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ACORl7 N CERTIFICATE OF LIABILITY INSURANCE <br />IDDMYYYI <br />DATE FIN 0212762014 <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 SUBROUNTION 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 />Cecil W. Powell & Co. <br />CONTACT Brenda Otto CSSR <br />PHONE 9 904,353,5722 <br />No EX: 04, 353.31 BS UAlc,rvn <br />P.O, drawer 41490 <br />219 Newnan St. <br />Jacksonville, FL 32203 -1490 <br />AoCRESS: Sotto @cwpowe77ins.com <br />IN$URER(S) AFFORDING COVERAGE <br />NAICA <br />_ <br />INSURER A: Lloyds Underwriters at London <br />INSURED ELM, .Inc. <br />INSURER B; <br />1035 Kings Avenue <br />INSURER C: <br />Jacksonville, FL 32207 <br />INSURER D: <br />INSURER E <br />INSURER F: <br />PREMISES (Ea adeurrence <br />$ <br />COVERAGES CERTIFICATE NUMBER: 2014 Prof Liab REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN SSUEO 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 />TRW <br />LTR <br />TYPE OF INSURANCE <br />S <br />D <br />POLICY NUMBER <br />MMIDDRYYY <br />I MWDD"YY <br />LIMITS <br />James C. Coleman 11I CSC6BSO <br />GENERAL <br />LIABILITY <br />EACH OCCURRENCE <br />$ <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS.MADE ❑ OCCUR <br />PREMISES (Ea adeurrence <br />$ <br />MEDEXR(AnYOnBpemon) <br />$ <br />&ADV INJURY <br />$ <br />iPERSONAL <br />GENERAL AGGREGATE <br />$ <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS -COMPIOP AGG <br />$ <br />POLICYi PE0 ,7 LO( <br />$ <br />AUTOMOBILE LIABILITY <br />' <br />En acement) <br />GODLY INJURY (Per person) <br />s <br />ANYAUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />BOD14Y INJURY(Peracoideat) <br />$ <br />NON. OWNED"pRDP6RT9T)AAIiCGE <br />HIRED.AUTOS 'AUTOS <br />" �. <br />Peraccidpnp <br />"$......_...... <br />_ <br />II— <br />$ <br />UMBRELLA LIAR <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />EXCESS UPS <br />117 <br />CLAIM &-MADE <br />AGGREGATE <br />Y <br />OEO 1 1 RETENTIONS <br />—__ <br />Y <br />$ <br />— <br />l-- ____.. -._ <br />WOREMPLOYE COMPENSATION <br />ANO EMPLOYERS' LIABILITY <br />S' LI A ILIT YIN <br />ANY PRGPRIETORIPARTNER /BXECUTIVTrt —}. <br />OFFICEMVFMSER. EXCLUDED? (_f <br />NIA! <br />TORY LIMITS ER <br />EL EACH ACCIDENT <br />S <br />EL. DISEASE.- EA EMPLGYE <br />(Mandatory In NHl <br />If yyos, tlescciba under <br />DE SCRIPTION OF OPERATIONS below. <br />F DISEASE- POLICY UMfP <br />I s <br />Professional Liability <br />ANE10204561 <br />02(2612614 <br />02/2612016; <br />$1,000,000 Limit <br />A <br />Claims Made Policy <br />1 ,$15,.000 Deductible Per Claim <br />I <br />DESCRIPTION OF OPERATIONS I LOCATIONS l VEHICLES' {Aaach ACORD icLAdditlonai Remarks Scalmnia, ifmoresIescols requir"OkP'I,OVED AS TO nrr RIS <br />ffelltt A � YY LL'' JJLLFF P iXE41 <br />-C! <br />Laura A. Rossini <br />Assistant City Attorney <br />CERTIFICATE HOLDER CANCELLATION <br />(91086.2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (201 OJOS) The ACORD name and logo are registered marks of ACORD <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POL.ICYPROVISION$. <br />City of Santa Ana <br />AUTHORIZED REPRESENTATIVE <br />20 Civic Center Plaza, M36 <br />Sarlta Ana, CA 92701 <br />James C. Coleman 11I CSC6BSO <br />(91086.2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (201 OJOS) The ACORD name and logo are registered marks of ACORD <br />