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<br />A� ®® CERTIFICATE OF LIABILITY INSURANCE
<br />°$i31/ DIi
<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 (NSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND TH CE FI AT OLDER.
<br />IMPORTANT: If the certificate a n "ADDITI NA I SURED, the policy(!as) 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 e o s rpe t( r "•, I ,
<br />PRODUCER r�6 I I �. ,(`i/ I
<br />White and Company Insura °8'W Y (�4 (
<br />P O BOX 70
<br />Santa Monica CA 90406 -0070
<br />NAME: `Yuan Ramos '
<br />PHONN Ez ('10)393-9477 A No: (310)393 -7186
<br />MAIL ramos @whitecoinsurance.com
<br />ADDRESS:3
<br />INSURER (S) AFFORDING COVERAGE
<br />NAIC M
<br />INSURER A:Federal Ins Cc
<br />20281
<br />INSURED
<br />Intratek Computer Inc
<br />9950 Irvine Center Drive
<br />Irvine CA 92618
<br />INSURER B :His COX
<br />COMMERCIAL GENERAL LIABILITY
<br />INSURER C:
<br />INSURER D:
<br />INSURER E :
<br />EACH OCCURRENCE
<br />INSURER F:
<br />A
<br />COVERAGES CERTIFICATE NUMBER :14- 15gl,ba,wc,um, 15 /16pro 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 />INSR
<br />LTR
<br />rypE OF INSURANCE
<br />ADDLSUBR
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM /DDIYYYY
<br />POLICY EXP
<br />MM DO
<br />LIMITS
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />A
<br />CLAIM &MADE X OCCUR
<br />DAMAGE TO RENTED
<br />PREMISES Ea occurrence)
<br />$ 1,000,000
<br />MED I(Any one person)
<br />$ 10,000
<br />36001449
<br />12/31/2014
<br />12/31/2015
<br />PERSONAL B ADV INJURY
<br />$ 2,000,000
<br />GENT AGGREGATE LIMIT APPLIES PER',
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />X P- E71 POLICY JECT LOC
<br />PRODUCTS - COMP /OP AGO
<br />$ 2,000,000
<br />Employee Beneflies
<br />$ 2,000,000
<br />OTHER
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$ 1,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />A
<br />qOMOBILE
<br />ANY AUTO
<br />ALL OWNED X SCHEDULED
<br />AUTOS AUTOS
<br />73582560
<br />12/31/2014
<br />12/31/2015
<br />BODILY INJURY(PeraccldenQ
<br />$
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />X NON -OWNED
<br />HIRED AUTOS AUTOS
<br />72UECZN4710
<br />10/29/2014
<br />10/29/2015
<br />Como/Coll Deductible
<br />$ 1,000
<br />X
<br />UMBRELLA LIAB
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 10,000,000
<br />AGGREGATE
<br />$ 10,000 000
<br />A
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED X
<br />RETENTION 10,000
<br />$
<br />179890455
<br />12/31/2014
<br />12/31/2015
<br />WORKERS COMPENSATION
<br />EMPLOYERS' LIABILITY YIN
<br />STATUTE ER
<br />X STATUTE
<br />ANY PROPRIETORIPARTNER/EXECUTIVE
<br />E. L. EACH ACCIDENT
<br />$ 1,000,000
<br />A
<br />OFFICER /MEMBER EXCLUDED? ❑
<br />(Mandatory In NH)
<br />NIA
<br />71719716
<br />12/31/2014
<br />12/31/2015
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS bd.
<br />EL .DISEASE - POLICY LIMIT
<br />$ 11000,000
<br />B
<br />Professional Liability
<br />UCS2629952.15
<br />9/28/2015
<br />9/28/2016
<br />Policy Limit (Aggregate) 2,000,000
<br />(Efi0)
<br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
<br />City of Santa Ana, its officers, agents, volunteers, and employees are named as Additional Insureds per
<br />form 80- 02- 2000(Rev.4 -01), attached to General Liability Policy.
<br />*30 days notice except for 10 days notice of cancellation for non payment of premium.
<br />wLgag9Ci
<br />City of Santa Ana
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92701
<br />UANUI 11VN
<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 />Juan Ramos /JAR
<br />no 1QRR -2014 ACORD Cl'1RPORATION_ All rinhfs rescrva
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD (/�
<br />INS025(nn14n1) 9ewMeC ✓C �
<br />(7- 1/1
<br />
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