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ACC)R1 :> CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 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 policy(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 endorsements . PRODUCER United Agencies, Inc. One Post, Ste. 200 Irvine CA 92618 NT CT NAME: Janae PHONE FAX - Arc No): EMAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # N INSURER A.:Arner'Qao Fire and Casualty Company 4/8/2015 4/8/2016 INSURED DEKRIND -01 INSURER B: asu I ny 24074 INSURER C: Dekra -Lite Industries, Inc. 3102 W. Alton Ave Santa Ana CA 92704 INSURER D DAMAGE T RENTED PREMISES Ea occurrence $100,000 MED EXP (Any one person ) INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 17048727[}3 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 TYPE OF INSURANCE INSR WVD POLICYNUMBER POLICY Err MMIDDfYYYY POLICY EXP MMIODNYYY LIMITS B GENERAL LIABILITY Y N BKO56706360 4/8/2015 4/8/2016 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE T RENTED PREMISES Ea occurrence $100,000 MED EXP (Any one person ) $5,000 CLAIMS -MADE FX1 OCCUR PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $2,000,000 $ X POLfCY FRO- LOC A AUTOMOBILE LIABILITY Y N BAA56553508 41812015 418/2016 O accident 1 000 000 X BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED :AUTOS AUTOS: BODILY INJURY (Per accident)$ X HIREDAUTOS X NON -OWNED AUTOS PROPERTY DAMAGE Per accident $ Hired Car Phy Damage $125,500 A X UMBRELLA LIAR OCCUR N N ESA56553508 4!812015 4/8/2016 EACH OCCURRENCE $2,000,000 AGGREGATE $ LIAR. CLAIMS -MADE 1DED X RETENTION $10,000 $ -:4EXCESS WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN N WC STATU• OTH- ER E.L. EACH ACCIDENT $ ANY PROPRI ETC RMARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? ❑ NIA E.L. DISEASE - FA EMPLOYE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below F.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES {Attach ACORD 901, Additional Remarks Schedule, If more space Is required) The City of Santa Ana its officers, employees, agents, volunteers and representatives are named as Additional In ured as required by written contract per attached forms. CERTIFICATE HOLDER CANCELLATION O 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, O 1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD