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Ac"R'H CERTIFICATE OF LIABILITY INSURANCE <br />CERTIFICATE <br />DATE YYI <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(ies) 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 endorsement(s). <br />PRODUCER <br />Wells Fargo Insurance Services USA, Inc.PHONE <br />CA DOI Lic. #OD06408 (916) 589-8000 <br />CONTACT Tracy Dolan <br />916 589-8153 aIc No 877 611-1971 <br />ADDRESS: tracy.dolan@wellsfargo.com <br />10940 White Rock Road, 2nd floor <br />INSURER(S) AFFORDING COVERAGE <br />NAIC4 <br />INSURER A: Valley Forge Insurance Company <br />20508 <br />Rancho Cordova, CA 95670-6076 <br />INSURED <br />INSURER B: National Fire Insurance Company of Hartford <br />20478 <br />Wittman Enterprises, LLC <br />INSURER C: Continental Casualty Company <br />20443 <br />PO Box 269110 <br />INSURER D <br />INSURER E: <br />PERSONAL &ADV INJURY $ 2,000,000 <br />Sacramento, CA 95826 <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 7915340 REVISION NUMBER: See below <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 />LTH <br />TYPE OF INSURANCE <br />ADDLSUBR <br />JUM <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />MWDDIYVVV <br />POLICY EXP <br />MMIDDIVVVY <br />LIMITS <br />A <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE X OCCUR <br />84034654035 <br />7/1/2014 <br />7/1/2015 <br />EACH OCCUTO EN RRCE $ 2,000,000 <br />DAGE RENTED <br />M <br />PREMISES Ea occurrence $ 300,000 <br />MED EXP (Any one person) $ 10,000 <br />PERSONAL &ADV INJURY $ 2,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE $ 4,000,000 <br />X POLICY PRO JECT LOC <br />PRODUCTS AGG $ 4,000,000 <br />_— <br />$ <br />OTHER: <br />B <br />AUTOMOBILE <br />LIABILITY <br />84012487490 <br />7/1/2014 <br />7/1/2015 <br />COMBINED SINGLE LIMIT $ 1,000,000 <br />Ea accident <br />X <br />_ <br />BODILY INJURY (Par person) $ <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />BODILY INJURY (Per accident) $ <br />X <br />PROPERTY DAMAGE <br />Peraooident $ <br />NON -OWNED <br />HIRED AUTOS X AUTOS <br />_ <br />CX <br />UMBRELLA LIAB <br />X <br />OCCUR <br />84034654083 <br />7/1/2014 <br />7/1/2015 <br />EACH OCCURRENCE $ 2,000,000 <br />AGGREGATE $ 2,000,000 <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED X RETENTION$ 10,000 <br />$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />PER OTH- <br />STATUTE ER <br />_ <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />E.L. EACH ACCIDENT $ <br />OFFIOERIMEMBER EXCLUDED' <br />NIA <br />---- <br />(Mandatory in NH) <br />E.L. DISEASE - EA EMPLOYEE $ <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE -POLICY LIMIT $ <br />7" Liability <br />596476165 <br />07/01/2014 <br />07/01/2015 <br />$1,000,0001$2,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) w� <br />Certificate holder named additional insured per attached form. g xC <br />*10 day notice applies if cancelled for non-payment of premium.`,'* ��-- <br />STORCK <br />t ISA E• Attorney <br />Assistant G(tY <br />CERTIFICATE HOLDER CANCELLATION <br />City of Santa Ana <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />1439 BroadwayTHE <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Santa Ana, CA 92701 <br />AUTHORIZED REPRESENTATIVE <br />The ACORD name and logo are registered marks of ACORD @ 1988.2014 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2014/01) <br />