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s iz °® CERTIFICATE OF LIABILITY INSURANCE <br />�� <br />­DATE 0 /29 /DD013 <br />10/29/2013 <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 Li Zette Barges <br />Amorelli, Rosemann & Assocaites Insurance <br />RHONE ExtI. (909) 987 -7600 F' Nor (909)997-7656 <br />3333 E Concours St <br />EMAIL <br />ADDRESS.lizetteb@arainsurance.com <br />Building 9 -200 <br />INSURERS AFFORDING COVERAGE <br />NAIC# <br />INSURERA:State Compensation Insurance <br />35076 <br />Ontario CA 91764 <br />INSURED <br />INSURER B <br />$ <br />INSURER C: <br />Mdg Associates, Inc. <br />INSURER D: <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />POLICY 7 PRO- LOG <br />10722 Arrow Route Ste 822 <br />INSURER E <br />$ <br />1 INSURER F: <br />AUTOMOBILE <br />Rancho Cucamonga CA 91730 <br />COVERAGES CERTIFICATE NUMBER:CL135606768 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 />INSR <br />LTR <br />rypE OF INSURANCE <br />ADDL <br />SUBR <br />POLICY NUMBER <br />POLICY EFF <br />MMIDD/YYYY <br />POLICY EXP <br />MMIDDM'VY <br />LIMITS <br />GENERAL LIABILITY <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE OCCUR <br />COMMUNITY DEVELOPMENT AGENCY <br />20 CIVIC CENTER PLAZA <br />SANTA ANA, CA 92701 <br />EACH OCCURRENCE <br />$ <br />DAMAGE TO RENTED <br />PREMI E E ,U1 ence <br />$ <br />MED EXP(Any one person) <br />$ <br />PERSONAL & ADV INJURY <br />$ <br />GENERAL AGGREGATE <br />$ <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />POLICY 7 PRO- LOG <br />PRODUCTS - COMP /OP AGG <br />$ <br />$ <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />ALLOWNED F7 SCHEDULED <br />AUTOS AUTOS <br />NON-OWNED <br />HIRED AUTOS AUTOS <br />COMBINED SINGLE LIMIT <br />Ea accident <br />BODILY INJURY (Per person) <br />$ <br />BODILY INJURY (Per accident) <br />$ <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />UMBRELLA LIAR <br />EXCESS UAB <br />OCCUR <br />CLAIM .MADE <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />DED I I RETENTION <br />$ <br />A <br />WORKERS COMPENSATION <br />ANDEMPLOYERS'LIABILITY Y/N <br />ANY PROPRIETORIPARTNERIEXECUTIVE <br />OFFICERIMEMBER EXCLUDED? ❑ <br />(Mandatory In NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />NIA <br />1634190 -13 <br />5/1/2013 <br />5/1/2014 <br />X NI STATU- CEH- <br />E.L. EACH ACCIDENT <br />$ 1,000,000 <br />E.L. DISEASE - EA EMPLOYEE <br />$ 1,000,000 <br />E.L. DISEASE - POLICY LIMIT <br />$ 1r000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) <br />PROOF OF INSURANCE FOR CERTIFICATE HOLDER. <br />CERTIFICATE HOLDER CANCELLATION <br />ACORD 25 (2010105) <br />INSD25 mn1nn51 n1 <br />© 1988 -2010 ACORD CORPORATION. All rights reserved. <br />Th. ACr1RfT namn and Innn oru rnnicknroA ri of ACr1Rn <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 />CITY OF SANTA ANA <br />ATTN: TERRI EGGERS, SENIOR MNGMT. ANALYST <br />AUTHORIZED REPRESENTATIVE <br />COMMUNITY DEVELOPMENT AGENCY <br />20 CIVIC CENTER PLAZA <br />SANTA ANA, CA 92701 <br />Priscilla Udave /UDAVEdJ <br />ACORD 25 (2010105) <br />INSD25 mn1nn51 n1 <br />© 1988 -2010 ACORD CORPORATION. All rights reserved. <br />Th. ACr1RfT namn and Innn oru rnnicknroA ri of ACr1Rn <br />