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A''C"'EIIr CERTIFICATE OF LIABILITY INSURANCE
<br />FDATEtMMIDY`(Yj
<br />TYPE OF INSURANCE
<br />11/312014
<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 Phoue: (707)996-2912
<br />Far: (707)996-7912
<br />Apollo General insurance Agency, Inc. (1)
<br />P. Q. Box 1508
<br />CONTACT Jeriiee Lewis
<br />MANE:
<br />NE
<br />AIC, No. Ex • c No);
<br />EMAIL jerileela�apgen.com
<br />ADDRESS:
<br />Sonoma, California 95476
<br />INSURERS AFFORDING COVERAGE NAIC N
<br />INSURER A: Interstate Fire & Casualty Company 22829
<br />DAN 1000347
<br />INSURED
<br />INSURER B: American Automobile Insurance Cont ally 21849
<br />J&G Industries, Inc.
<br />INSURER c: Torus Speciality Insurance Company 44776
<br />27 Broolchurst Street
<br />342
<br />Fountain
<br />Fountain Valle}�, CA 92748
<br />INSURER D, State Compensation Insurance Fund Of California 35476
<br />INSURER E: AGCS Marine Insurance Company 22337
<br />INSURER F ;
<br />t.,VVEKAGES Ul=HI IFICAIE NUMBER: µst RFVIRION NIIMRFR:
<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 />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />SD
<br />S DR
<br />WVD
<br />POLICYNUMBER
<br />MMILDDYEFF
<br />MML�DIYYYY
<br />LIMITS
<br />A
<br />COMMERCIAL GENERAL LIABILITY
<br />L"LAIMS•P,dADEOCCUR
<br />DAN 1000347
<br />II/1/2014
<br />11%1/2015
<br />EACH OCCURRENCE $ 1,404,400
<br />PREMISES.( a occu encs $ RENTED 34Q,t}4©
<br />MED EXP An 5,000
<br />(Any one person) ) $
<br />� yi
<br />; IFr
<br />s''I'°Pn
<br />t r rr,E/ ..f�
<br />is I€ .;_:
<br />io d"v", 1 ;€,, c
<br />1i4.s fi`"' l<.` in p(
<br />r ,..-,
<br />i r,J"= b
<br />[icy,
<br />t . ,._PERSONAL
<br />�_; J�
<br />°&AOVINJURY $ 1,400,040
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICY F�I PdEOT RO LOC
<br />OTHER:
<br />GENERALAGGREGATE $ 2,040,000
<br />PRODUCTS - COMPIOP AGG 2,000,000
<br />5
<br />$
<br />AUTOMOBILE
<br />LIABILITY
<br />AUTO
<br />1vt.XA.30348S26
<br />11/1/2414
<br />1 1/1%2015
<br />�C�Eoa,8',BWEO SINGLE L3MIT $ 1 040,400
<br />ccident} ,ANY
<br />OLY IN(Per parson) S
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />BODILY INJURY (Per $
<br />( I
<br />✓
<br />✓
<br />HIREDAUTOS �/ NON -OWNED
<br />AUTOS
<br />utas specified Ca$
<br />PROPERTY DAMAGE $
<br />Per accident
<br />C
<br />uMBRELLALIAB
<br />EXCESS LIAB
<br />✓ i OCCUR
<br />C€AH,IS-MADE
<br />37639CI42ALI
<br />11/1/2014
<br />11/1/2015
<br />EACH OCCURRENCE $ 7,000,000
<br />AGGREGATE $ 7,000,040
<br />DED I RETENTIONS
<br />Per accident $ 7,400,000
<br />D
<br />WORKERS COMPENSATN
<br />AND EMPLOY RS' LIABILITY YIN
<br />ANY PRO PR IETOPJPARTNERIEXECU —
<br />OFFICER/MEMBER EXCLUDED? ❑
<br />N /A
<br />342847-2014
<br />10/l/2014
<br />10/1/2015
<br />✓ STATUTE TIP RT
<br />E.L. EACH ACCIDENT $ 1,400,000
<br />E.L. DISEASE • EA EMPLOYEE $ 1,040,044
<br />(Mandatory In NH)
<br />li yes, deso be under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT S 1,000,000
<br />E
<br />Equipment Floater
<br />NM93045900
<br />11/1/2014
<br />11/1/2015 1
<br />RenteNLe-ed: Per It— 754,440
<br />Remed/LLa,Ld Per 0.c 750,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS f VEHICLES (ACORD 105, Additional Remarks Schedule, may ba attached If more space Is squired)
<br />RE: Operations of the Named Insured. Additional Insured coverage is included if required by written contract per
<br />endorsement hereto.
<br />Holder's Nature of Interest: Certificate holder
<br />City of Santa Ana
<br />20 Civic Center Plaza - Ross Annes
<br />Santa Ana, CA 92701
<br />k. AIVLCLLA 1 tLIN
<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 />AUTHORIZED REP7ENTATIVE,
<br />© 1988-2014 ACORD(CORPORATION. All Hohts reservers
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
<br />
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