ACCURATE PERFORMANCE MACHINING INC. 3 - 2014

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�ecoRd� CERTIFICATE OF LIABILITY INSURANCE `...�'" F oATEIMM/DD(YYYY) 1 1012712014 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 pollcy(les) 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 endorsement(s). PaooucER EX2CUiIVB Team Insurance services, LLC An Affiliate of United Agencies, Inc. 23421 S. Pointe Drive Ste. 190 Laguna Hills, CA 926�a3 CONTACT Executive Team Insurance Services, LLC PHONE -- FAX- - A C Nn Ext. 626- 214.70az -_�1n c Nor _., -.__ E DEC etisunited@ualteda encies com, ADORES�S;. _�L! -_ -. „_ INBURERLe.LAPFOR0INO COVERAGE NAIL0 6/15/2015 OG23764 — J INSURER A: Nova CasualLomp_any__ INSURED Accurate Performance Machining Inc. 2086 S. Grand Avenue INSURER e_ -- INSURER G .$ -- _5,000 INSURER $ 1,000,000 Santa Ana CA 92705 INSURER E: —_— PRODUCTS - COMP /OP AGO INSURER F; _ S COVERAGES CERTIFICATE NUMBER: 22113531 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN 18SUED 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. ILTfi TYPE OF INSURANCE L 6 POLICY UMBER MAiDe YFY t �IEYN LIMITS A ,/ COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR a ✓ MSOCLOO10119 -3 6/15/2014 6/15/2015 EACH OCCURRENCE $ 11000,000 A A - S-RENTEO LES ocarrenca $ 300,000 ,RREMjS,ES MEDEXP(Any one person .$ -- _5,000 PERSONAL &ADV INJURY $ 1,000,000 GC_N'L AGGREGATE LIMIT APPLIES PER: _ IRO- ✓ POLICY PRO- El LOG OTHER: GENERAL AGGREGATE _ S 2,000,000 PRODUCTS - COMP /OP AGO s Excluded___ _ S AUTOMOBILE LIABILITY ANVAUTO ALL OWNED 101-O SCHEDULED AUTO§ AUTOS AUTOS NED HIRED AUTOS AUTOS COMBINED LIMIT aidat § BODILY INJURY(Por person) $ BODILY INyl)AMAar accitlonp $ pROPERTV DAMAGE Ler accitlenJ § - -`-� -- UMBRELLA LIAB EXCESS LIAB OCCUR. CLAIMS-MADE EACH OCCURRENCE AGGREGATE $ DEC RETENTION$ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR /PARTNERIEXECUTIVE OFFGER/NIEMBER EXCLUDED? ❑NIA (Mandatory I"NH) IIyes,describe under DESCRIPTION OF OPERATIONS below M5OWK0010066 -3 6/15/2014- 6/15/2015 STATU OrnH- - TE W E.L EACH ACCIDENT $ 1,000,000 EL DISEASE -EA EMPLOYE - - --— S 1,000,000 -I E.L. DISEASE -POLICY LIMIT — 1 $ 1000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 1N, Addelonai Remarks Schedule, may ba atleched if more apace is required) The City of Santa Ana, its officers, employees, agents, and representatives are named as additional insureds in res ects lo,the genera liab' it policy only per the attached forms. iILe City of Santa Ana Santa Ana Work Center 20 Civic Center Plaza Santa Ana CA 92701 ACORD 25 (2014101) 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 The ACORD name and logo are registered marks of ACORD CEAT NO- 22113531 Na tbor[ne DumaCol 10/21/2014 1,53,02 PM (PVr) Pago 3 of 6 EXHIBIT C rights reRPYVP.rI.