTS - COMP/OP AGS <br />$ <br />POLICY PRO <br />JECT - LOC <br />$ <br />AUTOMOBILE <br />LIABILITYaA.Aa`4A <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />HIRED AUTOS OS NON -OWNED <br />q -9,'V` y <br />s0 1"' <br />Vv <br />'�� NJRO(paPEbenl <br />ONMINEDSINGLE LIMIT <br />$ <br />BODILY INJURY (Per person) <br />$ <br />BODILY INJURY (Per accident) <br />$ <br />D AMAGE <br />$ <br />� <br />~J ` <br />UMBRELLA LIAB <br />EXCESS LIAB <br />OCCUR <br />CLAIMS -MADE <br />-'C <br />„ YU GOtt1 1�1�p( <br />`yi`aU (malty <br />$s1st" <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />DED RETENTION$ <br />$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />NIA <br />WC STATUS OTH- <br />ER <br />E.L. EACH ACCIDENT <br />$ <br />E.L. DISEASE - EA EMPLOYEE <br />$ <br />(Mandatory in kin <br />If yes, describe under <br />DESCRIPTION OF OPERA MS below <br />E.L. DISEASE -POLICY LIMIT <br />$ <br />A <br />Professional Liab <br />B0621PCOR03213 <br />09/27/2013 <br />09/271201A <br />$1,000,000 Per Claim/Ag <br />"Claims Made" <br />Ded: $25,000 Per Claim <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) <br />Verification of Insurance <br />City of Santa Ana <br />20 Civic Center Plaza <br />Santa Ana, CA 92702-1988 <br />ACORD 25 (2010/05) 1 of 1 <br />#S11122359/M11122300 <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 />© 1988-2010 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />LXMCN <br />