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<br />SBAGO -1 OP ID:
<br />CERTIFICATE OF LIABILITY INSURANCE °A0310912015
<br />� �sr2a15
<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 policytes) 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 />Brothers,lnc.
<br />Thomas Hunt, Esquire
<br />5900 NW Broken Sound Parkway
<br />Boca Raton, FL 33487
<br />412.261
<br />INSURERS} AFFORDING COVERAGE
<br />,NS1,RERA,Travelers Prooerty Casualty Co
<br />INSURER B: St Paul Fire & Marine Ins Co
<br />INSURERc:lllinois Union Insurance COMIDa
<br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<br />-4149
<br />NAIC #
<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,
<br />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 />ILTft TYPE OF INSURANCE DD U
<br />POLICY NUMBER (HMdDDtYYYY MMfDOtYYYY LIMITS
<br />GENERAL LIABILITY
<br />( EACH OCCURRENCE $
<br />900,00
<br />A X COMMERCIAL GENERAL LIABILITY X
<br />TJEXGL474MB138TIL15 0311612015103115!2616 p MALSES Eeoccuirerxe (8
<br />900,
<br />CLAIMS MADE OCCUR
<br />1 MED EXP(Apy.m person) $
<br />NIA
<br />X $100,00GSIR
<br />PERSONAL 3 ADV INJURY $
<br />900,00
<br />GENERALAGGREGATE $
<br />2,000,00
<br />GEN'LAGGREGATE LIMIT APPLIES PER:
<br />PRODUCTS - COMP /OP AGO $
<br />2,000,00
<br />PRO
<br />$
<br />POLICY X LOC
<br />AUTOMOBILE LIABILITY
<br />COMBINED SINGLE LIMIT _._.,
<br />Ea accitlent
<br />1,000,00
<br />A X ANY AUTO
<br />TC2JCAP474MB14ATIL15 0311512015 0311612016 SODILYINJURY(Per person) $
<br />ALL OWNED SCHEDULED
<br />BI BODILY INJURY (Per accident) $
<br />AUTOS AUTOS
<br />NON -OWNED
<br />X X
<br />PROPERTY DAMAGE
<br />$
<br />HIRED AUTOS AUTOS
<br />PERACCIDENTL__.
<br />X 100,000 DED -HCPD
<br />1 s
<br />X UMBRELLA LIAa X OCCUR
<br />I EACH OCCURRENCE _$
<br />26,000,00
<br />-_
<br />B EXCESSUAB ''CLAIMS -MADE
<br />UP16N3740516NF 0311512015 0311512016 AGGREGATE s
<br />�
<br />25,ODO,00
<br />DED X REENTiONS 10,000
<br />$�
<br />WORKERS COMPENSATION
<br />X VVC STATU- OTH-
<br />ANO EMPLOYERS' LIABILITY YIN N
<br />TORV LIMITS c_. ER- _ _,,,,__,,,
<br />A ANY PROPRIETORIPARTNERIEXECUTIVE
<br />OFFICERIMEM BER IN INIA
<br />TC2JUB476M437816 (ADS) 03115!2015 03116/2016 E.L. EACH ACCIDENT $
<br />1,000,00
<br />A (Mandatory in NH)
<br />TRJUB476M438A15 03/1512096 03/15/2015 E.L. DISEASE - EA EMPLOYE $
<br />1,000,00
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />IE.L. DISEASE - POLICY LIMIT $
<br />1,000,00
<br />C PROFESSIONAL
<br />1COOG24541800005 03/1512016 03/1612016 C
<br />5,000,00
<br />POLLUTION
<br />SIR
<br />100,00
<br />DESCRIPTION OF OPERATIONS I LOCATIONS )VEHICLES (Attach ACORD iei, Additional Remarks Schedule, if more space to required)
<br />Number: CA46019 -A -0, Site Name: Salvador Center, 1825 Civic Center Dr. aje44ed
<br />Site
<br />s``y��GuPd��r
<br />S�
<br />City of Santa Ana, Executive
<br />Director Parks, Rec and
<br />Community Services (M -23)
<br />26 Civic Center Plaza, M -75
<br />Santa Ana, CA 92701
<br />ACORD 26 (2010105)
<br />CA46019
<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 />O
<br />The ACORD name and logo are registered marks of ACORD
<br />CORPORATION.
<br />
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