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Client#:1259431
<br />305CORDOCOR
<br />ACORD,. CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MMIDOIYYYV)
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />1/17/2014
<br />THIS CERTIFICATE IS ISSUED ASA 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 I CONTACT
<br />Christy Mata
<br />BB&T Insurance Services PHONE 714 578.7370 FAX
<br />Ext: AIC, No:
<br />of Orange County IA E DMA Lo
<br />DRESS: CMata@bbandt.com
<br />680 Langsdorf Drive Suite 100
<br />INSURER(S) Property
<br />AFFORDING Casualty CoE NAIC p
<br />Fullerton, CA 92831 INSURER A, Travelers Property Casualty Co 25674
<br />INSURED INSURER 8:
<br />Cordoba Corporation
<br />INSURER C:
<br />1401 N. Broadway if OC.� o//._. {� 3 INSURER D:
<br />1.1 / J
<br />Los Angeles, CA 90012
<br />INSURER E:
<br />P���������
<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 CONTRACTOR 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 />ILTRR
<br />TYPE OF INSURANCE
<br />NSB
<br />SUSR
<br />MD
<br />POLICY NUMBER
<br />MMIDDIVYYV
<br />POLICY EXP
<br />LIMITS
<br />A
<br />GENERAL LIABILITY
<br />6306CO2815114
<br />01/20/2014
<br />01/20/201
<br />EACHOCCURRENCE $1,000,00-0
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE Ai OCCUR
<br />DAM E RENTED
<br />PRE E Ea occurrence $366,6-0-0
<br />MED EXP (Any one person) $5,000
<br />PERSONAL&ADV INJURY $1,000,000
<br />GENERAL AGGREGATE 52,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />PRODUCTS - COMPIOP AGO $2,000,000
<br />X POLICY JECT LOC
<br />$
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />8106C82815114
<br />01/20/201401120/201
<br />BIN
<br />Fe aJc,EDSINGLE LIMIT
<br />Ea Et $1,000,000
<br />BODILY INJURY (Par person) $
<br />X
<br />ANY AUTO
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />BODILY INJURY (Par accident) $
<br />X
<br />HIRED AUTOS X NON -OWNED
<br />AUTOS
<br />_
<br />PROPERTY DAMAGE $
<br />Par accident
<br />A
<br />XUMBRELLALIAB
<br />X
<br />OCCUR
<br />CUP6C82815114
<br />01120/2014
<br />01120/2015
<br />EACH OCCURRENCE $10000000
<br />AGGREGATE $10 006 006
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED RETENTION $
<br />_
<br />$
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANY PROPRIETOR/PARTNERIEXECUTIVE
<br />OFFICER/MEMBER EXCLUDED? �
<br />(Mandatory In NH)
<br />f,, describe under
<br />DESCRIPTION OF OPERATIONS be
<br />NIA
<br />U136CB7099214
<br />�g �p rpgq �^p�rq.+q+�
<br />y-1%'&'ROVE_L/'
<br />01/20/2014
<br />5
<br />AS �'`^'�
<br />01/20/2015
<br />e'
<br />y��k �
<br />X WCSTATU- OTH-
<br />E
<br />E.L. EACH ACCIDENT $1000000
<br />E.L. DISEASE - EA EMPLOYEE $1,000,000
<br />E.L. DISEASE POLICY LIMIT $1,000,000
<br />l/
<br />LISA E,
<br />ST11 K
<br />DESCRIPTION OF OPERATIONS (LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required)
<br />Certificate Holder is named as Additional Insured, as respects General Liability, as required by written
<br />contract per the attached form CGD4140408 pg 1 and 2 of 2.
<br />Additional Insured amended to include the following: The City of Santa Ana, 20 Civic Center Plaza, Santa
<br />Ana, California 92702; its officers, employees, agents and volunteers are named as additional insureds with
<br />regard to liability and defense of suits arising from the operations and uses preformed by or on behalf of
<br />the named insured.
<br />City of Santa Ana
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92702.1988
<br />ACORD 25 (2010105) 1 of 1
<br />#S11695431/M11693570
<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 />&)z
<br />@ 1988-2010 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />LXMCN
<br />
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