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") I I'/f - <br />AliCCORbr CERTIFICATE OF LIABILITY INSURANCE <br />5/12/2014 <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 Ts an ADDITIONAL INSURED, the policy(les) 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 <br />NOW Century Insurance Services <br />16 N. 2nd Street <br />Alhambra, CA 91801 <br />NANEACT New Century Ins Srv, Inc. <br />PN°NE.Exel• (626)300-9000 FAX <br />Noll:(626)570-0908 <br />EMAIL ._......._........_......__.. <br />AODR :lft O(Jusnci.com / License No. OB07085 <br />INSUREWID AFFORDING COVERAGE <br />NAIC p <br />INSURER A:American Fire and Casualty <br />4066 <br />INSURED <br />AVT, Inc. <br />341 Bonnie Circle Ste 102 <br />Corona CA 92880 <br />INSURERS Peerless Insurance Company <br />24198 <br />INSURER C:National Union Fire_ Ins Cc Pa <br />19445 <br />INSURERD:Foremost Signature Insurance Cc <br />41513 <br />INSURER E : <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBERsALL 14-15 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 />INSft <br />1113. <br />TYPE OF INSURANCE <br />AD LSU <br />R <br />POLICY NMBER <br />POLICY EFF <br />IMMIDDNMt <br />POLICY EXP <br />JRMLPDX=LIMITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ 1,000,000 <br />X COMMERCIAL GENERAL LIABILITY <br />PREMISES <br />ELATED <br />fee <br />$ 500,000 <br />A <br />CLAIMS -MADE OCCUR <br />3KA55963427 <br />/31/2014 <br />/31/2015 <br />MED EXP(Any one person) <br />$ 5,000 <br />PERSONAL &ADV INJURY <br />$ 1,000,000 <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMPfOP AGG <br />$ 2,000,000 <br />X POLICY PRO- LUC <br />$ <br />AUTOMOBILE <br />LIABILITY <br />COMBINE <br />dEDt SINGLE LIMIT <br />1 000 000 <br />X <br />_adnB <br />BODILY INJURY (Per parson) <br />$ <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />BA2442759 <br />/22/2014 <br />/22/2015 <br />BODILY INJURY (Per accident) <br />$ <br />HIRED AUTOS No OSWNED <br />PPROPE dTYacc,DAMAGE <br />$ <br />$ <br />X <br />UMBRELLA LIAR <br />X <br />OCCUR <br />EACH OCCURRENCE <br />$ 4,000,000 <br />AGGREGATE <br />$ 4,000,000 <br />L• <br />EXCESS LIAR <br />CLAIMS -MADE <br />DED I I RETENTION <br />$ <br />BU063717909 <br />11/412013 <br />1/4/2014 <br />D <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETOP/PARTNERIEXECUTIVE ❑ <br />OFFICERIMEMBER EXCLUDED? <br />(Mandatory in NH) <br />NfA <br />04007748 <br />f6/2014 <br />j6/2015 <br />WC STATD- Ol'H- <br />X 1 <br />E.L. EACH ACCIDENT <br />$ 11000,000 <br />E.L. DISEASE EA EMPLOYEE <br />$ 1,000,000 <br />If Yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />..—.---.....___..__...._._. <br />E.L. DISEASE POLICY LIMIT <br />$ 1 000 000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) <br />THE CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS, VOLUNTEERS AND REPRESENTATIVES ARE NAMED AS <br />ADDITIONAL INSURED PER POLICY FORM NUMBER: CG70020101. THIS CERTIFICATE IS VALID ONLY IF THE CERTIFICATE <br />HOLDER REQUIRES IN A WRITTEN CONTRACT TO BE NAMED AS ADDITIONAL INSURED. THIS POLICY IS PRIMARY 4 <br />NON-CONTRIBUTORY. 10 DAYS NOTICE OF CANCELLATION FOR 112N PAYMENT OF PREMIUM. 30 DAYS OTHERWISE. <br />,TO TOVIV, <br />(714)571-4211 <br />The City of Santa Ana <br />Parka, Recreation and <br />20 Civic Center Plaza <br />P.O. Box 1988 <br />Santa Ana, CA 92702 <br />4tar G�{y ^`- <br />P5St5tatt <br />Community Services <br />M-23 <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 />Shen/BIH <br />9)1988-2010 ACORD CORPORATION. All rinhts reserved. <br />INSn25r9Mnmsint Thu AChRn nemu and Innn oru runicfaruA enerke of Arnion <br />