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Fax: (714)647-6944 ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE (MMIOD YYY) 1 � 05/06/2016 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 CONTACT : NAMERyan HagarPRDNE Steven P Hagar Insurance Services FAX 41891 Kalmia St Suite B AMAI o Ex (957)677-3631 Alc No: (951)69&3411 Ab DRESS, SS: an hagarinsurance.com Murrieta, CA 92562 License #: 6700596 MSUREgSIAFFCRDINGOOVERAGE NNC# _ - INSURERA: Scottsdale Insurance Company pRMMISEG Ea occuFar $ 100 OOO INSURED INSURER B: California AutomObilelnotranCeCompany 38342 INSURER C: Everest Insurance Company ROSE EQUIPMENT INSURER o: 8218 Sorensen Ave INSURER E: Santa Fe Springs, CA 90670-2124 INSURER F: PERSONAL&ADVINJURY $ 1,000,000 COVERAGES CERTIFICATE NUMBER: 00000000-202941 REVISION NUMBER: 43 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. /LTR TY PE OFINSURANCE sUBR POLICY NUMBER —POLICY—EFF— MMIODIYEYYY LIMITS A Y CPS2437904 05/02/20161.05/02/2017 EACHOCCURRMCE $ 1,000,000 rCOMMERCIALGENERALUAEkLITY CIAIM6-MODE C' OCCUR pRMMISEG Ea occuFar $ 100 OOO MEDEXP(Anyonepemon) $ 5000 PERSONAL&ADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGR_EGATE s 2,000000 X POLICYPLOC E� 1, - PRODUCTS -COMPIOP AGG $ 1,000,000 OTHER: I BA040000001207 071 7712015 on12ols ED LE LIMITBAUTOMOSILEUABIUTY (Easurm.st) $ 1,000,000 BODILY INJURY (Per person) $ ANY AUTO I X ALLOME0X SCHEDULED BODILY INJURY(Peracdd.re $ PROPERLY DAMAGE $ Perawitlen NON-OMED X HIREDAUT06 AUTOS UMBRELLA LIAB H OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS ILIA B CLAIMS -MODE I I OED RETENTION$ $ / C' WORKERSAND COMPENATIOIN ANY PROPRIETORIPARTNERIEXECUTIVE Y� 1760001391151 11/24/2015 11/24/2016 X STATUTE ERµ E, L EACH ACCIDENT $ 1000,000 OFFICERIMEMBER ERCLUDEDi (Mandatary in NH) NIA - E.L. DISEASE EA EMPLOYE $ 1 000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT $ 1,000,000 B Hired Auto Phys Dam BA040000001207 0711712015 711712016 ded 500 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is mqulrea) Ten (10) days notice of cancellation for non-payment only. City of Santa Ana, its officers, agents and employees are named as additional insureds as respects to general liability policy limits per attached CG2010. City of Santa Ana Attn:Purchasing Dept 20 Civic Center Plaza Santa Ana, CA 92701.4010 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ©1988-2014 ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD Printed by RMH on May 06, 2016 at 03:12PM