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,4 —JAI 41- Axel -6/ <br />A!2°® CERTIFICATE OF LIABILITY INSURANCE <br />Dnr6/25/2014 (MMIDDNWY) <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 TechServe Alliance Services Corp. <br />1420 King Street; Suite 610 <br />Alexandria, VA 22314 <br />CONTACT <br />NAME <br />PHONE FA% <br />(A/C, No Ext: 703- 997 -4271 A/C No: 703.997.7727 <br />E -MAIL <br />ADDRESS: <br />INSURERS AFFORDING COVERAGE <br />NAIC N <br />INSURER A: Star Insurance <br />CP0791984 <br />www.techseNeallianw.org <br />INSURED <br />Comdyn Group Inc., The <br />100 E. Thousand Oaks Blvd. <br />INSURER B: ProCentu Ins <br />$ 1,000,000 <br />INSURER c: Travelers Casualty & Surety Cc of Amer <br />CLAIMS -MADE ❑✓ OCCUR <br />INSURER D: <br />Suite 284 <br />Thousand Oaks CA 91360 <br />INSURER E: <br />INSURER F: <br />$ 1,000,000 <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 />ILTR <br />TYPE OF INSURANCE <br />ADDL <br />SUn <br />POLICY NUMBER <br />POLICY I"YY <br />POLICY INYYPV <br />LIMITS <br />A <br />�/ <br />COMMERCIAL GENERAL LIABILITY <br />CP0791984 <br />611512014 <br />6/15/2015 <br />EACH OCCURRENCE <br />$ 1,000,000 <br />CLAIMS -MADE ❑✓ OCCUR <br />PREMISES (Es ocED <br />PREMISE Ea occurrence ) <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 11 PRO- <br />JECT ❑ LOG <br />PRODUCTS - COMP /OP AGO <br />$ 2,000,000 <br />$ <br />OTHER: <br />A <br />AUTOMOBILE <br />LIABILITY <br />CA0791984 <br />6/1512014 <br />6/15/2015 <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$ 1,000 000 <br />BODILY INJURY (Per person) <br />$ <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUT05 <br />BODILY INJURY (Per accident ) <br />$ <br />✓ <br />NON WINED <br />HIREDAUTOS ✓ AUTOS <br />PROPERTY DAMAGE <br />Peraccident <br />$ <br />A <br />✓ <br />UMBRELLA UAB <br />,/ <br />OCCUR <br />UM0791984 <br />6/15/2014 <br />6/15/2015 <br />EACH OCCURRENCE <br />$ 1000000 <br />AGGREGATE <br />$ 1,000,000 <br />EXCESS LIAB <br />CLAIMS -MADE <br />TIED ✓ RETENTIONS10,000 <br />$ <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETORIPARTNERIEXECUTIVE ❑ <br />OFFICERIMEMBER EXCWDEDP <br />NIA <br />WC0791984 <br />6/15/2014 <br />6/15/2015 <br />✓ STATUTE ERH <br />E. L. EACH ACCIDENT <br />S 1,000,000 <br />E. L. DISEASE - EA EMPLOYEE <br />$ 1,000,000 <br />(Mandatary in NH) <br />If yes, Epson be under <br />DESCRIPTION OF OPERATIONS below <br />EL DISEASE - POLICY LIMIT <br />1 $ 1,000,000 <br />A <br />E &O /Professional Liab Claims Made <br />CP0791984 <br />6/15/2014 <br />6/15/2015 <br />$1,000,000 Ea Claim /$1,000,000 Aggregate <br />C <br />ERISABond <br />105021689 <br />10/1/2013 <br />10/1/2014 <br />$350,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is mqulmd) <br />City of Santa Ana, is Additional Insured as respects to General Liability <br />per attached CG2010 1185 Additional Insured Endorsement. <br />City f Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />yCivic Center Plaza THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />20 <br />Santa Ana Center 92702 ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />i aaa�L Q Onhn No <br />ACORD 25 (2014/01) <br />©1988 -2014 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />CENT NO.: 20635571 Bambie Staytoa 6/25/2014 9:39:25 Al (EOT) Page 1 of 2 <br />REVIEWED <br />t/2 <br />