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ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM,DO/YYYY) TM 1 10/30/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT — NAME: Mutual Insurance Agency HM oE#:626.795.9595 ac, NO: 626.793.7864 CA License # 0574081 Al, -M ADDRESS: 30 N. Marengo Ave _ INSURER(S) AFFORDING COVERAGE NAIC# _ Pasadena, CA 91101 INSURER A: American States Ins Co 19704 INSURED MDG Associates, Inc. INSURER B: 10722 Arrow Route, Suite 822 INSURERC: Rancho Cucamonga, CA 91730 INSURER D' COVERAGES CERTIFICATE NUMBER: 2013 -2014 GL Auto. Umh RF\ /IRION MIMRPn• THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NSR LTR TYPE OF INSURANCE INSR a V POLICY NUMBER POLICY MMIDDIYYYY EFF POLICY EXP 1 MMIDD /YYYY LIMITS � GENERAL LIABILITY O1CH0671489 071011201310710112014 EACH OCCURRENCE $ 1,000,000 j X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR TDAMAGGETIERI PREMISES Ea occurrence) $ 200,000 MED EXP (Any one person) $ 10,000 A X PERSONAL III ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT.AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OPAGG $ 2,000,000 POLICY PRO LOU JECT $ AUTOMOBILE LIABILITY OICI700]352 07/01/2013 07/01/2014 P. acoldent $ 1,000,000 X ANY AUTO BODILY INJURY (Per person) $ A X ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS X NON -OWNED AUTOS X 8001LV INJURY Per accident ( ) $ -- P�ry�AGi (Per accident) -- $ $ UMBRELLA LIAB X OCCUR 01XS149917800710112013 07/01/2014 EACH OCCURRENCE $ 4,000,000 /� X EXCESS LIAB CLAIMS -MADE X AGGREGATE $ 4,000,000 BED X RETENTION$ 10,000 $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITV ANY PROPRIETORIPARTNER /EXECUTIV VIN OFFICERIMEMBER EXCLUDED? ED NIA T �"�) y{`�?�. $ti. qv 1, . TORY LIMTITS OER E.L. EACH ACCIDENT $ ^E.T. DISEASE - EA EMPLOYE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below ki If ..- - (,V\ EL. DISEASE- POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) The City of Santa Ana, its officers, employees, agelits and volunteers are named Additional Insured, but only as respects the Insureds Operations as it relates to their Signed Contract in regards to the CDBG Administration Consulting Services per Form CG8674 attached. City of Santa Ana Community Development Agency Attn: Terri Eggers, Senior Mgmt. Analyst 20 Civic Center Plaza Santa Ana. CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Paul ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD �-Iii O.Z*_