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Certificate of Insurance (Proof of Coverage) Date Issued: 8/2212014
<br />THUS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />HOLDER, THIS CERTIFICATE DOES NOT AMEND EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />TASUred, aniea11d1Vlhilin °':
<br />=Pro
<br />Admil
<br />9 'Address ;
<br />rai stiator` J
<br />Wesley A Bosch
<br />Administered By;
<br />CPA and Associates
<br />711 S, Suite 205
<br />1000 E Santa Ana Blvd Suite 200
<br />Chicago, L
<br />Chicago, IL
<br />Santa Ana, CA 92701
<br />12-9
<br />P. 312. 987.9823 F. 312 -987 -0902
<br />_ 1nfo@cphins.com
<br />*Additional insured locations are often requested by individual
<br />business onvners B,ho have more iltan. one office. four coverage is
<br />Underwritten By:
<br />portable, mewdng that you are covered at any location forpraetico
<br />Philadelphia Indemnity Insurance Company
<br />tinder the occupation(s) listed on your policy.
<br />l 1 (8 5111 J _Y d t1 MiFW� t t "t:':
<br />t+ n.
<br />. : .: i.'.}. {.-, ,., -... ♦ y .. . .h.'::n i�. �..�:: sfiQYe� �
<br />Policy il: PHCPOB1041 EffectiveDate: 08/211201,
<br />Es irationDate: 08/21/2015
<br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,
<br />NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT" TO ALL THE
<br />TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWNMAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />r 13,1Nn "I r I1 It
<br />0bll i_N
<br />V Va l
<br />b�04t{ ���'.-
<br />Totalttmo�rltd{ '�kGYYg41)�r,,�r'r,w...,a�
<br />'.��p'•�;��f�'eC�i�{ all( Y. la, �, f)+ �i1�.
<br />2.;`. t( erl?t?
<br />„1✓„ ?I'c�.',;,�,:'u,
<br />$1 million
<br />$3 million
<br />flex, Profes9Cbha1 Llabtlt(3, ”
<br />r• ,,;.;
<br />,. � G'ommetclal,G�iipralLiubll�tyY ."t
<br />¢4rrulZrpbtlty,l!'r'ej
<br />$1,000,000
<br />$3,000,000
<br />Includes &` Warteif:T'r
<br />L 'e- tgllZ,ia`Litllt.' +andi}ersbn
<br />N/A
<br />N/A N/A
<br />'' 'max *Pr0`.Qi?t
<br />$1 million
<br />$3 mullion
<br />7e °mental Liatili,fis'
<br />Unlimited
<br />IJullni ted
<br />tLfeenalagBoa�dtlRVpistig�tt�gs�efensL4
<br />$35,000
<br />$ 35, 000Sta`
<br />$15,000
<br />$15,000
<br />y ,x >1 AssM1UI `Co Crfi e r - z'
<br />r ,;
<br />_
<br />$10,000
<br />$35,000
<br />ensellgpeYlt 6'�t .r`
<br />$5,0001 erson
<br />$50,000
<br />�,,:� „x4 "iYledlcalEz en'eCtirrrn ei mss''rs ?-
<br />$15 000
<br />$15,000
<br />w {'� -;:' ' :' Flt•st And CoytC,i're "''en`)`E.- ,;_:,:'
<br />Description/Special Provisions:
<br />City of Santa Ana, its Officers,
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
<br />Agents, and Employees
<br />BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED
<br />P.O. Box 1988
<br />IN ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Santa Ana, CA 92702
<br />Holder has also been added to the
<br />Authorized Representative
<br />policy as an additional insured: **
<br />X Yes/ No
<br />`
<br />!
<br />* *If the certificate holder is an
<br />ADDITIONAL INSURED, the policy(les)
<br />C. Philip Hodson i
<br />must be endorsed, A statement on this
<br />{
<br />certificate does not confer rights to the
<br />certificate holder in lieu of such
<br />�0
<br />endorsement(s),
<br />�j
<br />DISCLAFYIER: The Certificate of Insurance does
<br />and the certificate holder, nor does it affirmatively
<br />er(s), authorized representative or producer,
<br />afforded by the policies listed thereon,
<br />
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