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A ERTIFICATE OF LI,A ILITY INSURANCE b212Z20"16 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIfi <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 PRODU"FL AND THE CERTIFICATE HOLDER, <br />IMPORTANT: If the aortflaats holder Ie an ADDITIONAL INSURED, the poliey(IORH must he andorsod, If SUBROGATION IS WAIVED, subjeot to the <br />terms and eanditlpns of the policy, Colon policies may require an endorsement. A statement an this pontificate done not confer rights to the <br />Gardfloate holderin Ilea of such endcrsement(e), <br />PRaOVCER <br />HUB INTERNATIONAL INS SERVICES INC <br />CONTACT <br />NANI, <br />NaP S•8•YG24 <br />371 LATHAM 8T 101 <br />CONaCateQianOVer.COm.,........„„...._...`85"-.""._._..__..._.,v.. <br />.(Ale:,.nn,.exll__,.__.___,__.._�__._...IAs! <br />E-MAIL <br />RIVERSIDE, CA 926 92601 <br />'98A11hAd 7 <br />_m,_ „INSUkBR1a)AFPOkbiNG COVERAGE, I NAIGtt <br />tyQypE6AI CItizena ins Co D4 Amerlce 316NI <br />„.,...-f. <br />Ngugg_ Allmerica Financlel Benefit 41840 <br />LINEAR SYSTEMS <br />_ _ - <br />8403 MAPLE PLACE <br />!M8.4i4ED F.,.. _ _ ., <br />IryEpRsao <br />RANCHOCUCAMONGA,CA 91730 <br />•• A <br />__ ._._ ... <br />�INsuRsnP <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br />THIS IS TO CERTIFY THAITHE POLICIES OF INSURANCE LISTED BELOW HAVE BERN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PEHIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM ON CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, 'fHN INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IB SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE SEEN REDUCED BY PAID CLAyIgMpS. <br />IBb�F ATM15JBYIBp -- PeMM,OpIVYYYI W140 NVYY1II— LIMITa <br />TYPE OF INSURxANCE �Q L DUMPER <br />'I <br />GENER4L LITYPEV <br />EACH frgVRReNOE <br />8100D 000 <br />X <br />� <br />LTXMA"G "Yb'RETIYECT <br />•• A <br />A <br />COMMEPCkL D NER?I LlAllll•_^ <br />4- rrY <br />I-.ry <br />E REy AGS fSen {„„ a <br />$30D000 <br />,1CLAIMS-MADE OCd Uft <br />., <br />003 9895815 02 <br />026!2016 <br />426i2016 <br />10 D <br />PERSONALE ADV INJURY <br />1,100D000 <br />( ,.�_ <br />[3ENEPAL AeGRECJTE <br />S 2 DOD,DOO - <br />DENL \GGREGATS LIMIT APPOFS PER <br />PROGIJr'TS L@dPlOP AuG <br />S20DO,000 <br />_ I PY, LICY P + LOC000 <br />"•• •• ,••,' <br />3 .._.. .__ <br />AUTOMOBILE <br />tX. <br />IIAwL11'Y� <br />I, .�.7 <br />_I!;,9.5&FIAaA7..,.,.,.. <br />000 <br />ANYAUTG <br />80OILY INJURYIPgr P,uwnl <br />..__., _._.�._.. <br />I <br />B <br />ALL OWNED gchaOULEo <br />f <br />I <br />AW3989880002 <br />04/26016 <br />04PL6/201fi <br />`^' <br />100111 INJURY 1Psr so- Uany <br />-^• <br />9 <br />W' <br />n <br />PUTO5 <br />NN{N80E[I <br />I <br />TRbPE'RRY &MAGE <br />_.... <br />S <br />—'AUT05 <br />I11RE0 PLTOB AUtBOS <br />I <br />_ <br />Pof PctlJ I <br />I <br />1 <br />I <br />5 <br />UMSRELIA LIAeCCCUk <br />If�'�I•�"mm <br />.AOHCCCLIRRBJCE S <br />F,„.,..___...._.,..., <br />EXOESS LIPU -•. <br />-_., CLAIMS. M� <br />........ <br />AGGR CATF <br />DED (RETENTIONS <br />AND EMPLOYERS' NU Yrate) <br />ANOEMPLDYEPa'LAnIUTV <br />I—, <br />GggfAfU 0 H <br />�HY.WMI ^R ER <br />B <br />ANY PROPWEYOWPAWWWrXP_CVYNa (( <br />I NrA� <br />- <br />W239871564 tl2 <br />Ua/01M0'16 <br />D3/011EOiQ4 El EALM ACCIDLIIT S I VUQ DgD <br />OPPICUMEMMA ExcwOEm _.. <br />1Msndelury NNHI <br />I <br />,- <br />l,EL OIaEASE EA EMP OYES S10DD,OOp <br />fya. Aebcnbe vnAtler f <br />DI: <br />- EL DISEASE POUCYCMIr S 1,DDD,DOD <br />i <br />DEECRInION eF OPEBATlaNSI LOCATIONS f VE lI 'LEG (Attach ACORp ipi, AUeeFonal Remar'ne aahebuM, irmon space la rogWmgl <br />Cortlfluelo Halder l6 an Additional Insured purauant W the terms and conditions, of form: $911006(BU01hositAre dRabAQy SpecialB�doring Endorsement). <br />Additional In8urnd 19 primary and noncontributory to the extent provided by form 391- <br />1331. <br />'IV <br />V V �//S`/`Q�� <br />City of Santa Ana <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACaOROANC,E WI ON THE POLICY PROVISIONS. <br />AGORD 25 (2010105) The ACORD name and logo are rogistered marks of ACDRD <br />