FIELDMAN, ROLAPP & ASSOCIATIONS, INC.-2014

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, 6c Z`® llk. - ✓ V % r CERTIFICATE OF LIABILITY INSURANCE Acct4:1169655 DATE(MMIDDIYYYY) 09/02/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIV EG AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFIC 1- fA�TIVdgELL�Y A CONTRACT BETWEEN THE ISSUING INSURER(S), PRESENTATIVE OR R PRODUCER, AND HE CERT FICAT HOLDERS IMPORTANT: If the certificate holder is ''tt�� I AI��$$ RED the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the 'ain pull ,p�mj(tuire an endorsement. A statement on this certificate does not confer right to the certificate holder in lieu • d *01(6'1 '+ . PRODUCER Lockton Companies, LLC 5847 San Felipe, Suite 320 1/ Houston, TX 77057 ONT CT NAME: SHONE FAX A/C N Ex1): 888- 828 -8366 (A /C, No): DDRESS: INSURER(S) AFFORDING COVERAGE NAIC INSft INSURED ,✓NSURER -A: Ace American Insurance Co. 22667 Insperity, Inc. L /C /F FIELDMAN, ROLAPP & ASSOCIATES, INC. NSURER-13: R 19001 Crescent Springs Drive INSURER -C: INSURER -D: Kingwood, TX 77339 INSURER -E: INSURER -F: COVERAGES CERTIFICATE NUMBER: 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. IN ADDL 3UBR SOUCY EFF SOUCY EXP s INSft We MMIDDIYYYY) MMIOD/YYYY) R LT R TYPE OF INSURANCE POLICY NUMBER LIMITS GENERAL LIABILITY EACH OCCURRENCE DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR PREMISES Ea occurrence MED EXP (Any one pers an $ PERSONAL & ADV INJURY GENERAL AGGREGATE ENT AGGREGATE LIMIT APPLIES PER'. PRO- PRODUCTS — COMP/OP AGO POLICV JECT LOC PROFESSIONAL LIABILITY $ COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED Ea accident $ BODILY INJURY Per Person $ AUTOS AUTOS NON -OWNED BODILY INJURY Per acoldent $ PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ ED RETENTIONS ORKERS COMPENSATION ✓ WC STATU- OTH- A ND EMPLOYERS' LIABILITY X ORV LIMITS R NY PROPRIETORIPARTNERIEXECULVE / IN ✓ C4819087A 10/01/2014 10/0112016 FFICERIMEMBER EXCLUDED? E.L. EACH ACCIDENT $ 1,000,000 NIA MANDATORY IN NH) f yes, describe under E.L. DISEASE —EA EMPLOYEE $ 1,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE — POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS /LOCATIONSNEHICLES (Attach Acord 101, Additional remarks Schedule, if more space is required) FIELDMAN, ROLAPP & ASSOCIATES, INC, APPLIED BEST PRACTICES &FIELDMAN ROLAPP FINANCIAL SERVICES, LLC (3076300) IS INCLUDED AS A NAMED INSURED THROUGH ENDORSEMENT. BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE CITY OF SANTA ANA DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS AUTHORIZED REPRESENTATIVE CLERK OF THE COUNCIL 20 CIVIC CENTER PLAZA (M -30) SANTA ANA, CA 92701 r „ ✓ �' -�^ ACORD 25 (2010105) ©1988 -2010 ACORD CORPORATION. All Rights Reserved. The ACORD name and logo are registore0 marks of ACORD