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'`�CC)RV CERTIF-a�ATE OF LIABILITY INSURA. ��
<br />DATE(MM10D)YYYYI
<br />1/3012017
<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 pollcy(les) must have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br />PRODucrm Partee Insurance Associates Inc.
<br />584 S. Grand Avenue
<br />Covina, CA 91724-3409
<br />CONTACT
<br />NAME; Ana Arancibia
<br />PHONE
<br />Ic 626-866-1791 Alt No: 626-331-8132
<br />E-MAIL
<br />ADDRESS; anal auraanp arteeinsurance.com
<br />INSUR£R[S) AFFORDING COVERAGE
<br />NAIC #
<br />✓
<br />INS URERA: Ohio Security Insurance Company
<br />24082
<br />www.parteeinsurance.com License #0786033
<br />INSURED
<br />HDL Software LLC
<br />INSURERS: American Fire and Casualty Company
<br />24066
<br />TO RENT
<br />PREMISES Ea occurrence $ 504,000
<br />1340 Valley Vista Drive #201
<br />INSURER C: Twin City Fire Insurance Company
<br />29459
<br />INSURERD:
<br />Diamond Bar CA 91765
<br />INSURER E
<br />INSURER F ;
<br />PERSONAL&ADV INJURY $ 1,000,000
<br />COVERAGES CERTIFICATE NUMBER: 33996410 REVISION NUMBER:
<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 />INDICATED. 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 />!NSR
<br />LTR
<br />TYPE OF INSURANCE
<br />INSD
<br />WVD
<br />POLICYNUMBER
<br />POLICY EFF
<br />MM1DDlYYYY
<br />POLICY EXP
<br />MMDDfYYYY
<br />LIMITS
<br />A
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE OCCURDAMAGE
<br />✓
<br />BKS56441197
<br />11/15/2016
<br />11/15/2017
<br />EACH OCCURRENCE $ 1,000,000
<br />TO RENT
<br />PREMISES Ea occurrence $ 504,000
<br />MED EXP (Any one person) $ 15,000
<br />PERSONAL&ADV INJURY $ 1,000,000
<br />AGGREGATE LIMITAPPLIES PER:
<br />POLICY 1�1 PRO JEC7 F7LOC
<br />GENERAL AGGREGATE $ 2,000,000
<br />GEN'L
<br />✓
<br />PRODUCTS -COMPIOPAGG $ 2,000,000
<br />$
<br />OTHER
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />BAS56441197
<br />11/15/2016
<br />11/15/2017
<br />CEOMaBIINEDSINGLELIMIT $ 1,000,000
<br />BODILY INJURY (Per person) $
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />ALTOS ONLY AUTOS
<br />BODILY INJURY (Pi $
<br />(Per accident)
<br />HIRED NON -OWNED
<br />ALTCS ONLY AUTOS ONLY
<br />PROPERTYOAMAGE $
<br />Per accident
<br />B
<br />�/
<br />UMBRELLA LIAR
<br />�/
<br />OCCUR
<br />USA56441197
<br />'1111512016
<br />11/15/2017
<br />EACH OCCURRENCE $ 3,000,000
<br />AGGREGATE $ 3,000,000
<br />EXCESS LIAR
<br />CLAIMS -MADE
<br />DED I ✓ I RETENTION $10,000
<br />$
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y I N
<br />ANI ETORlPARTNERIEXECUTIVEE.L.
<br />0FFICFRIMFMRFRFXCLU07 'n ElN
<br />I A
<br />XVVS57640940
<br />11/15/2016
<br />11/15/2017�/
<br />STATUTE ORTH
<br />EACH ACCIDENT $ 1,000,000
<br />E.L. DISEASE - EA EMPLOYEE $ 1,000,000
<br />(Mandatory in NH)
<br />Ifyes, describe under
<br />DESCRIPTION OFOPERATIOINS belcw
<br />E.L.DISFASE- POLICY LIMIT $ 1,000,000
<br />C
<br />PROFESSIONAL LIABILITY
<br />72PGO246728
<br />11/15/2016
<br />11/15/2017
<br />EACH CLAIM $1,000,000
<br />CLAIMS MADE FORM
<br />RETRO 2/15/2003
<br />AGGREGATE $2,000,000
<br />DEDUCTIBLE $25,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
<br />The City of Santa Ana, Its officers, employees, agents, volunteers and representatives are named as additional insured, �� �����
<br />primarylnon-contributory as respects to the General Liability.
<br />u�,A PROA.�.Vi e1� C�
<br />!
<br />CERTIFICATE HOLDER CANCELLATION I —
<br />City of Santa Ana
<br />Cl
<br />Ci yCi�ic Center Plaza
<br />Santa Ana Cent
<br />92701
<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 />Sylvia Coronado
<br />©1988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />33996110 1 OlNDE-1 1 15/17 GS,/13A/X3/PL/WC -- HDL SOFTWARE ONLY I Ana Arancibia 11/30/2DL7 17.;14;01 AM IPDTI 1 Paae 1 of 3
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