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EPIC LAND SOLUI"[ON S.4 20'I Li-1 ti'I RcVIEVVFIT BY
<br />EUNICE HF. REC PI�� 'I F 4) ROSEM
<br />CERTIFICATE OF LIABILITY INSURANCE
<br />DAT1
<br />arE(MM;DD,YYYY,
<br />t 4rza15
<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($), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) most 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 Rot confer rights to the
<br />certificate holder in lieu of such endorsements).
<br />PRODUCER License # OE67768
<br />0 NTACT Dana Schwartz
<br />IDA Insurance Services
<br />PHONE --"-- """-NAx `
<br />aPA&,Ns €xc (6t9) 574.6220 I IAIc,,N.),-"(��9�574_5288
<br />4360 La Jolla Village Drive
<br />Suite 900
<br />_
<br />E-MAO-, . pana.Schwartzm�l1toausa.com
<br />ADDRESS,_ QI
<br />San Diego, GA 92122
<br />INSURER(S)AFFORDING COVERAGE
<br />NAICI
<br />wsuRERA: VaNey Forge Insuranc,opany
<br />o Cm
<br />20508
<br />INSURED
<br />INSURERS:Trarisportation Insurance Company
<br />20494
<br />INSURER
<br />Epic Land Solutions
<br />INSURER D;
<br />2601 Airport Drive Suite 115
<br />Torrance, CA 90505--"-"-"-
<br />INSURER E : ---
<br />�—
<br />INSURER F :
<br />I
<br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<br />THIS IS TO CERTIFY 'THAT THE POLICIES OF INSURANCE LISTED BELOW 14AVE'BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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 />LTg
<br />TYPEbPINSURA—NGE A LT37
<br />INMIT
<br />POLICYE f
<br />POLICY NUMBER ''� MMIDD(Y Y
<br />...
<br />PeLlbytX
<br />IDO
<br />..............—..—." _
<br />LIMITS
<br />A
<br />XABILITY
<br />�COMGLA
<br />ERA1 LIOGCUH
<br />EACH OCCURRENCE
<br />S 2000,000
<br />MISMApkAL
<br />X X
<br />4031022253 i 1010112015
<br />f 10101K016
<br />�
<br />oarerlce]
<br />a 1000 00MEb
<br />TXC,ont Liabl5evPREMISFsffa
<br />EXP (A y ens person;
<br />S 10,000
<br />Owned Autos
<br />�'-
<br />PERSONALes A❑V INJURY
<br />$ - 2,000,000
<br />AGGREGATE LIMIT APPLIES PER.
<br />GENERAL AGGREGATE_ a
<br />G 4,000,00
<br />GENII
<br />_.IPOLICY
<br />I X� JECT i 1 OG
<br />PRODUC IB COMPIOP AEG
<br />a 4,000,000
<br />OTHER: 1
<br />)Ded�ucttbl¢
<br />_
<br />S
<br />AUTOMOBILE
<br />LIABILITY
<br />I OaBNEO INNMLIhn
<br />S-"_1,000,00
<br />A
<br />ANY AUTO
<br />-4031022263
<br />10/0112015
<br />101011201E4
<br />BODILY INJURY tPerpamoN
<br />S
<br />t—
<br />__
<br />AL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />.............. _.
<br />I BODILY INJURY P r ecieient}
<br />......�
<br />B
<br />X
<br />NON WINED
<br />HIRED AIITpa X AUTOS
<br />PROPERWDAMACE
<br />Perxcaldente
<br />-"
<br />A
<br />UMBRELLALIAR -- OCCUR
<br />EACH OCCURRENCE
<br />S 6,000,000
<br />8
<br />Exeses Una _�
<br />60142539H0
<br />1016112015110101
<br />l2016
<br />AGGREGATE
<br />s 6,00Q000
<br />OED I X I RETENTION.a Oi
<br />a
<br />PR
<br />AND EMPLOVERSELIA ILII'Y YIN !
<br />17, ER4
<br />A
<br />ANY PROVRIETORIPARTNER,eXECUTIVE
<br />594617867
<br />1010112015
<br />101011201Q
<br />EL EACHACCIOENT
<br />s 1,000,000
<br />OFFICERIMEMBFR EXCLUDED9 ❑!NIA
<br />IMmeldory In NVi
<br />F;.L.DISEASE-EAEMPLOYE-
<br />S 11000,000
<br />If yes de.rilm onAm-
<br />,DES(RIPTIONOFOP RATIONS balow
<br />E. L, OIREASE-POLICY LIMIT
<br />_
<br />S 1,000,000
<br />I
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, AAAItimml Remarks Sahelale, may ba attacbod if Pam space is metulred)
<br />Re: All Operations
<br />City of Santa AND, its offciers, employaos, agents, volunteers and representativs are Additional Insured's with respect to General Liability per the attached
<br />endorsement as required by written contract. Insurance is Primary and Non -Contributory,
<br />30 Days Notice of Cancellation with 10 Days Notice for Non -Payment of Premium in accordance with tiro policy provisions.
<br />City of Santa Ana
<br />20 Civic Center Plaza (M-21)
<br />P.O. Box 1988
<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 />7- ' i-i'1l. _ 401
<br />@ 1988-2044 ACORD
<br />ACORD 26 (2014101) The ACORD name and logo are registered marks of ACORD
<br />reserved
<br />
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