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DATE (MAVODIYYYY) <br />ACOOMY CERTIFICATE OF LIABILITY INSUMNICE 1012812015 <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 poli . c . y(les) meet he 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 enclorsementiai. COMTACT <br />PRODUCER Mike S Brandon <br />Michael Brandon, Insurance Agency 909- 8191 <br />E -MAI <br />31629 Outer Highway 10 Ste A _AQDF�LFIA;_'_ <br />RadIands CA 92373-7590 INSURER Ae NOrthIMICI insurance uornpany <br />INSURED INsuRERa: <br />I WATER ING. -INSURERC: Mid Century Insurance Ct,(i,P"n 21.687 <br />12 GOODYEAR S7E 130 INSURER 0; <br />t,co7U=tr1ATV rUIRAM12-0. RFVI1.ql0N NUMBER! <br />TI IIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LIST I ED I BELOW HAVE .BEEN l$SUED TO THE INSURED NAMED ABOVE FOR TML POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAiN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL 1HF- TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCE=D BY PAID CLAIMS. <br />- 'Rl--'� - --7-- - <br />TVPE OF MSURANCE DOL 'R tMWOV LIMIT$ <br />LTR w a wvn P LICY MUM <br />THE EXPIRATION DATE THEREOF', NOTICE WILL BE DELIVERED IN <br />GENERAL LIABILITY <br />-C <br />COMM814CAAL GENERAL LIABILITY <br />1-tX-7 <br />ACCORDANCE WITH THE POLICY PROVISION& <br />Ross Annex (M-1) <br />AUTHORIZED RFFR0EN1'XTIVE <br />EACH OCOtJRRFNC8 <br />-UAKM­E-TOWATff <br />PRQPALSRaff� <br />1,000,000 <br />100,000 <br />A <br />OLIUMS-MADE [XI OCCUR <br />Y <br />VVH0O6655 <br />10/27/2015 <br />10/27/2016 <br />_ItLDExf(An�,onq e2Lon <br />S 1,000,000 <br />PERSONAL & ADV INJURY <br />GENERA,LAGGREGATE,� <br />._!�110Lu ITS-COmPIOPAaG <br />2,000QQO <br />$ , <br />"EN'L AGGREGATE LIMR APPLIClcyS PEW <br />9ho -- <br />--L-1-PRO.'Ji� LOC <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />At;# <br />000 <br />BODILY $NJURY (Per person) <br />$ <br />AN'Y AUTO <br />BOUILYINJURY(PorocWenQ <br />- <br />4 . ...... <br />X <br />ALL OWNED SCHEDULED <br />r, <br />I^t <br />ALTOS AUT SWNF <br />ON?o 'n <br />HIRED AUTOS AUTOS <br />IN <br />605861543 <br />09164)2015 <br />0910412016 <br />�rCF �DAMA �E <br />NT wdTidsant <br />UMaRrLLA LIA111 <br />DCCLIFt <br />EACH OCCURREMP <br />C <br />AGGREGATE <br />EXCESS IJAS <br />CLAIMS -MAGE <br />DED T RETENTIONS <br />WORKERSCOMPENSA ION' <br />AND EMPLOYERWLIABILWY YIN <br />ANY PROPMETOMPARTNEMEXECUTIVF <br />7 OFFICE"EMBER EXCLUDED? <br />(Mandatory in NH) <br />MIA <br />GTATU- <br />UlTaLl-Tall- <br />F I- FACK ACCIDENT <br />E. AoLoyii <br />lf�as. 4e00be undar <br />0 SCRIPTION OF OPERATIONS blow <br />E,L,OISFASE-POLJC'YUM(T <br />S <br />DESCRIPTION OF OPERATIONS! LOCATIONS I VEHICLES (Alb.h ACORD 101, Additional RemnrUs Sthedule, It mare spam 1, mqulrvdl <br />ACORD 25 (2010105) <br />The ACORD name and logo are registered marks of ACORD <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />City of Santa Ana <br />THE EXPIRATION DATE THEREOF', NOTICE WILL BE DELIVERED IN <br />20 Civic Center Plaza <br />ACCORDANCE WITH THE POLICY PROVISION& <br />Ross Annex (M-1) <br />AUTHORIZED RFFR0EN1'XTIVE <br />Santa Ana, CA, 92701 ADE8 <br />ACORD 25 (2010105) <br />The ACORD name and logo are registered marks of ACORD <br />