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<br />Fhlla CERTIFICATE OF LIABILITY INSURANCE
<br />DAT3 /26 /2OMW)
<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(les) 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 Wood- Gutmann & Bogart/IIIB
<br />940 Calls Negoclo, Ste. 240
<br />San Clemente, CA 92673
<br />NAME'
<br />PHONE
<br />049 542 -7800 PAC No • 949 542 -7804
<br />EMAIL
<br />O s
<br />INSURER (S) AFFORDING COVERAGE
<br />NAIL N
<br />4/1/2015
<br />INSURER A: SentlnellnsuranceCom an Lttl AXV
<br />11000
<br />www.Integrityint.com
<br />INSURED
<br />Fleldman, Rolapp & Associates
<br />Fieldman, Rolapp Financial Services, LLC
<br />Applied Best Practices, LLC
<br />19900 MacArthur Blvd, #1100
<br />Irvine CA 92612
<br />INSURER e: Indian Harbor Insurance Company AXV
<br />36940
<br />INSURERC:
<br />$ 10,000
<br />INSURER D;
<br />INSURER E:
<br />$ 1,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICY jEG ❑ LOG
<br />OTHER:
<br />OENERALAGGREGATE
<br />$ 2,000,000
<br />INSURER P:
<br />$ 2,000,000
<br />�N�\ r{ gNeltl3: �Ma: ��IMINe \�idUerH- larfiL•GiT,C�LX r {pr16Y1�1. MDILhW: {y ^�
<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 />LT
<br />TYPE OF INSURANCE
<br />A DL
<br />SUER
<br />PGLICYRUMBER
<br />POWCV EPF
<br />TIMID YY
<br />POLICV EXP
<br />MMDO
<br />LIMITS
<br />A
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIM84AOE © OCCUR
<br />�/
<br />728BAAF9892
<br />4/112014
<br />4/1/2015
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />PREMUS"'crou"mrI
<br />$ $00,000
<br />MED ENO (Any one arson
<br />$ 10,000
<br />PERSONAL &ACV INJURY
<br />$ 1,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICY jEG ❑ LOG
<br />OTHER:
<br />OENERALAGGREGATE
<br />$ 2,000,000
<br />PRODUCTS COMP /OP AGG
<br />$ 2,000,000
<br />Deduotlble
<br />$ 0
<br />A
<br />AUTOMOBILE
<br />✓
<br />LIABILITY
<br />ANY AUTO
<br />ALLOWNED SCHECULED
<br />AUTOS AUTOS
<br />HIREDAUTOO ✓ ADN60WNED
<br />LIT S
<br />fired PD
<br />72SBAAFOB92
<br />4/112014
<br />4/1/2016
<br />BINEOSINGLE LIMIT
<br />$ 1000,000
<br />BODILY INJURY (Per parson)
<br />$
<br />BODILY INJURY (Per ecdtlenq
<br />$
<br />PROPERTY DAMAGE
<br />$
<br />Como/Coll Ded. Q1.00 0
<br />$
<br />A
<br />,/
<br />UMBRELLA LIAR
<br />EXCESS LIAO
<br />✓
<br />OCCUR
<br />CMMS -MADE
<br />72SBAAr9892
<br />4/1/2014
<br />4/112015
<br />EACHOCCURRENCE
<br />$ 3,000,000
<br />AGGREGATE
<br />S 3,000,000
<br />DEO I ✓
<br />I RETENiION$10,000
<br />$
<br />WORKER$ COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANY
<br />OFF ICERIMEMWER EXCLUDED7�CUI'IVe ❑
<br />(Mandatory In NH)
<br />If yyess describe under
<br />DESCRIPTION OF OPERATIONS below
<br />NIA
<br />I PER OTH-
<br />a ER
<br />E,L.EACM ACCIDENT
<br />$
<br />E,L, DISEASE. EA EMPLOYEE
<br />$
<br />E.L. DISEASE. POLICY LIMIT
<br />$
<br />B
<br />Errors & Omissions- Claims Made
<br />Retro Date 12/20/04
<br />ELU132492.1a
<br />12/2012013
<br />12120/2D14
<br />$2,000,000 Maximum Aggregate
<br />$250,000 Retention
<br />DESCRIPTION OF OPERATIONS 1 LOCATIONS /VEHICLES (ACORD 101, Additional somerAs Schedule, may be attached If more spaoa Is required)
<br />City of Santa Ana Is named as Additional Insured with respect s General Liability ATiMA per the attached carrier policy endorsements.
<br />City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />Attn: Clerck of the Council ACCORDANCE WITH THE POLICY PROVISIONS,
<br />20 Civic Center Plaza (M -30)
<br />Santa Ana CA 92701
<br />AUTHORI2ED REPRESENTATIVE
<br />I Dan Gorman
<br />©1988.2014 ACORD CORPORATION. All rights reserved
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
<br />�%� (��
<br />CER1' NO., ;9501223 Vail 5Yady-HOa 3/25/2014 10:44,15 AN Page 1 of 7 MAR 2 5 2014r / ✓ � "'"' / /
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