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�.. CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MMYY)
<br />---'
<br />of /os 12D1/2o1a
<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: It the certificate holder is an ADDITIONAL INSURED, the policy(les) 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 />NAME:
<br />Hub Internakicnal Northeast Limited- LI
<br />PHONE .._ _. jFMK _.___ .._._..•.�_._.
<br />A IL ' 516-496-7600 1 qX NJ; 516 495 -4040
<br />---- - - ----
<br />100 Sunnyside Blvd
<br />AbWRESS
<br />Woodbury NY 11797
<br />INSURER(S) AFFORDING COVERAGE
<br />_
<br />HAICP
<br />INSURERA :Hartford Fire Insurance Co.
<br />_
<br />19682
<br />PERSONAL &ACV INJURY
<br />INSURED CuaR90373
<br />INSURERS:
<br />$3,000,000
<br />INSURER D;
<br />33,000,000
<br />BSFG, LLC
<br />INSURER D:
<br />A
<br />c/o Focus Financial Partners LLC
<br />825 Third Avenue, 27th P1
<br />INSURER E:
<br />New York, NY 10022
<br />INSURER P
<br />01/01/2019
<br />COMBINE 51 L•LIMIT
<br />EP eaitlenlL
<br />COVERAGES CERTIFICATE NUMBER- NFV!RInM M11"ARta•
<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 POUCHES 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 />ILTq
<br />— � TYPE OF INSURANCE
<br />17S0e
<br />I
<br />POLICY NUMBER
<br />MM'DdYHe
<br />MM'Db/YVYY
<br />LIMITS
<br />A
<br />GENERAL LIABILITY
<br />E COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE —Zj OCCUR
<br />_,_,,, ,_.,,_,_,,,,,,„_,•r,Y„_,.,,.,_„
<br />.............._ ._....e...�.....e.�____.....„„.
<br />GEN'L AGGREGATE LIMIT APPLIES PER: _
<br />POLICY F PRO- F-1 LOG
<br />hrI
<br />1013ONJT9543
<br />01103/2014
<br />01/01/2010
<br />EACH OCCURRENCE
<br />$1,000,000
<br />REMISES EaEurtanED ce
<br />51,000,000
<br />MEW EXP(Any one Pelson)
<br />610,000
<br />PERSONAL &ACV INJURY
<br />51,000,000
<br />GENERALAGGREGATE
<br />$3,000,000
<br />PRODUCTS- OOMPA7PAGG
<br />33,000,000
<br />3
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />ANY AUTO
<br />AUTOS AUTOSU D
<br />E NON-OWNED
<br />HIRED AUTOS AUTOS
<br />lOUBNJT9543
<br />O1j01 /2tllk
<br />01/01/2019
<br />COMBINE 51 L•LIMIT
<br />EP eaitlenlL
<br />31 �p 00,pOB_�._.
<br />BODILY INJURY (Per person)
<br />5
<br />BODILY INJURY (Par accident)
<br />S
<br />—PROPERTY DDAMAGE
<br />fE51B qs denn
<br />S
<br />5
<br />A
<br />I7L
<br />UMBRELLAIJAB
<br />EXCESS LIAR
<br />E OCCUR
<br />CLAIMS-MADE
<br />IOHHUJT4532
<br />01/01/2014
<br />I
<br />01/0112015
<br />EACH OCCURRENCE
<br />510,000,000
<br />II—
<br />AGGREGATE
<br />$10,000,000
<br />BED I E I RETENTION 510 1 0 DO
<br />5
<br />A
<br />AND EMPLOYERCOMPENSATION ABILITY YIN
<br />ANY PROPRIETORIPAftiNERIEXECUTIVE
<br />OFMCERIMEMBER EXCLUWED7 ❑
<br />(Myandatory In NH)
<br />under
<br />DESCRIPTION OF OPERATIONS beIPw`u
<br />NIA
<br />lOWBAG3832 ;!01/01/2034
<br />01!01/2015
<br />E WCSTATIT5 OTW
<br />E. L. EACH ACCIDENT
<br />$1,000,000
<br />E. L. DISEASE- EA EMPLOY
<br />$1,000,000
<br />El. DISEASE - POLICY LIMIT
<br />51,000,000
<br />j
<br />I
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, It more space Is required)
<br />Evidence of insurance
<br />City of Santa Ana
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92701 -4058
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZ REPRESENTATIVE
<br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
<br />All rights reserved.
<br />Doce7356730 Cartholder A 69
<br />7 6n)
<br />
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