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CERTIFICATE OF LIABILITY INSURANCE <br />°�0/09�20 <br />TYPE OFINSURANLE <br />3" <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 0726293 1- 415 -546 -9300 <br />Arthur J. Gallagher & Co. <br />Insurance Brokers of California, Inc., License #0726293 <br />One Market Plaza, Spear Tower <br />Suite 200 <br />CONTACT <br />NAME: <br />PHONE PAX <br />Eat <br />E -MAIL <br />ADDRESS: <br />INSURERS AFFORDING COVERAGE <br />NAIL# <br />San Francisco, CA 94105 <br />Loan Le <br />INSURER A: AMERICAN ALT INS CORP <br />19720 <br />INSURED <br />Orange County Fire Authority <br />INSURER B <br />EACH OCCURRENCE <br />INSURER C <br />X <br />DAMAGE TIT-RENTED <br />PREMISES Ea occurrence <br />MED EXP(Anyone person) <br />1 Fire Authority Road <br />INSURERD: <br />T 51000 <br />INSURER E: <br />PERSONAL& ADV INJURY <br />Irvine, CA 92602 <br />INSURER F <br />GENERALAGGREGATE <br />nu-s -Olum RUMCCK: <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 />INSR <br />LTR <br />TYPE OFINSURANLE <br />AODL <br />SUBR <br />POLICY NUMBER <br />MMIUDY� <br />MM%UDY/YYYY <br />LIMITS <br />A <br />GENERAL <br />LIABILITY <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE OCCUR <br />$0 SIR <br />VFIS -TR- 0022468 -10 <br />07/01/1 <br />07/01/14 <br />EACH OCCURRENCE <br />$ 1,000,000 <br />X <br />DAMAGE TIT-RENTED <br />PREMISES Ea occurrence <br />MED EXP(Anyone person) <br />$ 1,000,000 <br />T 51000 <br />X <br />PERSONAL& ADV INJURY <br />$ 1,000,000 <br />GENERALAGGREGATE <br />$ 2,000,000 <br />GEN'L AGGREGATE <br />X POLICY <br />LIMIT APPLIES PER: <br />PRO- LOC <br />PRODUCTS - COMP /OP AGO <br />$2,000,000 <br />$ <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />HIRED AUTOS NON -OWNED <br />AUTOS <br />COMBINED SINGLE LIMIT <br />Ea ao:Adenl <br />BODILY INJURY (Paupers.) <br />S <br />BODILY INJURY (Per accident) <br />$ <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />UMBRELLA LIAR <br />EXCESS LIAR <br />OCCUR <br />N/A <br />1 1\ ®`i Y L` �Tq L A <br />T6 F0 <br />EACH OCCURRENCE <br />$ <br />HII-AIMS-MAD <br />AGGREGATE <br />$ <br />DED R <br />WORKERS COMPENSATION <br />AND EMPLOYERS'LIABILITY YIN <br />ANYPROPRIETOR/ EXCLUDED' <br />OFFICEFJMEMBER EXCLUDED? ❑ <br />(Mantlatoryin NH) <br />If yes, IPTIOeantler <br />DESCRIPTION OF OPERATIONS below <br />WC STATU- OTH- <br />TORY LIMITS <br />$ <br />Laura A. Rossini <br />Assistant City <br />Attorney <br />E.L. EACH ACCIDENT <br />$ <br />E.L. DISEASE - EA EMPLOYE <br />$ <br />E.L. DISEASE - POLICY LIMIT <br />$ <br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remark. Schedule, if more space is required) <br />Evidence of coverage in force. Professional Liability included in General Liability coverage. <br />renrrv.Isre u ..-r. _ <br />City of Santa Ana <br />ATTN: Laura Rossini, Sr. Assistant City Attorney <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 />20 Civic Center Plaza, M29 <br />AUTHORIZED REPRESENTATIVE <br />Santa Ana, CA 92702 <br />12 1 <br />IISA <br />/� <br />W 1988 -2070 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD <br />rgreen <br />36314855 <br />