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Policy Number; Date Entered: 9/25/2014
<br />ACO011iCERTIFICATE OF LIABILITY INSURANCE 5/5/2015YYY,
<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 poltoy(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 CONTACT
<br />ASL Insurance Services NAME ,,_...............
<br />.... .............
<br />PHONE (818)957 3366 FAx ....._ ..._.
<br />3533 North Verdugo Road E No. EXU ...._- .(818)957-3369
<br />....... ....__ice, Nol,
<br />Glendale, CA 91206 ADDRESS: instogo4Qsbcglobal net
<br />._. .._INSURERIsj AFFORDINQ COVEaAtlE .NAICb
<br />INSURER A: Scottsdale Insurance Company '
<br />INSURED INSURER B. Infinity COmmerCi81 Auto - ---
<br />Insure Protective Security Inc. INSURER C! State Compensation Insurance Fund
<br />1260 North Hancock Steet Suite# 102-D INSURER D:
<br />Anaheim, CA 92807INSURERS ..
<br />INSURER F ;
<br />COVERAGES CERTIFICATE NUMRFR- REVISION NIIMRFR-
<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
<br />ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />...'ADbl SUER",,..... -.. ............. .._......_.
<br />LTR TYPE OF INSURANCE POLICY NUMBER
<br />POLICY EFF - POLICY EXP . ._......._
<br />MMIUDIYYV MMIDD/YYYY LIMITS
<br />.._............. ...-___
<br />A COMMERCIAL GENERAL. LIABILITY -i.
<br />EACH OCCURRENCE -'
<br />t 1, DDD, DOD
<br />CLAIMS MADE OCCUR /� CpS19922$9
<br />9/23/2014 9/23/2015 OAMAGE'r0 flENTED
<br />MED
<br />IOD'00 O
<br />X ERRORS & OMISSIONS ',..
<br />EREg1Ea.m.ponnsa) -'$5,000
<br />MED EXP iAnYOna parson) .$
<br />PERSONAL& ADV INJURY
<br />$1,000,000
<br />GEN'L AGO REGALE LIMIT APP LIES P ER:
<br />GEN E RAL AGG REGATE ';$3,000,000
<br />X...
<br />POLICY _ JEPRCTO- LOC
<br />_._
<br />PRODUCTS-COMP(OP AGO '$3,000,000
<br />.. ........... ........
<br />..OTHER: ''..
<br />,$
<br />-. AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT !
<br />LEa see daunt,-
<br />$ 1OOOODO
<br />, , __-... _.
<br />B
<br />IANYAUTO ',504-61007-0156-001
<br />5/5/2015 5/5/2018 BODILY INJURY (Par person)ALL L$
<br />_
<br />AUTOS NED AUTOSULED
<br />Be OIL YINJURY(Par acadent)
<br />$
<br />NON -OWNED
<br />PROPERTY DAMAGE
<br />HIRED AUTOS AUTOS
<br />�(Pe accde_nr1.
<br />UMBI EA
<br />_$
<br />$300,000...
<br />UMBRELLA LIAB OCCUR :
<br />EACH OCCURRENCE
<br />$
<br />EXCESS LIAR CLAIMS -MADE
<br />AGGREGATE _$
<br />11
<br />OED RETENTION$
<br />$
<br />WORKERS COMPENSATION
<br />PER OTH
<br />AND EMPLOYERS' LIABILITY YIN
<br />- -STATUTE ER
<br />L. _ ANY PROPRIETORIPARTNER/EXECUTIVE
<br />❑ NIA 9100826-14
<br />- EL EACH ACCIbENT
<br />5/7.8/2014 5/2B/2015
<br />-OFFICER/NeMalin EXCLUDED?
<br />(Mandatory In NH)
<br />EL. DISEASE -EA EMPLOYEE'.
<br />T$1,000,000
<br />_
<br />$ 1, 000, 000
<br />11 Van. describe under
<br />DESCRIPTION OF OPERATIONS below
<br />.....__.... _
<br />EL.DISEASE - POLICY LIMIT
<br />-$1,000,000
<br />S -Commerical Automible ! i504-61007-0156-001
<br />5/5/2035 5/5/2016 IDMBI Ea...-
<br />100,000
<br />UMPD
<br />3,500
<br />'.Medical
<br />5,000
<br />DESCRIPTION OFOPERATIONSSanta LOCATIONS IVEHICLES Schedule, may attached it more space Is required)
<br />The Cit of Santa Ana, it's officers mpyRemarks
<br />City employees, agents,
<br />officers,
<br />a
<br />and representative are included as
<br />additional insured on the General Liability policy with
<br />respects to the operation of the named
<br />insured only.
<br />* Except 10 day notice of cancellation for non-payment of
<br />�1�y.
<br />premium.
<br />Ve�`ev'N
<br />City of Santa Ana, its officers, SHOULD ANY O A'98 AB(
<br />Employees, Agents, Volunteers and Representatives THE EXPIRATION DATE
<br />ACCORDANCE WITH THE F
<br />20 Civic Center plaza
<br />Santa Ana, CA 92701 I AUTHORIZED REPRESENTATIVE
<br />LUGO
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
<br />Produced using Forms Ross Plus software, vww.FonnsBoss.00m; Impressive Publishing 800.2084977
<br />3S BE CANCELLED BEFORE
<br />WILL BE DELIVERED IN
<br />PROVISIONS.
<br />reserved.
<br />
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