CARPENTER, ROTHANS & DUMON, LLP.-2014

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Al v® CERTIFICATE OF LIABILITY INSURANCE 1//29/29/ D ID0IYYYY) 2015 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(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). PRODUCER White and Company Insurance Inc. P O BOX 70 Santa Monica CA 90406-0070 CONTA T NAME: Maribel SOBA PHONE ) (310)393-9477 FAX o•t3101393-7186 -MAILRES msosa@whitecoinsurance. corn ADO INSURENS) AFFORDING COVERAGE NAICft INSURER A:Sentinel Ins Company LTD 11000 INSURED Carpenter & Rothans DBA Carpenter, Rothans & 888 S. Figueroa St. #1960 II�� 1 11'' Los Angeles CA 90017 y'C';40^ INSURER B:Re ublic Ind Cc Of America INSURER C: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:CL1512903180 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 REDU CED BY PAID CLAIMS. INSR R TYPE OF INSURANCE A D POLICY NUMBER MMIDDY� MMfDDmYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ 1,000,000 MED EXP (Any one person) $ 10,000 A CLAIM&MADE I—XI OCCUR X 72SBADZ5095 /11/2015 /11/2016 PERSONAL &ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENTAGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOPAGG $ 2,000,000 $ _X7 POLICY I RAPT -LOC AUTOMOBILE LIABILITY COMBINEDSINGLELIMIT $ 1 000 000 BODILY INJURY (Per person) $ A ANY AUTO ALLOWNED SCHEDULED SAUTOS ON -OED AUTOS X NWN X HIRED AUTOS X 72SBADZ5095 /11/2015 /11/2016 BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident $ X UMBRELLA LIAR OCCUR EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 A EXCESS LIAB CLAIMS -MADE X 72SBADZ5095 /11/2015 /11/2016 DED X RETENTIONS 10,00 $ B WORKERS COMPENSATION TWO STATU- OTH- CRY AND EMPLOYERS' LIABILITY ANY PROPRIETORIPAWNERIEXECUTIVE E.L. EACH ACCIDENT $ 1 000 000 EL DISEASE -EA EMPLOYEE $ 1,000,000 OFFICEWMEMBER EXCLUDED? IMandatory in NH) NIA 161909-11 5/9/2014 5/9/2015 E. L. DISEASE -POLICY LIMIT $ 1,000,000 If yes, desaibe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Certificate Holder is included as Additional Insured as respects General Liability as required by written contract per policy form SS0008 attached to this policy. *Except 10 days notice of cancellation for non payment of premium. TION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Santa Ana 20 Civic Center Plaza P.O. BOX 1986 AUTHORIZED REPRESENTATIVE Santa Ana, CA 92702 APPROVED AS TO FOR Maribel soca/MS1 ..m.. INS025 onions) m Laura A. l osstnt Senior Assistant City Attorney mnrke of ArrTRn reserved.