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ACORO®DATE (MWDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 7/5/2011 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 enda,mement(s). PRODUCER NAMEACT T=iah IC-3- CusalC. PHONE (818)224-6100B)22a-6099 ac N0 C.M. Mme=s Company, Inc. 21045 Cali£a St. (1100 -MRL-TGr@@n@®maiara. oom GENERAL LIABILITY PRODUCERCUSTOMER In 00027846 INSURERS) AFFORDING COVERAGE NAICa Woodland Hi11s CA 91367 INSURED INSURERA—j a=tfOrd Casualty Inauranoa CO EACH OCCURRENCE E 1,000,000 INSURER B-Ha=tf0=c3 Fi=@ Tnauranca CO. LaSalle Ma=V 1n, SnC. INSURERC:U.S. SpraCialty 2na CO 2700 Sc,. Grand Air® INSURER D: - INSURER E: /16/2012 Sa.nt-a. Santa Ana Cli 92705 INSURER F - COVERAGES CERTIFICATE NUMBERCL116621047 REVISION NUMBER: 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. ILTR TYPE OF INSURANCE B POLICY NUMBER MWD Y EFF MOM/LI Y EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE E 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FX7 OCCUR X 72SELANUG283 6/16/2011 /16/2012 PREMISES Ee occurterx:e $ 300,000 MED EXP (An one person) $ 10,00 PERSONAL B ADV INJURY S 1,000,000 GENERAL AGGREGATE E 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG S 2,000,000 X POLICY j LOC $ 13 AUTOMOBILE IJABILITY X ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS X HIRED AUTOS 72LTECAH0364 APPRO V Ei� A 6/16/2011 TO F /16/2012 RM COMBINED SINGLE LIMIT (E—d—)S 1,000,000 BODILY INJURY (Par parson) $ BODILY INJURY (Per accident) S PROPERTY DAMAGE $ (Par acudent) X NON -OWNED AUTOS aura '455151201 Dhv other oar $ Uninsured motorial combined $ 1'000'000 X UMBRELLA ILIA EXCESS LIAB X OCCUR CLAIMS-MAOE CC Y Attorne`. EACH OCCURRENCE S S , 000 , 000 AGGREGATE S 5,000,000 DEDUCTIBLE S A X RETENTION S 10 000 72SHAMU6293 6/16/2011 6/16/2012 S B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ N ANY PROPRIETOWPARTNER/EXEGUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) r'i / A 72WECRQ5643 6/16/2011 6/16/2012 X N/C STATU- 0TH - E.L. EACH ACCIDENT E 1 000 000 E.L. DISEASE - EA EMPLOYE S 1,000 000 11 ea describe Under DESCRIPTION OF OPERATIONS I.wlow E.L. DISEASE -POLICY LIMIT E 1,000,000 C Pro££aaiortal Liability 931020500 6/16/201.1 6/16/2012 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Aitch ACORD 101, Addltia—I Remarks Schedule, %mora space Ie required) City of Santa Ana is included as Additional 2naurad per the Bus!—.Liability Coverage form SSOOOB grid a General Liability waiver of subrogation applies to the certifi0ata holder par form 890008. cR 6,NIYlrCLW I IVIY mboothe@ Santa -ane . Org SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City o£ Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Marilyn BOOth- 20 Civic Cantor Plaza (M-36) AUTHORIZED REPRESENTATIVE Santa Ana, CA 92702 Horb@rt R,o thman/TRSSH ��J'+�-ev`-�" ACORD 25 (2009/09) ® 1988-2009 ACORD CORPORATION. All rights reserved. I-- (aoo—) 1 nee ,ra -- nems ono logo ars regrsrerso -- or ----