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<br />CERTIFICATE OF LIABILITY IVSUQ& III,
<br />CE
<br />DATE (MMIDDIYYYY)
<br />02;26f2016
<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 policy(ies) 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 />PRODUCER CONTACT
<br />Marsh USA, Inc -NAME:
<br />PHONE FAX
<br />9830 Colonnade Blvd Ste 400 AAA,.'ho. FA):..._ (AIC, No
<br />San Antonio, TX 78230 E-MAIL
<br />_ADDRESS:
<br />INSURER(S) AFFORDING COVERAGE NAIL 9
<br />CN103820276-Dyna-GAWXM-16- INSURER A: AGE American Insurance Company 226
<br />INSURED INSURER B AIIlan7 Global Risks Us Insurance Company 353
<br />Dynarnex Operations West, LLC
<br />2051 Raymer Avenue, Unit A INSURER C Liberty Mutual Fire Insurance Company 230
<br />Fullerton, CA 92833 INSURER D N/A _NIA
<br />COVERAGES CERTIFICATE NUMBER: HOU-002697422-12 REVISION NUM[BER-12
<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 />INDlCATLD. 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, 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 />ADDL. SUBR POLICY EFF (POLICY EXP
<br />LTR TYPE OF INSURANCE INSP WVD POLICY NUMBER (MMIDDIYYYY MMIDDIYYYY) LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />627405708
<br />03/0112016
<br />0310112017
<br />EACH OCCURRENCE
<br />$ 10,000,000
<br />FYI
<br />CLAIMS-MADE _`_.] OCCUR
<br />DAMAGE TO RENTED
<br />..EBFMI��9S occurrence
<br />$ 10,000,000
<br />MED EXP (Any one person)
<br />$ 10,000
<br />PERSONAL & ADV INJURY
<br />$ 10,000,000
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGAiE
<br />$ 10,000,000
<br />POLICY F-1 JPECT LOC
<br />� _]
<br />PRODUCTS - COMPIOP . AGO
<br />$ 10,000,000
<br />OTHER:
<br />F
<br />$
<br />A
<br />AUTOMOSiLE
<br />LIABILITY
<br />H09041230
<br />03101/2016
<br />03101/2017
<br />COMBINED SINGLE LIMIT
<br />_.tEa accident)
<br />$ 10,000,000
<br />X
<br />ANY AUTO
<br />BODILY INJURY (Per person)
<br />$
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />BODILY INJURY (Per accident)
<br />$
<br />NON-OWNED
<br />HIRED AUTOS AUTOS
<br />PROPERTY DAMAGE
<br />Per accidentl
<br />$
<br />B
<br />X
<br />UMBRELLA LIAR X OCCUR
<br />XYZ00015227226
<br />0310112016
<br />0310112017
<br />EACH OCCURRENCE
<br />5,000,000
<br />AGGREGATE
<br />$ 5,000,000
<br />EXCESS LIAR CLAIMS-MADE
<br />...........
<br />T _ 1 -] ..... .....
<br />DEC RETENTION $
<br />. .......
<br />$
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANY PROPRIETOR/PARTNEPJE�. I —
<br />OFFICFWMEMBER EXCLUDED? N
<br />(Mandatory in NH)
<br />N J A
<br />WA2B7DI70841015
<br />09130/2015
<br />0913012016
<br />-T-F—PER i OTH-
<br />TATUTE
<br />_LfR
<br />E,L. EACH ACCIDENT
<br />1,000,000
<br />__ . . .. ........
<br />E.L. DISEASE - EA EMPLOYEE 1,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT $ 1,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks ScheduIe, may be attached if more space is required)
<br />City of San Ana, its Officers, Employees and Agerls are recognized as an Additional Insured on General Liability and Auto Liability as required by written contract
<br />City Of Santa Ana
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92701
<br />MORI
<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 />of Marsh USA Inc.
<br />-AVLDUI,A� " 1Nd--1t4-KAA44,1-
<br />@ 1988-2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
<br />
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