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1'01,4 _.4 (/'-Z -I ) CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDOIYVYV) 09/23/2013 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 ADD Risk services Northeast, INC. MOrristowr NJ Office CONTACT NAME: PHONE (866) 283 -7122 FAX (800) 363 -0105 (AC. No. Eat): AS NO.: 44 Whippany Road, Suite 220 MorristOWM NJ 07960 USA EMAIL ADDRESS: INSURERIS) AFFORDING COVERAGE NAIC If 5094699 INSURED INSURER A: National Union Fire Ins c0 of Pittsburgh 19445 cellCo Partnership dba Verizon Wireless One Verizon Way Basking Ridge NJ 07920 USA INSURER e: X COMMERCIAL GENERAL LIABILITY INSURER O: INSURER D: /q tot tot INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570051309375 REVISION NUMBER: 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. Limits shown are as requested MISS LTR TYPE OF INSURANCE INSR ME POLICY NUMBER POLIC EFF MMIDD P L E MMIODA" ri LIMITS A GENERAL LIABILITY 5094699 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES Eacccurmnce $1,000,000 CLAIMS -MADE [K ]OCCUR MED EXP (Any one parson) $10,000 PERSONAL A ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'LAGCREGATELIMIT APPLIES PER'. PRODUCTS - COMPIOP AGO $2,000,000 X POLICY PRO LOG AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea eccident BODILY INJURY ( Per P..dn) ANY AUTO ALL OWNED SCHEDULED rry A3 rl'�'�AY py TO � �� BODILY INJURY (Per accident) AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS SL`d APPI i_ PROPERTY DAMAGE accident) nN✓ UMBRELLA LIAR OCCUR LISA Attorn y� EACH OCCURRENCE AGGREGATE EXCESS LIAe CLAIMS -MADE Assistant Ci y OED I RETENTION WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN ANY PROPRETOR /PARTNERIEXECUTIVE WC STATU- OTH. TORY LIMITS ER E. L. EACH ACCIDENT OFFICER /MEMBER EXCWOE09 ❑NIA E.L. DISEASE -EA EMPLOYEE (Mandatory in NH) Iry describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ADDED 101, Additional Remarks Schedule, If more space Is reruled) Named Insured also includes LOS Angeles SMSA Limited Partnership dba Veri Zon Wireless by Air touch cellular Its General Partner. RE: Jerome Par( Location No. 250206. city of Santa Ana officers and Jerome Parl(, agents, representatives, employees and volunteers are included as Additional Insured, under the General Liability policy where required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City Of Santa Ana AUTHORIZED REPRESENTATIVE clerk of the council 20 civic Center Plaza M -30 PO box 1988 /f Santa Ana CA 92702 USA A! .0 v 4 a 2 O Z w u L) ©1988 -2010 ACORD CORPORATION. All rights reserved, ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD