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'q o� /3 -01 15� 7 <br />A44E�!FE) CERTIFICATE OF LIABILITY INSURANCE <br />6/24/220113 <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 FOR NEQATl!VELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW, THIS CERTIFICATE OF INSURANCE DOES ttOT CONSTRU72A 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(loc) 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 />certifiable holder In lieu of Such endorsement s . <br />PRODUCER <br />Millannium Corporate Solutions <br />Licensa # OC13480 <br />Diem Qurkosky <br />"Hone (949j 679 -6604 F . (3471 934 -5063 <br />0190masina.0om <br />E .call- <br />INSURlRe APFORDINOCOVERAOE <br />NAJOS <br />5530 Trabuao Road <br />M) <br />Irvine CA 92620. <br />INSURE A:Citirrena Insurance Cop%2anY of <br />INSURED <br />IMIVRERII, <br />S 1,000,000 <br />INSURER C: <br />3 2,000,000 <br />Acire, Ina <br />211 Simplicity <br />INSURERD: <br />IxswaERe <br />PFIQOItGTa•CtlMPIOPAGG <br />Ix <br />Irvine CA 92620 <br />COVERAGES UCKIIrIUAI MEN •----------°_-.. - - -- <br />THIS IS 70 CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAKED ABOVE FOR THE PCLICY 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 13 SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMfTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />LTR <br />A <br />TYPE! or INSURANCE <br />GUERALLIAS14ITY <br />x COhlh4ERCIALGENERAL LIABILITY <br />CLAIMS -HIDE pCCU0. <br />M— <br />Ma <br />pougYNUMOUR <br />03 A034S91 00 <br />Writ LICY <br />/6/2013 <br />POLICYB <br />/6/2014 <br />LIMRB <br />EACH OCO�N E <br />$ 3"00c), 000 <br />M) <br />S 300,000 <br />Men E* ".. srsm <br />$ 6,000 <br />PERSONAL &ADV INJURY <br />S 1,000,000 <br />GENERAL AWR90ATE <br />3 2,000,000 <br />PFIQOItGTa•CtlMPIOPAGG <br />S 2,000,000 <br />GENLAGPREOATE <br />X POLCY <br />LIMB APPlJE3 <br />PRO• <br />PER: <br />LOO <br />S <br />AUTOMOBILE WAWUTY <br />IEumff <br />1 000 000 <br />BOUILYINJURY(Perp non) <br />3 ° <br />A <br />ANY AUTO <br />ALIOW14EO SCHEDULE5 <br />AUTOS AUTOS Oy rNED <br />1: HIREDAUTOS OL AUTOS <br />33 A034891 00 <br />/912013 <br />/6/2014 <br />WDILY INJURY(Pv otddMO <br />S <br />PROP ft 1AGE <br />S <br />- <br />S <br />UMBRELLAUAB <br />EXCESS LAB <br />OCCUR <br />CLNM$,KWE <br />EACHOOCURRENC <br />S <br />ACOR9009 <br />5 <br />DEO I I RE ION <br />WORXBRS COMPENSATION <br />WC 97A OTF4 <br />EL. EACH ACCIDENT_ <br />a <br />A <br />ANDEMPLOYERS- LIASILITY <br />ANY PROPRIETONPARTNERMXeCUTIVE LJ <br />OFFICERMIRMBER EXCLUDED? <br />{ReWabry In NH) <br />U' d4wba aWa <br />NPTIONOFOPERATIONSb ow <br />PR08ESSIOKAL LIABILITY <br />CLAIMS -MADE POLICY <br />N/A <br />B3 A034591 00 <br />/6/2013 <br />/6/201.4 <br />EL DISEASE. EA EMPLOYEE <br />S <br />EL DISEASE - POLICY LIMIT S <br />EACH CLAM LIMIT $1,0001 OOD <br />AOOREOATEUMIT $2,0001000 <br />MmORIPTIONOF OPERATIONS/ LOCATIONS IVBHIC463 (Alaoh ACORD 101, Additional Remarks SehsduN, amore ep.ce4 fequlnd) <br />The City of Santa Ana is included as additional insured with primary G non - Contributory warding for <br />general liability par attached form 991 -1006 0609 when required by written Contract ae respects to the <br />insureds operation$. <br />k10 days notice of Cancallation for non- payment of premium, <br />4PPROVEU AS TO ]FORM <br />904 77 <br />CITY OF SANTA ANA Assistant City Attorney <br />20 CIVIC CENTER PLAZA, <br />SANTA ANA, CA 92701 <br />M -36 <br />TIDULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION OATS THEREOF, NOTICE WILL RE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS, <br />Ng0 /DIEM ` --"`� �" r✓ <br />INS026 (201005) el The AUUKu name ana logo are roBrure, ew 1„a, no — .. - -,. <br />25A -70 <br />