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Ac CERTIFICATE OF LIABILITY INSURANCE ` o D ) 02 /13 /201 4 PRODUCER RICHARD DONG, AGENT (949)855 -1310 27772 Vista Del Lago, Suite 20 Mission Viejo, CA 92692 THIS CERTIFICATE IS ISSUED AS MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. ._AGGREGATE TYPE OF INSURANCE POLICY NUMBER ... POLICY EXPIRATION DATE (MMIDD/YY) LIMITS L INSURERS AFFORDING COVERAGE NAIC # 25151 INSURED INSURERA'State Farm General Insurance Company 25151 INSURERS State Farm Mutual Auto Insurance Company 25178 25176 APA ENGINEERING 9880 IRVINE CENTER DR $ 1,000,000 IRVINE CA 92618 -4353 INSURER MED EXP (Any one person) INSURER D' INSURER E'. VER 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 LIR �__ INSRD] ._AGGREGATE TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM /DDIYV POLICY EXPIRATION DATE (MMIDD/YY) LIMITS A X GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY 92- BQ- FO64 -9 06/19/2013 06/19/2014 EACH OCCURRENCE $ 1,000,000 DAMAGE RENTED PREMISES Ear occurrence)$ 300,000 MED EXP (Any one person) S 5,000 CLAIMS MADE OCCUR PERSONAL S ADV INJURY $ 110001000 GENERAL AGGREGATE $ 2, 000, 000 GEMLAGGREGATELI ITAPPLIESPER PRODUCTS- COMP,OPAGG $ 2,000,000 X PRO POLICY JECT LOG B AUTOMOBILE LIABILITY 321 4094-FO5-75 06/05/2013 06/05/2014 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 'X ANY AUTO - -- - - -- X BODILY INJURY (Per person) ALL OWNED AUTOS $ X SCHEDULED AUTOS -- -- X BODILY INJURY (Peraccident) HIRED AUTOS $ X NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY APPROVED A TO AS ORM AUTO ONLY - EAACCIDENT $ ANY AUTO OTHER THAN EA ACC AUTO ONLY AGO S $ EXCESSIUMBRELLA LIABILITY OCCUR CLAIMS MADE _. _._ Laura A,ssistani EACH OCCURRENCE $ Stitt 6heedy City Attorney AGGREGATE $ $ S DEDUCTIBLE $ RETENTION $ WCSTATU- OF WORKERS COMPENSATION AND TORY LIMITS ER EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE E L EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? EL DISEASE - EA EMPLOYEE $ EL DISEASE - POLICY LIMIT $ I(yes, descrbe undar SPECIAL PROVISIONS below X OTHER BUILDING COVERAGE 92- BQ- FO64 -9 06/19/2013 06/19/2014 $787,800.00 Replacrnent Cost DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER IS LOSS PAYEE AND MORTGAGEE I cm Iri iAI a nui_ I r, - -""--- - "' - -- City of Santa Ana S SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 20 Civic Center Plaza D DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Santa Ana, CA 92701 N NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE RICHARD DOING their res ec Ive owners y P All rights reserved 132649 03 -13 -2007