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<br />CERTIFICATE OF LIABILITY INSURANCE DAT0513011 Y7
<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 Ileu of such endorsement {s),
<br />PRODUCER Phone: 925.860.7050 NAME
<br />HUB International Insurance Fax: 925 - 366-8275 m o
<br />INSURER A. Peeriesa mairanp* Dompmry 2499$
<br />IwsuREO EHS internatlonai, Inc.
<br />Golden 8aeta inauranae Carp
<br />26741 Portola Parkway
<br />INSURER -8 10$30
<br />Suite 1E #823 INSVRERC Preferred Employers In., Co. _ 10900
<br />_ _
<br />Foothill Ranch, CA 92810.1783 INSURER D: Admiral Inauranae Company 24$58
<br />INSURER E:
<br />INSURER _F__
<br />COVERAGES CERTIFICATE NUMBER: 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 />RSR- aDt "aua POLSOYYY al7LT('.Y E%P UMRS
<br />L?5, TYPE DF INSURANCE :;6..YRUD. POLICYNUMEER ;",�1140LI t.TY7 .dMa�trioayrr.�! _
<br />GENERALLIABadTY EACHCCCURRENOE $ 1,000,0
<br />oAMA'R7'RENTr35 ... —_
<br />A X COMMERCIAL GENERAL LIABIUTV X �CBP9599092 06101114 PREMSes tEemaunanc) S_ 100,0
<br />.� CLAIMS MADE X OCCUR I pRgq{�'y, MED EXP (anyone parson) $ 6,0
<br />PERSONAL* aavINJURY $ 1,000,0
<br />GENERAL AGGREGATE $ 2,600,0
<br />,,..., ----- ._.. . .. .
<br />GENL AGGREGATE LIMIT APPLIES PER i �tT aN' PRODUCTS- COMPIOP ACC S 1,000,0
<br />X POLICY I 1 Frtn" Loc - .jpS!8� pfT+t"
<br />_....,„,.„.,.
<br />AUTOMOBILE LIABILITY b.�t�l. +e`J [CPOMBINED SINGLE LIMIT
<br />1,OOQ0
<br />,MInf„nt
<br />A _ ANYAU'r0 PB809 06101113 06101114 BODILY INJURY (Par person) $
<br />_ AUTOS
<br />ALLOWNED _ AUTOS
<br />BODILY INJURY (Per accltlenn $
<br />NON"OWNED PROPERTY DAMAGE
<br />X HIREDAUTOS X AUTOS ip -,Itla n $
<br />Dad
<br />X UMBRELLA LIAB .00CUR - _ EACH OCCURRENCE
<br />B EXCESS UA9 CLAIMS -MADE CU8738010 06101113 06101114 AGGREGATE. s 2,000,0
<br />OEDX
<br />STATU OTH,
<br />WORKERS COMPENSATION 1 X TORY
<br />AND EMPLOYEAV LIABILITY
<br />C ANY PROPRIETORIPARTNEWE XECUTIVEY /N KN118028.11 06101/13 06101114 E.L. EACH ACCIDENT $ 1,000,6
<br />OF%CERIMEMBER EXCLUDED? F] NIA
<br />(Mandatory In NH) E.L. iDISEASE- EA EMPLOYEE)$ 1,000,6
<br />DESCRIPTION OF OPERATIONS I LOCATIONS) VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more spec* Ix r*RUlred)
<br />Cho City of Santa Ana, its officers, agents, volunteers and employees are
<br />named as Additional Insured with respect to General Liability as required by
<br />mitten contract per the attached. Snoured'a General Liability coverage is
<br />Primary and Non - Contributory.
<br />Briza Morales
<br />City of Santa Ana
<br />Risk Management, M28
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92701
<br />CITYSA5
<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 />AUTHORIZED REPRESENTATIVE
<br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
<br />
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