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�`� " CERTIFICATE OF LIABILITY INSURANCE <br />DATE /2014 VW) <br />97117/20,4 <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 policy(ies) 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 <br />MARSH USA, INC <br />445 SOUTH STREET <br />CONTACT <br />NAME: <br />PHONE FAX No <br />E -MAIL <br />AOORESS: <br />MORRISTOWN, NJ 07960 -6454 <br />Attn: Morristown, cedrequest @marsh,com Fax 212- 948 -0979 <br />INSURER (S) AFFORDING COVERAGE <br />NAIC p <br />INSURER A: National Union Fire Ins, Co. of Pittsburgh, Pa. <br />$ <br />123456 -- PROFE -14 -15 <br />INSURED <br />York Insurance Acquisition, LLC <br />INSURER B: <br />INSURER C: <br />and its Subsidiaries <br />99 Cherry HIII Road, Suite 102 <br />Parsippany, NJ 07054 -1102 <br />INSURER D <br />CLAIMS -MADE F7 OCCUR <br />INSURER E: <br />INSURER F: <br />MED EXP (Any one person) <br />$ <br />COVERAGES CERTIFICATE NUMBER: NYC-006901750 -01 REVISION NUMBER:1 <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 />INSRR <br />TYPE OF INSURANCE <br />ADDL <br />SUBR <br />POLICY NUMBER <br />MMIDDY <br />MMIOOY� <br />LIMITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ <br />COMMERCIAL GENERAL LIABILITY <br />DAMA E 0 RENTED <br />PREMISES Ea occurrence <br />$ <br />CLAIMS -MADE F7 OCCUR <br />MED EXP (Any one person) <br />$ <br />PERSONAL &ADV INJURY <br />$ <br />GENERAL AGGREGATE <br />$ <br />GENT AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS- COMP/OP AGG <br />$ <br />POLICY PEo DOE <br />$ <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />Ea accident <br />Is <br />BODILY INJURY (Per person) <br />$ <br />ANYAUTO <br />H <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />BODILY INJURY (Per accident) <br />$ <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />NON -OWNED <br />HIRED AUTOS AUTOS <br />$ <br />1 <br />1 <br />UMBRELLA LIAR <br />H <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />EXCESS LIAS <br />CLAIMS�MADE <br />DED RETENTION$ <br />1 <br />$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS'LIABILITY YIN <br />WC STATU- OTH- <br />T T <br />OFFICER/MEMBER EXCLUDE�I ECUTIVE FN <br />NIA <br />E.L. EACH ACCIDENT <br />$ <br />E.L. DISEASE -EA EMPLOYE <br />$ <br />(Mandatory In NH) <br />If yes, describe under <br />DE SCRIPTION OF OPERATIONS belew <br />E.L. DISEASE - POLICY LIMIT <br />$ <br />A <br />PROFESSIONAL <br />01- 357 -06-61 <br />06/30/2014 <br />06130/2015 <br />LIMIT 10,000,000 <br />LIABILITY <br />RETENTION 500,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach AC ORD 101, Additional Remarks Schedule, if more space is required) <br />s�( RGK <br />✓""� li�A �'c�ty Pttorney <br />psslatan ,,� <br />CERTIFICATE HOLDER CANCELLATION <br />City Of Santa Ana <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />Attn: Purchasing Department <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />20 Chic Center Plaza, P.O. Box 1988 M -16 <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Santa Ana, CA 92702 <br />AUTHORIZED REPRESENTATIVE <br />of Marsh USA Inc. <br />Manashi Mukherjee .- it.rMrt +aarsk nu,� -ex. <br />©1988.2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD <br />