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,` CERTIFICATE OF LIABILITYINSURANCE �A��2M��lr�YYYY)
<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 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 doe's not confer rights to the
<br />certificate holder in lieu of such ondorsoment(s).
<br />PRODUCER CONTACT New Century Ins Srv, Inc,.
<br />NAME:
<br />New Century Insurance Services PHaNE Q625)3aa-9aaa (AC.
<br />N©:(E26)570-0908
<br />16 N. 2nd Street E-MAIL ADDRESS: in£a@usnc .eam ,✓ License No. aB07085
<br />INSURERS AFFORDING COVERAGE NAIC #
<br />Alhambra, CA 91801 INSURERA:Ohio SecurityInsurance Com am 4082
<br />_._ . ._
<br />.. _...... -
<br />INSURED
<br />AAA ,-,,` )131 (` l-(, NSURERBAmerican Fire and Casualty CO 24066
<br />AVT, Inc. INSURERCNational Union Fire Ins Co Pa 19445
<br />341 Bonnie Circle Ste 102 INSURER D:Hartford Insurance Co. Of The 37478
<br />INSURER E :..
<br />...._. __...__..-
<br />Carona CA 92880 INSURER I=:
<br />C0VFRACFS CFRTI'FIrATF N141i RFR•ALL 15-16 UMS 14-15 RPVICI()N NI INIRPI:P•
<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-__,.... ADDL..SUBR EFF.._ POLICY EXR, mm .....___.......... .
<br />LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER. MMIDDYYYY MMIODfYYYY LIMITS
<br />GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />X COMMERCIAL GENERAL LIABILITY
<br />DAMAGE OmR"C TED---
<br />PREMISES Ea occurrence
<br />_.
<br />$ 500,000
<br />A
<br />'., CLAIMS -MADE F OCCUR
<br />KS (16) 55963427
<br />/31/2015
<br />5/31/2016
<br />MED EXP (Any one person)
<br />$ 15,000
<br />PERSONIAL & ADV INIURY
<br />$ 1,000,000
<br />.GENERAL AGGREGATE
<br />$ 2,000,000
<br />GEN'L AGGREGATE LIMITAPPLIES PER_m..m.._
<br />-GENERAL
<br />- COMPIOP AGG
<br />$ 2,000,000
<br />X POLICY ''',, PRO- LOC
<br />$
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />1 04a (Pl7a
<br />r_.._.....
<br />�
<br />ANY AUTO
<br />_
<br />BODILY INJURY (Per parson)
<br />...$...,.._.. .c.__.-_.._-
<br />$
<br />g
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />AA 1 7
<br />( 6)5596342
<br />/22/2015
<br />2/22/2016
<br />.._
<br />BCDILYINJLIR'Y(Peraccfident)
<br />$
<br />WON-OWNIED
<br />—PROPERTYDAMAGE
<br />$
<br />FIRED AUTOS AUTOS
<br />-Inderinsured motorists
<br />$ 1,000,000
<br />.X
<br />UMBRELLA LIAR X
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 4,000,000
<br />AGGREGATE
<br />.--...__.___...,...-.......�-.._w._._....
<br />$ 4,000,000
<br />C
<br />EXCESS LIAR
<br />CLAIMS -MADE
<br />-..i.
<br />DED RETENTION $
<br />EBU020447604
<br />11/4/2014.
<br />11/4/2015
<br />D
<br />WORKERS COMPENSATION
<br />VVC STATU- OTH-
<br />X
<br />AND EMPLOYERS' (.(ABILITY Y f N
<br />T Y_I.it�IP.T.S. _-_..
<br />ANY PROMEMRERfEXCLUCRrEKECUTIVE
<br />E.L..EACHACCIDENT.
<br />$ 1 000 000
<br />aFFtlCER�MEMEER EXCLUCED?
<br />(Mandatary in NH)
<br />N f A
<br />72TnTECVEC5513(Y
<br />/6/2015
<br />/6/2016
<br />E.L. DISEASE - EA EMPLOYE(
<br />$ 1,000,000 '..
<br />It yes., describe under
<br />..................
<br />DESCRIPTION OF OPERATIONS deYow ...._.
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 1 000 000
<br />DESCRIPTION OF OPERATIONS 1 LOCATIONS f 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. CG88830412. THIS CERTIFICATE IS VA11D ONLY IF THE CERTIFICATE
<br />HOLDER REQUIRES IN A WRITTEN CONTRACT TO BE NAMED AS ADDITIONAL INSURED, THIS POLICY IS PRIMARY &
<br />NON-CONTRIBUTORY. la DAYS NOTICE OF fi LLATION FOR NON PAYMENT OF PREMIUM. 30 DAYS OTHERWISE.
<br />(714) 571-4211 0sGvu (.\
<br />The City of San Ana
<br />Parks, Recreation and C mmunity Services
<br />20 Civic Center Plaza M-23
<br />P.O. Boat 1988
<br />Santa Ana, CA 92702
<br />UA,NLI=LLA I IUN
<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 />Yang Qiao/YINQIA
<br />ACORD 25 (2010105) 01988-2010 ACORD CORPORATION, All rights reserved.
<br />INS029;l�ninn,a n1 Thn Ar`.OPn nnma and I'nnn nra ranieffarari mneke off A(`r)0r5
<br />
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