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�``c''� °® CERTIFICATE OF LIABILITY INSURANCE 2DATE 1201 MIDOIYVYV) 9/2/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollcy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER United Agencies, Inc. One Post, Ste. 200 Irvine CA 92618 TA NAME: CT Janae Duvall PHONE FAX AIC No Ext: - - A/C No: E -MAIL ADDRESS: duvallQuoifladageodies.corn INSURERS AFFORDING COVERAGE NAIL H 4/8/2016 INSURER A:American Fire $1,000,000 DAMAGE TO RENT D PREMISES Eeoccumence INSURED DEKRIND -01 INSURER B:T , Ohio Casualty Insurance Company 40 INSURER C: $1,000,000 Dekra -Lite Industries, Inc. 3102 W. Alton Ave Santa Ana CA 92704 INSURER D $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER X I POLICY PRO LOC PRODUCTS - COMP /OP AGO $2,000,000 INSURER E, $ INSURER F: AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS X NON -OWNED AUTOS COVERAGES CERTIFICATE NUMBER: 1704872703 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR rypE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF (MMUDDPYYYYI POLICY EXP flMM1DDfYYYYI LIMITS B GENERALLIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FX7 OCCUR Y N I BKO56706360 I 4/8/2015 4/8/2016 EACH OCCURRENCE $1,000,000 DAMAGE TO RENT D PREMISES Eeoccumence $100,000 I EXP (Any one person) $5,000 PERSONAL &ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER X I POLICY PRO LOC PRODUCTS - COMP /OP AGO $2,000,000 $ A AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS X NON -OWNED AUTOS Y N BAA56553508 41812015 4/8/2016 Ea accident $1,000,000 BODILY INJURY(Perperson) $ BODILY INJURY Peracciden[ $ PROPERTY DAMAGE Per eccident $ Hired Car Phy Damage $125,500 A X UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS -MADE N N ESA56553508 4/8/2015 4/8/2016 EACH OCCURRENCE $2,000,000 AGGREGATE It BED X RETENTION $10,000 1 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ N ANY PROPRIETOR /PARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) Ifyes, describe under DE SCRIPTION OF OPERATIONS below N/A N WC STATU- OTH- E E. L. EACH ACCIDENT $ E.L. DISEASE EA EMPLOYEE $ E. L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) The City of Santa Ana its officers, employees, agents, volunteers and representatives are named as Additional Insured as required by written contract per attached forms. V CERTIFICATE HOLDER CANCELLATION ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza Santa Ana CA 92701 AUTHORIZED REPRESENTATIVE c ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD