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CERTIFICATE OF N_IAN3NN_NTY INSURANCE,03192
<br />nraol=l
<br />I..lYYYY)
<br />3121/2013
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OP 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 policy(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 endorsement(s),
<br />PRODUCER Lockton Insaranee BrOkErS, IA,C _
<br />CONTACT
<br />19800 MtaeArthur Blvd., State 1250
<br />CA License HOF 15767
<br />Irvine 92612
<br />PHONE
<br />(_ALC N_o-Exl), ,,,_..____.
<br />EMAIL
<br />-ADDRESS;__,_,,___ _._.....,.___.......-
<br />949-252-4400
<br />INSURERS AFFORDING COVERAGE SAID
<br />INSURER A rTraveldrs Property Casualty Cu ofAmoricu 25674
<br />NO I APPLICABLE
<br />_
<br />INSURE. AHCONT Tachno IDgy Corporation
<br />INSURER. r
<br />i. ii_.
<br />1075642 AECOYT Technical Services, Inc.INSURER
<br />2727 (,am[IU9 IiriVD
<br />Irvine CA 92612
<br />INSURER 0'
<br />INSURER E:
<br />INSURER F
<br />COVERAGES AECTFOI. CERTIFICATE NUMBER: 11729371 REVISION NUMBER: XXXXXXX
<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 />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 MAY HAVE BEEN REDUCED BY PAID CLAIMS,
<br />RISE
<br />TYPE OF INSURANCE
<br />ADDL NSR
<br />S
<br />MO
<br />I POLICY NUMBER
<br />MOUC YSEE
<br />FMIDONYP
<br />POLICY EXP
<br />POLICYYVYY
<br />LIMITS
<br />GENERAL LIABILITY
<br />20 Civic Center Plaza, 2I-36
<br />NO I APPLICABLE
<br />Santa Ana CA 92701a�^--,—
<br />EACH OcCURRENaaE
<br />DAMAGE TO RENTEO
<br />1 `XXXXXX
<br />MMERCIAL GFN2 WS6y1pBILiTY
<br />MED Far JAp1.11k FaNrsan' .9...1X ......................_
<br />'_
<br />CLAIMSMAOE OCCUR
<br />LJ
<br />PERSONAL &ADV INJURY S XXXXX,`CX
<br />GENERAL AGGREGATE 5 XXXXXXX
<br />GENL AGGREGATE LIMIT APPLIES
<br />�
<br />PER:
<br />PRODUCTS -COMRADE GG $ XXXXXX
<br />$
<br />PRO-
<br />POLICY EC'r
<br />LOC
<br />___
<br />AUTOMOBILE LIABILITY
<br />NOT APPLIG,ABEE 4N
<br />m.,..-TCOM81NED
<br />SINELELIMIT---
<br />IM(Eenxidmt) 5 XXX XXX
<br />(E. nxidma)
<br />BODILY INJURY (Per person) S x ' XX'xX
<br />ANY AUTO
<br />1 ALL OWNED SCHEDULED
<br />(AUTOS tAUTO$
<br />i HIRED AUTOS NON AUIO3WNE.
<br />eOGLY INJURY.Paraenldaai $XXXXXXX
<br />PROPERTY DAMAGE $XXXXXxx
<br />$ XXXXXX:t
<br />UMBRELLA LIAB ___
<br />OCCUR
<br />_
<br />NCYI APPLICABLE
<br />EACH OCCURRENCE $ X XXXXXX
<br />EXCESS UAB I
<br />CLAIMS -MADE
<br />AOGRFGATE S , XXX. X
<br />DED RETENTION 5
<br />xxxxxxx
<br />A
<br />A
<br />A
<br />.A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANYPROPHIETOPoPARTNERIEXECUTIVE YIN
<br />OFF ICERIMEMBEREXCLUDED'
<br />(MandravyinAD)
<br />If yes', describe under
<br />DC-SCRIPTIONOFOPE TI NSbel.
<br />N!A
<br />Y
<br />TRJ1 B-424513231.13
<br />((AI1bN)
<br />TC2JLB4245H32V13
<br />(AllOtherstales)
<br />4,1'2013
<br />4/1/2017
<br />471/2014
<br />4W1!2014
<br />4 'fA TW
<br />.1' TORYUMIT Eft
<br />E.L. EACH ACCIDENT S 1.000.000
<br />„
<br />FIT, DISEASE -EAEMPLOYEE $j000000
<br />EL, ODEASE, POLICY LIMIT $ 1.000,000
<br />Urn It
<br />DESCRIPTION OF OPERATIONS lLOCATIONS IVENICLES(AHWhACORD 101 Addalonal Remarks Sshedule,f,aMd spade N UNe I
<br />red
<br />Noted ofC,anecllauon applies per anaahed endorsement. PH: 60196303 Santa Ana Blvd Grade Seperntien
<br />O
<br />a J1,y",liS^c0'
<br />CERTIFICATE HOLDER CANCELLATION See Attachments
<br />AGOKU ZO (2,U1 UIU51 Tho ADDED name and togo are rogistarod marks of ACON. ATC 1988.2010 ACORD CORPORATION. All rights reserved
<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 />11729371
<br />AUTHORIZED REPRESENTATIVE.
<br />Cityof Santa Aria.
<br />Public Works Agency
<br />Jason Gabriel
<br />20 Civic Center Plaza, 2I-36
<br />Santa Ana CA 92701a�^--,—
<br />AGOKU ZO (2,U1 UIU51 Tho ADDED name and togo are rogistarod marks of ACON. ATC 1988.2010 ACORD CORPORATION. All rights reserved
<br />
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