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BLUER-2 OP ID: GI <br />CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MMIDDIYYYY) <br />03/25/2014 <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(Sb AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT; If the certificate holder is an ADDITIONAL INSURED, the polloy(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 endorsements). <br />PRoouasa Phone;818.833-2700 <br />Momentous Insurance Brokerage <br />5990 Sepulveda Blvd, Suite 550 Fax: 81 B-933-2701 <br />Van Nuys, CA 01411 <br />Gregg Inboden <br />N "EgQT 6regglnboden <br />PI#ONE FAx <br />,� 1.818-833.2729 tArc. No,: 818.933-2795 <br />A cress; inbaden mmibi.com <br />INSURERIM AFFORDING COVERAGE <br />_ <br />NAOI <br />INOORERA:Philadeiphia Insurance Company <br />18058 <br />INSURED Blueray Management LLC <br />INSURER B t State Compensation Ins. Fund <br />PO Box 12529 <br />Newport Beach, CA 92658 <br />INSURER C: <br />INSURER D ; <br />INSURER E I <br />INSURER Fi <br />CF,VFRAGFR CERTIFICATE NUMBER: REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PER= <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WTH 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 SEEN REDUCED BY PAID CLAIMS. <br />(NTRR <br />TYPEOFiNSURANCO __ <br />ADM <br />SUBS <br />11 <br />P VOY NUMBER <br />P_ <br />O <br />M/1CYYYYY <br />M IDD YYY <br />LIMITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ 2,000,00 <br />A <br />X GO_MMERCIALGENERALLIAEILrrY <br />mm CLAIMS -MADE ®gCCUR <br />PHPK1147404 <br />0312412014 <br />0312412015 <br />Eno o0curronea ^ <br />S -.� 100.00 <br />MeD E%P (An one person <br />It <br />PERSONAL$ ADV INJURY <br />$ 2,000,00 <br />GENERALAGOREGATE <br />S 4,000,00 <br />_ <br />GEML AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS-COMP/OP AGG <br />$ 4,000,00 <br />S <br />POLICY PRO- LDC <br />AUTOMOBILE LIABILITY <br />EOMBI a anc d DISINGL LIMIT <br />$ 1,000,00 <br />BODILY INJURY (Per persooi <br />$ <br />A <br />X ANY AUTO <br />PKPK1147404 <br />0312412014 <br />0312412013 <br />BODILY INJURY (Per accident) <br />3 <br />ALL 07 X AUZgS E0 <br />NON•OWNEO <br />X HIREDAT'OO AUTOS <br />POPERTY AGE <br />d <br />S <br />$ <br />UMBRELLA LIAR <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />AGGREGATE L <br />S .. <br />EXCESS LIAR <br />CLAIMS -MADE <br />D TE TiONS <br />$ <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRICTORWARTNERiE%ECUTIVE <br />OFFICERM1EMaER EXCLUDED? <br />(Mandatory in NH) <br />MIA <br />�.�.�.� <br />9054636.13 <br />05/01/2013 <br />05F0112014 <br />X WC STATU• OTW <br />YLIMITS <br />_ -5 <br />EL. EACH ACCIDENT <br />$ 1,000,00 <br />E.L. DISEASE - EA EMP40YEE <br />$ 1,000,00 <br />E , 013EASE •POLICY LIMIT <br />; 1,000,00 <br />Ir. descdbounder <br />O goaCRIPTI OF OPERATIONS nelaw <br />DESCRIPTION OF OPERATIONS I LOCATIONSIVaHIGLBS (AUeon ACORD 101, Additional Remain SclltduM, It more space is required) <br />certificate holder is named as additional insured per the attached rt3 '•�`,�� � • <br />endorsements. Primary and non contributory endorsement attached.} <br />tC1V r, <br />/2-- <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES HE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />City Of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. <br />Parks, ReGreation & Community AUTHORIZED� REPRESENTATIVE <br />Services Agency bR�4 <br />1825 W. Civic Center h <br />iSanta Ang. CA 92701 <br />0 1988-2010 ACORD CORPORATION, All rights reserved. <br />ACORD 25 (201(1105) The ACORD name and logo are registered marks of ACORD <br />