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OP ID: KA CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDMW) 08/12/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such enciorsement(s). PRODUCER Phone: 858 - 457.5720 Rubin Insurance Agency Inc. 6363 Greenwich Dr, #120 Fax: 858 - 457.5729 CA #0645355 San Diego, CA 92122 Stuart Rubin CONTACT NAME: AIC, No Ext: AIC No: EMAIL ADDRESS: PRODUCER MELAD -1 CUSTOMER ID #: INSURERIS) AFFORDING COVERAGE NAIC # 8907 INSURED Melad & Associates Huntington, CA 92646 Warner Ave #161 Hunt wsURERA;Hartford Casualty Insurance Co 29424 INSURERS Continental Casualty Co I INSURER C : EACH OCCURRENCE INSURER D: A INSURER E INSURER F 72SBAGE8240 V Y T AS COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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 LTR TYPE OF INSURANCE DDLfiUBR POLICY NUMBER POLICY ERE MMIDONYYYI POLICY EXP flMMIDDi LIMITS GENERALLIABILIT/ I EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR 72SBAGE8240 V Y T AS 106/07/2014 V A i o FORD 06/07/2015 DMA ETO PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 10,00 PERSONAL &ADV INJURY $ 1,000,000 GENERALAGGREGATE $ 2,000,000 GEN'L AGGREGATE LI MIT APPLI ES PER POLICY P C - LOC PRODUCTS P /OP AGG $ 2,000,000 �L S T7 ( $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS p RY A tri !ll ill City 0G G W(Ed lloiney COMBINED SINGLE LIMIT accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per eccldenl) $ SCHEDULED AUTOS PROPERTY AGE (Per accident) ident) - $ A X HIRED AUTOS 72SBAGE8240 0610112014 0610112075 X NON OWNED AUTOS $ i �- Is X UMBRELLA LIAB X OCCUR EACH OCCURRENCE Is 1,000,000 A EXCESS LIAB CLAIMS -MADE 72SBAGE8240 0610112014 0610112015 AGGREGATE I$ 1,000,000 DEDUCTIBLE - , $ I X RETENTION $ 10,000 $ WORKERS DOM PENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? ❑ NIA WG STATU- 0TH -I I9RV LIMITS ER _ E.L. EACH ACCIDENT $ __ , E.L. DISEASE - EA EMPLOYEE! $ - (Mandatary f wa d in NH) d describe under - -- - E.L. DISEASE - POLICY LIMIT ! $ Dyes, DESCRIPTION OF OPERATIONS below B Professional Liab MCH288373457 0411312014 04/1312015 Aggregate 1,000,000 Retention $10,000 Per Claim 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if mare space is required) Proof of insurance. CITYSA City of Santa Ana 20 Civic Center Plaza Santa Ana, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD CORPORATION. All AGURU 25 (2009/09) The ACORD name and logo are registered marks of ACORD