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<br />AC"R& CERTIFICATE OF LIABILITY INSURANCE
<br />iI.�'
<br />DATE IMMNDlYYYY)
<br />r 4/27/2017
<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 on ADDITIONAL INSURED, the policy(ios) 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
<br />Daly Merritt Insurance
<br />y
<br />5099 Biddle Avenue
<br />Wyandotte MT 9.6192
<br />__
<br />CONTACT Cathy Stennis
<br />PHONE (734)263-1400 FAX Nql Ip39)283-119'1.._._^_.
<br />nnoae :Cathy. Stannis@dalymezritt.com
<br />INSURERS AFFORDING COVERAGE
<br />POLICY EFF'
<br />IDD
<br />IrvsuRER A:Hanov®;-America
<br />36064
<br />INSURED
<br />-FRAC Inc.
<br />1229 Oak Valley Drive
<br />Ann Arbor MI 48108-9675
<br />INSURER B AIImexica Financial Benefit
<br />41840
<br />INSURERC:The Hanover Ins. Co.
<br />22292
<br />..__..__......._... -,
<br />INSURER D:
<br />INSURER E
<br />EACH OCCURRENCE $ 1,000,000
<br />INSURERP:
<br />COVERAGES CERTIFICATE NUMBER:CL1742713074 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 70 ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />ILTR
<br />TYPE OF INSURANCE
<br />AD
<br />��
<br />POLICY NUMBER
<br />POLICY EFF'
<br />IDD
<br />POLICY EXP
<br />MMIDO YY
<br />LIMITS
<br />X'I
<br />COMMERCI,4LGENERALLIABILITY
<br />EACH OCCURRENCE $ 1,000,000
<br />A
<br />CLAIMS -MADE 1X.]OCCUR
<br />PREMISES Ea currency $ 1,000,000
<br />EP
<br />MED EXP (Any one person) 8 10,000
<br />228-D238395-00
<br />5/1/2017
<br />5/1./2018
<br />PERSONAL&ADV INJURY $ 1,000,000
<br />AGGREGATE UMI f APPLIES PER
<br />GENERAL AGGREGATE $ 2,000,000
<br />GENT
<br />POLII:Y Lxl JEC El LOU
<br />PHUDUCIe-OUMN/UP AGG $ 2,000,000
<br />Employee GsneBL $ 1, 000, DO
<br />OTHER:
<br />AUTOMOBILE
<br />LIABILITY
<br />I
<br />COMBINED SINGLE LIMIT $ 1, 000, Deo
<br />Be accidenh
<br />BODILY INd.1RY(Pon Prss,) $ 1,000,000
<br />B
<br />X
<br />ANY AUTO
<br />ALLOWNED SCHEDULED
<br />AUTOS AUTOS
<br />AWD-0239115-00
<br />5/1/2017
<br />5/1/2018
<br />BODILY INUURY(Per -aellmno $
<br />X
<br />NON OW IN
<br />HIRED AUTOS X AUTOS
<br />PROPERTY DAMAGE
<br />Pse auIIN $
<br />PTMQIY Hamas Fl back $
<br />X
<br />UMBRELLA LIAR
<br />X
<br />OCCUR
<br />EACH OCCURRENCE $ 8,000,000
<br />AGGREGATE $ 81000,000
<br />C
<br />EXCESS LIAR
<br />GIAIMS-MADE
<br />DEO 1
<br />11 RETENTION.
<br />$
<br />❑IBB -0238395^00
<br />5/1/2017
<br />5/1/2018
<br />C
<br />WORKERS COMPENSATIONPER
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANY PROPRIETORIPARTNERIEXECUnVE ❑
<br />OFFICERIMEMBER EXCLUDED? N
<br />(Mandatory in NH)
<br />If yes dascrihaunder
<br />NIA
<br />WBB-D217136-00
<br />5/1/2017
<br />.5/1/2018
<br />OTH
<br />_X__STAlOTC-,_,
<br />EL. EACH ACCIDENT $ 500,000
<br />F. L, DISEASE- EA EMPICYE .$ 500,000
<br />EL DISEASE -POLMY LIMIT $ 500.000
<br />DESCRIPTION OF OPERATIONS bsov,
<br />C
<br />Professional, Liability
<br />LRB -1323839'1-00
<br />5/1/2017
<br />-'8/1/2018
<br />Unp 1,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES IACORD 101, Additme.1 Remarks Schedule, may be etlachod if more space le. required)
<br />The certificate holder is listed as additional insured with respects to the General Liability as required
<br />by written contract, 0°�{1�
<br />0
<br />City of Santa
<br />Attn: Police
<br />P.O. Box 1981
<br />Santa Ana, CA
<br />ACORD 25 {2014109)
<br />INS025190Lim1
<br />psemelsberger@santa-ana.or
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />Dept ACCORDANCE, WITH THE POLICY PROVISIONS,
<br />92701 I AUTHORIZED
<br />O'Malley/STANNI
<br />The ACORD name and logo are registered marks of ACORD
<br />
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