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A-120ly-06q
<br />AC®RO® CERTIFICATE OF LIABILITY INSURANCE
<br />�.�
<br />DATEIMM /ODY )
<br />612512014
<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 p
<br />TechServe Alliance Services Corp.
<br />1420 King Street; Suite 610
<br />Alexandria, VA 22314
<br />CONTACT
<br />NAME:
<br />PHONE FAX
<br />AIC D 703- 997 -4271 AIC No), 703.997.7727
<br />EMAIL
<br />ADDRESS:
<br />INSURERS AFFORDING COVERAGE
<br />NAICN
<br />INSURER A: Star Insurance
<br />CP0791984
<br />www.techserveallianC .org
<br />INSURED
<br />Comdyn Group Inc., The
<br />100 E. Thousand Oaks Blvd.
<br />INSURER B: ProCentury Ins
<br />$ 1,000,000
<br />INSURER C: Travelers Casualty & Surety Co of Amer
<br />PREMISES (Ea occurrrece )
<br />INSURER D :
<br />Suite 284
<br />Thousand Oaks CA 91360
<br />INSURER E:
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: 20635571 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 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 />IL SR TYPE
<br />OF INSURANCE
<br />ADDLSUBR
<br />INSD
<br />WD
<br />POLICYNUMBER
<br />POLICY ERE
<br />MMIDDIYYY
<br />POLICY EXP
<br />MMIDDflVYY
<br />LIMITS
<br />A
<br />,/
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE 121 OCCUR
<br />CP0791984
<br />6/15/2014
<br />6/15/2015
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />PREMISES (Ea occurrrece )
<br />$ 1,000,000
<br />MED EXP (Any one person)
<br />$ 10,000
<br />PERSONAL &ADV INJURY
<br />$ 1,000,000
<br />AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />GEN'L
<br />✓
<br />POLICY JECT LOG
<br />PRODUCTS - COMRADE AGG
<br />$ 2,000,000
<br />$
<br />OTHER'.
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />CA0791984
<br />6/15/2014
<br />6/15/2015
<br />OMBINEDt SINGLE LIMIT
<br />Ea
<br />$ 1,000000
<br />BODILY INJURY (Per person)
<br />$
<br />ANY AUTO
<br />ALL OWNED SCHEDULED
<br />AUTOS S
<br />AUTO
<br />BODILY INJURY (Per accident)
<br />$
<br />✓
<br />NON -OWNED
<br />HIREDAUTOS ✓ AUTOS
<br />PROPERTY DAMAGE
<br />Peraecidere
<br />$
<br />A
<br />,'
<br />OMBRELLALIAB
<br />✓
<br />OCCUR
<br />UM0791984
<br />6/1512014
<br />6/1512015
<br />EACH OCCURRENCE
<br />$ 1000000
<br />EXCESS LIAR
<br />CLAIMS -MADE
<br />AGGREGATE
<br />$ 1,000,000
<br />DED I ✓ I RETENTION $10,000
<br />$
<br />1
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANY PROPRIETOWPARTNER /EXECUTIVE ❑
<br />OFFICERAMEMBER EXCLUDED?
<br />NIA
<br />WC0791984
<br />6/1512014
<br />6/1512015
<br />,/ STATUTE 'ER'_
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />(Mandatory, in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 1,000,000
<br />A
<br />E&O /Professional Uab Claims Made
<br />CP0791984
<br />6/1512014
<br />6/1512015
<br />$1,000,000 Ea Claim /$1,000,000 Aggregate
<br />C
<br />ERISA Bond
<br />105021689
<br />10/112013
<br />10/112014
<br />$350,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may he attached If more space is required)
<br />City of Santa Ana, is Additional Insured as respects to General Liability
<br />per attached CG2010 1185 Additional Insured Endorsement.
<br />CERTIFICATE HOLDER CANCELLATION
<br />Client
<br />City f Santa Ana
<br />20 Civic Center Plaza
<br />Santa Ana Center 92702
<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 />AUTHORIZED REPRESENTATIVE
<br />Mark B. Roberts
<br />©1988 -2014 ACORD CORPORATION. All ri''ghts reserved.
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD / ss fW2_
<br />CERT No.: 2063s571 Ramie Seaycoe 6/25/2014 9:39:25 AM (EDT) Page 1 of 2
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