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<br />AC40Rb CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MMIDDIYYW)
<br />1/16/2014
<br />THIS ERT
<br />CERTIFICATE
<br />BELOW, T}II3
<br />REPRESENTATIVE
<br />FICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED
<br />OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. if SUBROGATION 1$ WAIVED, subject 40
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights 4o the
<br />certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />Raytaard Tilton C, ROlapp insurance Associates,
<br />CA Dept. of Ins. Lic. #0614365
<br />888 S. Disneyland Dr., Ste 400
<br />Anaheim CA 92802-1846
<br />FTSue Reams
<br />PHON (714)905^1923 AIC 0;1719)905-1910
<br />".suerahtrinsure.com
<br />INSURER(S) AFFORDING COVERAGE NAIC0
<br />INSURER A:Travele s Indemnity CqMany 25658
<br />INSURED i
<br />Mullen &JLAssociates, Inc.
<br />1200 N. Jefferson street
<br />Suite D
<br />Anaheim CA 92807
<br />INSURER RMCGIferred Uployems Ins Co 10900
<br />ISURRC:O S Specialty Ins Co 9599
<br />INSURERO:
<br />INSU
<br />INSURER F:
<br />wwvcnnwcea ....,., ,, ....,... .........-...-___ '__ ___ __.
<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 WHICH THIS
<br />GERTIFICAT MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSION AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAYHAVE BEEN REDUCED BY PAID CLAIMS.
<br />ILSR
<br />TYPE OF INSURANCEhDOL
<br />POLI NUMBER
<br />M DIY
<br />MDDRYX
<br />LIMITS
<br />GENERAL�IASILITY
<br />EACH OCCURRENCE $ 1,000,000
<br />p E U^ e $ 300,000
<br />X COM�(jERCIAL GENERAL LIAOILRY
<br />MEDEXP(An onepors00 $ 5,00
<br />A
<br />Q AIMS.MAOE ® OCCUR
<br />X
<br />Y
<br />5802D291163
<br />7/24/2013
<br />7/24/2014
<br />PERSONAL &ADV INJURY $ I.COO, 000.
<br />GENERAL AGGREGATE $ 2,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER
<br />PRODUCT$ - COMPIOP AGO $ 2,000,000
<br />SINGLE
<br />X POLI IY PRP 10C$
<br />AUTOMOBI PLIABILITY
<br />each ent 1,000,000
<br />BODILY INJURYlPor person} $
<br />ANY UTO
<br />ALL NEr, SCHEDULED
<br />802D291163
<br />7/24/2013
<br />07/24/2014
<br />BODILY INJURY (Per AeddeN) $
<br />AUTO NUN OWNED
<br />iTiOPt �� A E $
<br />P,g,Lgrci n
<br />x HIR AUTOS X' AUTOS
<br />-- $
<br />UMBRELLA
<br />LIAROCCUR
<br />EACH OCCURRENCE $
<br />AGGREGATE $
<br />EXCE,SLIAB
<br />LAIMS.MA,E
<br />LIED I
<br />I P�TENTION$
<br />$
<br />WCST 0TH.
<br />I
<br />WORKERS
<br />OMPENSATION
<br />M
<br />ELEACH ACCIDENT $ 11000,00 0
<br />AND EMPL
<br />YERV LIABILITY YIN
<br />ANY PROPRIL-TORIPARTNERIBECUTIYE
<br />E.L. DISEASE - EA EMPLOYE $ 1,000,22 0
<br />(MandeRNEIUER)EXCLUDE09
<br />NIA
<br />KB133245-8
<br />02/4/2014
<br />02/4/2015
<br />EL. DISEASE ROLICY LIMIT $ 1. 000 000
<br />if
<br />fYyes desc
<br />0e under
<br />N Of OPERATIONS below
<br />C
<br />Profia
<br />Tonal Liability
<br />USS1424571
<br />01/4/2014
<br />01/4/2015
<br />Each Claim Limit 1,000,000
<br />Errorai
<br />& Omissions
<br />i
<br />Set,antion : $15,000
<br />Aggregate 1,000,000
<br />DESCRIPTIONO
<br />City of S
<br />OPERATIONSI LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is mclulred)
<br />nta Ana, its officers, agents & employees are Included as Additional Insured as respects
<br />General Lability
<br />is Primary and Non Contributory per Form CG D381 0907 attached. *CANCELLATION:10-days
<br />Notice fot
<br />Non -Payment of Premium/Non-Reporting of Payroll/30 days for all other reasons.
<br />APPROVED AS TO FORM
<br />('l14) 047
<br />I6956 LUwa Sti�f 5¢(U;tCV__-..�_ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />A. r,istant City Altarpep
<br />THE EXPIRATION BATE TWEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />City of Santa Ana
<br />Pub is Works Agency AUTHORIZED REPRESENTATIVE
<br />Att Su2i P'urjanic
<br />20 Ci.vic Center Plaza, 3r lPlr,
<br />RosAnnex�,.�,,
<br />Sarl a Ana, CA 92701 Sue Reams/ -%,M
<br />ACORD25( 010105) ©1988.2010 ACORD CORPORATION. All rights reserved
<br />I NS075Do rhoµ m Th, Anne n name anW Innn arw ranict oraH marh< of Arvin n
<br />
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