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C& <br />CERTIFICATE OF LIABILITY INSURANCE <br />DATE YY) <br />E /14 /2015 <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 does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER Beecher Carlson Insurance Services <br />6 Cadillac Drive, Suite 320 <br />Brentwood, TN 37027 <br />NAME: Beecher Carlson Insurance Services <br />PHONE 615- 277 -9840 <br />nIC No: 615- 277 -9879 <br />EMAIL <br />ADD ESS: <br />INSURERS AFFORDING COVERAGE <br />NAIC p <br />�/ <br />INSURER A: Greenwich Insurance Company <br />22322 <br />www.beechercarlson.com <br />INSURED <br />AutoZone West, LLC, <br />A Nevada Limited Liability Company <br />Dept 8030 123 So. Front Street <br />Memphis fN 38103 -3607 {'���q tC ''YY q y <br />f-t ZO`i S ^ V ` ('-:t <br />INSURER S: <br />INSURER C: XL Specialty Insurance Company <br />37885 <br />INSURER D: <br />SIR applies per policy <br />terms &conditions <br />INSURER E: <br />@' <br />INSURER F: <br />PREMISES RENT r �n�e <br />L. <br />COVERAGES CERTIFICATE NUMBER: 24692449 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 />INTRR <br />TYPE OF INSURANCE <br />ADDL <br />BUBR <br />POLICY NUMBER <br />MMIDOmYY <br />MMID�M'YY <br />LIMITS <br />A <br />COMMERCIAL GENERAL LIABILITY <br />�/ <br />�/ <br />RGE943759902 <br />9/1/2014 <br />9/1/2015 <br />EACH OCCURRENCE <br />$ 1,000,000 <br />CLAIMS -MADE 7OCCUR <br />SIR applies per policy <br />terms &conditions <br />@' <br />PREMISES RENT r �n�e <br />L. <br />$ 1,000,000 <br />MED EXP (Any one person) <br />$ Excluded <br />PERSONAL &ADV INJURY <br />$ 1,000,000 <br />.r� <br />®T yD <br />y'Y� Y <br />l <br />TO <br />y� <br />RCK <br />-" <br />GENL AGGREGATE LIMIT APPLIES PER <br />✓ POLICY PRO- <br />ECT LOD <br />OTHER. <br />GENERAL AGGREGATE <br />It 10,000,000 <br />PRODUCTS - COMP /OP AGO <br />$ 4,000,000 <br />SIR <br />$ 1,000,000 <br />AUTOMOBILE <br />LIABILITY <br />ANYAUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />cs <br />p,�sts�ant <br />try ja {O <br />I <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$ <br />BODILY INJURY person) <br />$ <br />BO DILYINJURY(Peraccidenl) <br />$ <br />NON -OWNED <br />HIRED AUTOS AUTOS <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />C <br />UMBRELLA LIAB <br />�/ <br />OCCUR <br />US00064067LI14A <br />9/1/2014 <br />9/1/2015 <br />EACH OCCURRENCE <br />$ 25000000 <br />EXCESS LIAB <br />CLAIMS -MADE <br />SIR applies per policy <br />terms & Conditions <br />AGGREGATE <br />$ 25,000,000 <br />OLD ✓ RETENTION $10,000 <br />Products Aggregate <br />$ 25,000,000 <br />WORKERS COMPENSATION <br />AND EMPLOYERTLIABILITY YIN <br />PER I OTH- <br />STATUTE I ER <br />E.L. EACH ACCIDENT <br />$ <br />ANY PROPRIETOWPARTNEWEXECUTIVE ❑ <br />OFFICERIMEMBER EXCLUDED? <br />NIA <br />E . DISEASE - EA EMPLOYE <br />$ <br />(Mandatory In NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT <br />$ <br />17— <br />1 7-7 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />RE: Store No. 5538 -01 -01 Store Location: 1101 S BRISTOL ST SANTA ANA CA 92704 -0000 <br />CITY OF SANTA ANA is included as Additional Insured as required by written Contract, but is limited to the <br />operations of the Insured and is subject to the policy terms, conditions and exclusions and endorsement #CG2011 as attachment. <br />A Waiver of Subrogation is granted in favor of Certificate Holder as required by written contract but is limited to the operations of the <br />Insured as is subject to the policy terms, Conditions and exclusions and endorsement #CG2404 as per attachment. <br />CERTIFICATE HOLDER CANCELLATION <br />5538 -01 -01 <br />CITY OF SANTA ANA <br />20 CIVIC CEN TER PLAZA, M -36 <br />SANTA ANA TE 92701 <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 u n \ <br />U'VtIM...r 016t <br />(NASH) Donna Bagley <br />© 1988.2014 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD <br />CERT NO.: 24652449 (NASH) eaxah Ivy 5/14/2015 4:21:05 PM (CDT) Page I of 3 FORM: 14/15 GL AL We OMB <br />