HODGES LACY & ASSOCIATES, LLC - 2014

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OP ID: SG � CERTIFICATE OF LIABILITY INSURANCE °02 /11 /2 14 02!1112014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER John J. Matsock & Assoc. Inc. 1750 N Washington Street CONTACT NAME: PHONE FAX IMC, No Bet: _lac No: _ — ADDRESS: Naperville, IL 60563 Steven L. Monteith _ PRODUCER LU$TOMER ID k_HODG E "2 _ I5 2,000,00 A INSURERISI AFFORDING COVERAGE NAICN INSURED Hodges Lace & Associates, LLC 9 Y Hartford Insurance Company INSURER 29424 19647 Valle View Or Y Topanga, CA 90290 -- _ INSURER B — - - - "- INSURER C INSURER D INSURER 5. S 2,000,00 _.. INSURER F: r:r1VFRAfFC CFRTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTE TYPE OF INSURANCE ADDL SUER? POLICY NUMBER POLICY EFF POLICY EXP MMIDDIVYI'Y MMIDDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE I5 2,000,00 A X .COMMERCIAL GENERAL LIABILITY X 83SBVX6302 0572012013 051 20/2014 --- OAMAGETORENT €D PREMISES Ea occunenc - - S 300,00 I MED EXP (Any one person) CLAIMS MADE �X ] OCCUR S 10,00 PERSONAL &ADV INJURY S 2,000,00 _.. GENERALAGGREGATE 5 4,000,00 PRODUCTS - COMP/OP AGG GEN'L AGGREGATE LIMIT APPLIES PER S 4,000,00 -- S X I POLICY PRO' DOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ I- (E. c. dent) I ANY AUTO BODILY INJURY (Per person) S ALLOW'NEDAUTOS BODILY INJURY (Peraccident) 5 SCHEDULED AUTOS S Pg)1P (,{8y@ff}PAMAGE IIPER�CCIDENT)..._ HIRED AUTOS NON OWNED AUTOS ,YII �UV i -Lam' _ _ __$. _ A Yl UMBRELLA LIAB OCCUR -EACROCCURRENCE $ - LIAB CLAIMS -MADE _ Cl GEXCESS 8 _ 3UL` 4ltOr 8 DEDUCTIBLE "'. (�,1lsi RETENTION $ S5 idd , WORKERS COMPENSATION WCSL T OTH- TORY LIMITS __ _ ER AND EMPLOYERS' LIABILITY YIN ANY PROPRI E70RII-ARTNERIEXECUTIVE E.L. EACH ACCIDENT $ - OFFICERIMEMBER EXCLUDED? ❑ NIA? - -_- — — - IMandatoryin NH) '. E. L. DI $EASE EA EMPLOYEE $ If yes descrite under i DESCRIPTION OF OPERATIONS Del. I E.L. DISEASE - POLICY LIMIT , $ A Property Section 83SBVX6302 0512012013 05/20/2014 Ded $250 1,00 DESCRIPTION OF OPERATIONS? LOCATIONSI VEHICLES ?Attach ACORD 101, Additional Remarks Schedule, if morespace is required) DITIONAL INSURED WITH RESPECTS TO GENERAL LIABILITY PER WRITTEN CONTRACT: CITY OF SANTA ANNA, ITS OFFICERS, EMPLOYEES, AGENTS, VOLUNTEERS AND REPRESENTATIVES "TED; INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO THE TERMS AND CONDITIONS OF SUCH POLICIES" rconnr ATE HOLDER CANICFI I ATION SANTAAN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF SANTA ANNA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 20 CIVIC CENTER PLAZA SANTA ANNA, CA 92702 AUTHORIZED REPRESENTATIVE .A ..R -Ii ©1988.2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD