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^1 TORRE-2 OP ID: CB
<br />ATE (MMIDDIYYYY)
<br />CERTIFICATE OF LIABILITY INSURANCE F
<br />506128/207 5
<br />05/28/2 5
<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 pollcy(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 endorsementtsl.
<br />PRODUCER
<br />Incorporated
<br />na Ave #202
<br />CA 92506
<br />Doan
<br />NAMEA"I James Henderson
<br />'HONE .r,951.300-9333 ain u�r 951-300.9332
<br />INSURERA:State Comp Insurance Fund 35076
<br />INSURED TMC Shooting Range Specialist, INSURERS: Everest Indemnity Insurance Co
<br />Inc. IN$URERC:PrOgressive Insurance Companie
<br />27431 Santa Clarita Rd
<br />Santa Clarita, CA 91350 INSURERS:
<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, NOTWrrHSTAN DING 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 MAYHAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSRADULISUB11
<br />LTR
<br />TYPE OF INSURANCE
<br />INSR
<br />MD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MMIDDIVVYV
<br />POLICY EXP
<br />MMIDDIYYVV
<br />LIMITS
<br />GENERAL LIABILITY
<br />EACH OCCURRENCE $ 1,000,00
<br />B
<br />X COMMERCIAL GENERAL LIABILITY
<br />X
<br />X
<br />EF4ML05247151
<br />04/04/2015
<br />04/04/2016
<br />DRESSES Ea occurrence $ 100,00
<br />CLAIMS -MADE 1XI OCCUR
<br />MED EXP (Any one person) $ 5,000
<br />PERSONAL &ADV INJURY $ 1,000,000
<br />GENERAL AGGREGATE $ 2,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />PRODUCTS-COMDOP AGO $ 2,000,000
<br />X POLICY PRO-
<br />JECT E-1LOC
<br />$
<br />AUTOMOBILE LIABILITY
<br />CO MBI NED SINGLE L IMIT 1,000,000
<br />Ea Sect d en[ $ i
<br />BODILY INJURY (Per person) $
<br />C
<br />X ANY AUTO
<br />01704102.2
<br />07/02/2014
<br />07/02/2015
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />BODILY INJURY (Per accident) $
<br />NONOWNEDPROPERTY
<br />HIRED AUTOS AUTOS
<br />DAMAGE $
<br />PER ACCIDENT
<br />Com /Coll ded. $ 50
<br />UMBRELLA LIAB
<br />OCCUR
<br />EACH OCCURRENCE $
<br />AGGREGATE $
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED I I RETENTION$
<br />$
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE Y
<br />OFFICERIMEMBER EXCLUDED?
<br />(Mandatory In NH)
<br />NIA
<br />X
<br />909391915
<br />03/26/2015
<br />03/26/2016
<br />X TWO STATU- OT H-
<br />TORY LIMITS
<br />E.L. EACH ACCIDENT $ 1,000,000
<br />E.L. DISEASE - EA EMPLOYEEI $ 1,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />I
<br />EL. DISEASE - POLICY LIMIT $ 1,000,000
<br />B
<br />Pollution
<br />EF4ML05247151
<br />04/04/2015
<br />04104/2016
<br />Ea. Occur 1,000,000
<br />Ded. 1,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required)
<br />*Ten-day notice of cancellation provided in the event of cancellation due to
<br />nonpayment of premium - no exclusions.
<br />Additional Insured: City of Santa Ana, its officers, agents and employees
<br />are named as Additional Insured as respects to General Liability per
<br />attached policy endorsement, CG 2010, coverage is primary/non-contributory
<br />CERTIFICATE HOLDER CANCELLATION
<br />STNAPOL
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />Cit of Santa Ana
<br />Y
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />P.O. Box 1961, M97
<br />Santa Ana, CA 92702
<br />AUT"RIHORIZ,
<br />,EEDR,E_P,RESENTATIVE
<br />�.�
<br />ACORD 25 (2010/05)
<br />O 1988-2010 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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