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� ---ait ® <br />ACOR® CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MMIOnIYYYY) <br />7/23/2013 <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 OONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(SI, AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, <br />IMPORTANT; If the certificate holder Is an ADDITIONAL INSURED, the pollcy(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 lieu of such andorssment(s), <br />PRODUCER <br />COMPLETE EQUITY MARKETS INC <br />1190 Flex Court <br />Lake Zurich TL 60047 <br />Zurich, <br />NAM <br />�oNa 1, ($47)541 -0900 acNO:(047)541 -0444 <br />E- - <br />Ann ss: <br />INSVRER 6) APFOROINO OOVBRAtlE T- <br />_ <br />NAIGfI <br />INSURER A: Underwri tars at Lloyds London <br />INSURED Barbara Echan <br />3056 Madeira Avenue <br />Costa Mesa, CA 92626 <br />INSURER B: <br />INSURER C: <br />INSURER O: <br />INSURER E <br />INSURER P <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br />THIS IS TO CERTIPY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT To WHIOH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLA�..IIIpMpS. <br />Um <br />TYPE OF INSURANCE <br />s <br />POLICY NUMBER <br />M I <br />M IODf/Y <br />LIMITS <br />COMMERMAL OENERALj'L"I�AD11.11! <br />_ CLAIMS -MADE L OCCUR <br />_ <br />IIQMW AS <br />ro k <br />EACH OCCURRENCE <br />it <br />PREMISEeEomurtence <br />$ _ <br />MW EXP A2Lahe p0mon) <br />it <br />PERSONAL &ADV INJURY <br />$ <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />POLICY El JEC C LOO <br />OTHER: <br />GENERAL AGGREGATE <br />$ <br />PRODUCTS - COMPIOP AGO <br />a <br />S <br />AUTOMOBILE LIABILITY <br />ANYAUTO <br />ALL OWNED ggCHEDULED <br />AUTOS AU rps <br />HIRED AUTOS A10)TOSWNED <br />a ri <br />p <br />a <br />I <br />Go accitlent SINGLE <br />$ <br />BODILY INJURY (Par parson) <br />$ <br />BODILY INJURY dcoldmtl <br />S — <br />PHI ar ytDAMA�— <br />$ <br />UMBRELLA LIAR <br />EXCESS LIAR <br />OCCUR <br />CLAIM6 -MADE <br />EACH OCCURRENCE <br />If <br />AGGREGATE <br />$ <br />OED RETENTION$ <br />$ <br />WORKERS COMPENSATION <br />AND EMPLOYER$' LIABILITY y) N <br />ANY PROPRIETORIPARTNeRAOXCOUTIVIR <br />OPROaR1EMaER EKCWDED9 <br />(Mandatory b, Mm <br />IPyaa describe Under <br />DESCRIPTION OF OPERATIONS below <br />NIA <br />STATUTE ER <br />E.L. EACHACCLIT <br />$ <br />F. I. DISEASE - EA EMPLOYE <br />$ <br />EL. DISEASE • POLICY LIMIT <br />I $ <br />A <br />Professional <br />,Liability <br />652764 <br />06/01/13 <br />06/01/14 <br />$1,000,000 Each Claim <br />$1,000,000 Aggregate <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORO 101, Addlllonal Remarks Schedule, maybe attached I more space Is rogto) <br />Please see pages 2 -4 for additional information. <br />The City of Santa Ana <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DFLIVFRED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />1988.2013 ACORD <br />ACORD25(2013104) The ACORD name and logo are registered marks of ACORD <br />