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<br />Policy Number: Date Entered: 8/28/2014
<br />AC"ROV CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MMIDDIYYYY)
<br />8/28/201&
<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(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 endorsements).
<br />PRODUCER
<br />ASL Insurance Services
<br />3533 North Verdugo Road
<br />Glendale, CA 91208
<br />CONTACT
<br />AME'
<br />PHONE - ,(818)987-3366 INC Nm;,(51 a) 957-3369
<br />INC No i,(818)4i7-336 obal.net
<br />_._...._._._.._....._.._......._ .............. ._...._.............._.
<br />INSURER($( AFFORDING COVERAGE
<br />NAIC#
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<br />INSURER A; Scottsdale Insurance Company
<br />R00,00'�/EACH OCCURRENCE $1,OOO,OOO
<br />DAM GE TGRENILL100,000
<br />$RORS
<br />INSURED
<br />INSURER S; State Compensation Insurance Sun
<br />PERSONAL&ADV INJURY 91,000,000
<br />Insure Protective Security Inc.
<br />INSURER _C: ^' _
<br />PRODUCTS -COMPfOP AIG $2,000,000
<br />15022 Cowan Street Suite # 270
<br />Irvine, CA 82614
<br />INSURER
<br />AUTOMOBILE
<br />._.._-.
<br />INSURER E:
<br />INSURER F;
<br />LtiSFi �'
<br />ppee�$15'feil°1i
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<br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<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 />1NAD
<br />SUBR
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />(MMIODNYYY
<br />POLICY EXP
<br />(Ni
<br />LIMITS
<br />A
<br />PCOMMERCIALCENERAL LIABILITY
<br />CLAIMS -MAGE ❑OCCUR
<br />R OMISSIONS
<br />X
<br />AUTHORIZED REPRESENTATIVE
<br />CPS1872209
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<br />9/23/2913
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<br />R00,00'�/EACH OCCURRENCE $1,OOO,OOO
<br />DAM GE TGRENILL100,000
<br />$RORS
<br />MED FXP(Anyone person) $S,D00
<br />PERSONAL&ADV INJURY 91,000,000
<br />GEN'LAGGREGATE LIMIT APPLIES PER:
<br />POLICY PRO- LOC
<br />OTHER:
<br />GENERAL AGGREGATE s2,000,000
<br />PRODUCTS -COMPfOP AIG $2,000,000
<br />$
<br />AUTOMOBILE
<br />._.._-.
<br />LIABILITY
<br />ANY ALI'0
<br />ALLOWNED SCHEDULE
<br />AUTOS AUTOS
<br />HIRED AUTOS AUTOSW NED
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<br />ppee�$15'feil°1i
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<br />COMBINED S INGLE LIMI $
<br />Ee accident
<br />BODILY INJURY (Par person) $
<br />$
<br />PftOPERTYDAM`AOEacciden9
<br />Per arooml S
<br />UMBRELLA LIAR
<br />EXCESS LIPS
<br />Id
<br />OCCUR
<br />CLAIMS -MADE
<br />EACH OCCURRENCE S
<br />AGGREGATE S
<br />DED RETENTIONS
<br />$
<br />B
<br />WORKERS COMPENSATIONPER
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANY
<br />OFFICERIMEMSER EXCLUDED?ECUTIVE
<br />(Mand at., in NH)
<br />Ifyes, describe under
<br />OE SCRIPTION OF OPERATIONS below
<br />9100826-14
<br />5/29/2014
<br />/2S/7.015
<br />STATUTE R
<br />EL EACH ACCIDENT $1,000,000
<br />E.L. DISEASE -EA EMPLOYEE $1,000,000
<br />E.L. DISEASE - POLICY LIMIT $1,000,000
<br />DESCRIPTION OF OPERATIONS LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schadnlo, may be attached If more space [stationed)
<br />The City of Santa Ana, itis officers, employees, agents, and representative are included as
<br />additional insured on the General Liability policy with respects to the operation of the named
<br />insured only.
<br />* Except 10 day notice of cancellation for non-payment of premium.
<br />CERTIFICATE HOLDER CANCELLATION
<br />City of Banta Ana
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />Parks, Recreation and Community Services Agency
<br />THE EXPIRATION DATE THEREOF, NOTICE
<br />WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92701
<br />AUTHORIZED REPRESENTATIVE
<br />/J V
<br />JAIME LVGO
<br />© 1988.2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
<br />Pradwed using scums Bass Plus sofaune. w .FermsBoes wia; Impressive Publishing 809-206-1977
<br />
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