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A� D CERTIFICATE OF LIABILITY INSURANCE
<br />3/6/2013y'
<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 holderin lieu of such endorsement(s).
<br />PRODUCER
<br />SPIB Insurance Agency, Inc.
<br />License Number 0719264-
<br />26441 Crown Valley Parkway#200
<br />Mission Viejo CA 92691
<br />NAME:Amy Alberding
<br />PHONE
<br />Et: (949)582-5220 AIC No:(949)582-3512
<br />INSURERS AFFORDING COVERAGE
<br />NAICa
<br />INSURERA:Peerless Insurance Co
<br />24198
<br />INSURED
<br />Rue Vac Property Services Inc
<br />600 W. Taft Avenue
<br />Orange CA 92865
<br />INsultgr he Netherlands Insurance CE,
<br />24171
<br />imuRERc:Golden Eagle Insurance Corp.0836
<br />INSURERO:State Comp Insurance Fund
<br />10
<br />INSURERE:
<br />INsuRERF:
<br />149•19:C194-�Ma:�ll]IMG\\a PU11Ar:1aaFluh�YC�IF91Bii$ilMSR11uP.�rly//1961J�A1$„e :
<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 W1ICH 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 />ILTR
<br />TYPE OF INSURANCE
<br />A
<br />POLICY NUMBER
<br />POLICY EFF
<br />M DOIYYYY
<br />POLICY EXP
<br />MMIDDIYYYY
<br />LIMITS
<br />GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 1,000,00
<br />PREMISES Esoccunoncol
<br />$ 100,000
<br />X COMMERCIAL GENERAL LWBILRY
<br />A
<br />7 CLAIMS -MADE aOCCUR
<br />869558563
<br />/1/2013
<br />/1/2014
<br />MED EXP(Any one person)
<br />$ 5,000
<br />PERSONAL &AOV IN.4IRY
<br />$ 1,000,000
<br />GENERAL AGGREGATE
<br />IF 2,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />PRODUCTS-COMP/OP AGG
<br />$ 2,000,000
<br />X POLICY 7 PRO- LOG
<br />$
<br />AVrOMOSILE
<br />LIABILITY
<br />Ea arc,lent) IP! Le LIMI
<br />11000,00
<br />B
<br />BODILY INJURY(Par peraoni
<br />$
<br />JX
<br />NJTOSSCHEDULED
<br />191066
<br />/1/2013
<br />/112014AUTOS
<br />BODILY INJURY (Par oacidenl)
<br />8
<br />HIREDAUTOG X NON-OMED
<br />PROPERTY DAmAG
<br />PorecciCOMP
<br />$AUTOS
<br />Underneured metonst grope
<br />$
<br />PER SCH X COLL PER SCH
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 2,000,000
<br />AGGREGATE
<br />$ 2,000,000
<br />L.
<br />X
<br />EXCESS LIAB
<br />CLAMS -MADE
<br />�139558863
<br />DED I I.RETENTION$
<br />$
<br />/1/2013
<br />/1/2014
<br />D
<br />WORKERS COMPENSATION
<br />-
<br />X IC STATU. OTH-
<br />T MITS I BE
<br />AND EMPLOYERS' LIABILITY YIN
<br />E L. EACH ACCIDENT
<br />$ 1 000 000
<br />ANY PROPRIETORFARTNEREHENTIYE
<br />OPFIr.ERIMEMOER EXCLODED?
<br />(MandalaNIn NH)
<br />NIA
<br />036319-13
<br />/1/2013
<br />/1 /2014
<br />E.LDISEASE-EAEMPLOYE
<br />$ 1,000,000
<br />�ES�RIFTION OF OPERATIONS Below
<br />E.L. DISEASE- POLICY LIMIT
<br />$ 1,000,000
<br />A
<br />PROPERTY, SPECIAL FORM
<br />BP9558563
<br />/1/2013
<br />/1/2014
<br />BUILDING 1,248,460
<br />REPL.COST $1000 DID
<br />BUSINESS PEPS PROPERTY 104,040
<br />DESCRIPTION OF OPERATIONS I LOCATIONS t VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required)
<br />^ RE: SANTA ANA REGIONAL TRANSPORTATION CENTER, 1000 E. SANTA A14A BLVD., SANTA ANA, CA.
<br />THE CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS, VOLUNTEERS AND RESPRESENTATIVES ARE NAMED AS
<br />ADDITIONAL INSUREDS WITH RESPECT TO GENERAL LIABILITY AS PER COMPANY FORM CG2010 07/04 AND CG2037 07/04,
<br />PER WRITEN CONTRACT PRIMAWr T BTfoTTP,:t�Ugq� YIWQM3:Tj., IS PROVIDED IN FORM ii 22-111 01/07,
<br />Assistant
<br />THE CITY OF SANTA ANA
<br />20 CIVIC CENTER PLAZA
<br />SANTA AKA, CA 92701
<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 />Hines, CPCU ARM CLU
<br />ACORD 25 (2010105)
<br />OO 1988-2010ACORDCORPORATION. Allrinhte
<br />INSUZS (201005)01 The ACORD name and logo are registered marks of ACORD
<br />
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