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<br />CORP A-2014-355 REVIEWED ByY . EUINICE h EREDIA (PG 1 OF 9)
<br />AC '"" I?
<br />CERTIFICATE OF LIABILITY INSURANCE
<br />r ATE (MMfDD7YYYYl
<br />TYPE OF INSURANCE
<br />6/3012015
<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 INSURR(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 Spectrum Risk Management
<br />CONTACT
<br />NAME. Account Mania er
<br />74 DISCC7Very
<br />Irvine, CA 9261
<br />PHONE FAX
<br />949- 756.5730 WC, No: 949- 756 -5740
<br />E -MAIL
<br />ADDRESS: office@spectrumrisk.com
<br />1/1/2016
<br />INSURER (S) AFFORDING COVERAGE
<br />NAIL p
<br />INSURER A; Navigators Special Insurance Co.
<br />36056
<br />www.spectrumrisk.com OC77485
<br />INSURED
<br />TSCM Corp.
<br />INSURER s: General Insurance Company of America
<br />24732...
<br />PERSONAL & ADV INJURY
<br />TSCM Corporation of Arizona
<br />INSURER C: National (Union Fire Insurance Co. of Pittsbur h PA
<br />19445
<br />INSURER D: Cypress Insurance CO.
<br />10855
<br />P ppano Investment Group, LLC
<br />INSURER E
<br />17791 Jamestown Lane
<br />Huntington Beach CA 92647
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />ANY AUTO
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />NON - OWNED
<br />HIRED AUTOS AUTOS
<br />edcutible -0
<br />INSURER F::
<br />COVERAGES CERTIFICATE NUMBER: 25392074 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 TERM'S,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />SUER,
<br />POLICY NUMBER
<br />POLICY EFF
<br />'MMIDDIYYYY
<br />POLICY EXIP
<br />MMIDDIYYYY..
<br />LIMITS
<br />' A
<br />�'
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE r_1/1 OCCUR
<br />Deductible- $2500
<br />LA15C'GL019568IC
<br />1%1/2015
<br />1/1/2016
<br />EACH OCCURRENCE
<br />$ 2,000,000
<br />DAMAGE TO RENTE
<br />PREMISES fEa occur ence
<br />$ 100,000
<br />✓
<br />MED EXP (Any one person)
<br />$ 5,000
<br />„✓
<br />GENT
<br />Contractual Liability
<br />PERSONAL & ADV INJURY
<br />$ 1,000,000
<br />AGGREGATE LIMIT APPLUES PER,:
<br />POLtOY I r Y I PE O LOC
<br />OTHER:
<br />GENERAL AGGREGATE
<br />2,000 „000
<br />PRODUCTS - COMP)OP AGG
<br />$ 2,000,000
<br />$
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />ANY AUTO
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />NON - OWNED
<br />HIRED AUTOS AUTOS
<br />edcutible -0
<br />24CC2983864
<br />111/2015
<br />1./1/20..16
<br />2MBINEDSINGLIE LIMIT .
<br />Ea accdent
<br />1 000,.000
<br />” J
<br />BODILY INJURY (Per person)
<br />$
<br />BODILY INJURY (Per accident)
<br />$...
<br />PROPERTY DAMAGE
<br />%Per accide,nt
<br />$
<br />$
<br />C
<br />UMBRELLA LIAE
<br />EXCESS LIAB
<br />✓
<br />OCCUR
<br />CLAIMS -MADE.
<br />BE 029502009
<br />1/102015
<br />r7/ 12016
<br />EACH OCCURRENCE
<br />$ 5,000,000
<br />AGGREGATE
<br />$ 5,000,000
<br />DED ✓ RETENTION $0
<br />...., $
<br />D
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABI••LITY YIN
<br />ANY PROPRIETORIPARTNERIEXECUTIVE �'
<br />OFFICERIMENIBER, EXCLUDED?
<br />(Mandatory inNH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATION'S below
<br />NIA
<br />TSWC603136
<br />7/112015
<br />/2016
<br />✓ STEATUTE OTRH-
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />—
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />E.L. DISEASE, POLICY LIMIT
<br />$ 1,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
<br />Re: Parking lot sweeping services.
<br />The City its officers, agents, employees are named additlonal insureds with resepect to the general liability and auto liability per the attached
<br />blanket. Carrier farm.
<br />a, ii U t:rl'.UTA l C InIVLL)MM L.AI4L.CLLF1. f II,TI1r
<br />The City of Santa Ana
<br />Community Development Agency
<br />20 Civic Center Plaza M -26
<br />Santa Ana CA 92701
<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 />Jim Waterhouse
<br />tJ 1988 -2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
<br />',11,307Q7s I Ginnia I 2015 . All L,n I P.inrnde Edaecamnntr_ 1 6/30/2015 11.55;06 AM (PDT) I Mage 1. of 5
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