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TMR CERTIFICATE OF LIABILITY INSURANCE R022 DATHOHN` /YYYY) 11/20/2014 THIS CERTIFICATEIS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND ORALTER 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, A H f IC OLDER. IMPORTANT: If the certificate holder is an ADDITIO 'AL IN FIR 'T t. eG 0licy(ies) must be endorsed. If SUBROGATIONIS WAIVED, subject to the terms and conditions of the policy, certain oliciesmay require an endorsement. A statement on this certificate does not confer rights to the r certificate holder in lieu of such endo e (. , €^ PRDDUCER (1 t )"`Y" �� C f1 IS}., HEFFERNAN INSURANCE BRC KERS�L'�f31 ` t) ?, ii, CONTACT NAME', ta°,"N,E„I: (866) 467-8730 ia�Nm: (888) 443-6112 255103 P: (8066) 467-8730 F: (888) 443-6112 EMIL PQ BOX 33015 INSURER(5) AFFORDING COVERAGE NAE# SAN ANTONIO TX 78265 INSURERA: Sentinel Ins Cc LTD 11000 INSURED INSURER B: INSURER C: LIEN ON ME, INC. INSURER D: PO BOX 91630 INSURER E: PASADENA CA 91109 INSURER F: COVERAGES CERTIFICATE NUMBER: 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. INSA LTR(MSR 7TPE OF INSURANCE ADDL SUVR POLICYNUAIJUR FOLICYEFF (MM/DD/YY 1 POLLCYEXP LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1, 000, 000 CLAIMS -MADE XI OCCUR DAMAGE TO RENTED 51 000 000 PREMISES (Ea occurrence) $I r X MED EXP (Any aneparson) $10, 000 A X General Liab 72 SBA AG7645 08/15/2014 08/15/2015 PERSONAL A AOV INJURY $1, 000, 000 GE NT_ AGGREGATE LI MIT APPLIES PER: GENERAL AGGREGATE 52, 000, 000 POLICY PELT ❑X LOC PRODUCTS - COMPIOP AGO $2, 000, 000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1r 000 000 (Es accident) $1, BODILY INJURY (Parameter) $ ANY AUTO A ALL OWNED SCHEDULED AUTOSAUTOS 72 SBA AG7645 08/15/2014 08/15/2015 BODILY INJURY (Per accident) $ X HIRED An X NON -OWNED AUTOS PROPERTY DAMAGE (Per sudda-ld $ 5 X UMBRELLA LIAR I X OCCUR EACH OCCURRENCE A EXCESS LIAB CLAIMS -MADE 72 SBA AG7645 08/15/2014 08/15/2015 AGGREGATE $1, 000, 000 DeD X RITENTIAN$ 10,000 WORNERS COMPENSATION PER Off - AMD SMPLOYERS'LWtILIfY STATUTE ER ANY PROPRIETORIPARTNEWEXECUTIVE YIN E.L. EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? (Mandatory In NJU ❑ N/A E.L. DISEASE -EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below EL DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is roquirmh Those usual to the Insured's Operations. I CERTIFICATE HOLDER CANCELLATION The City of Santa Ana, Its Agents, Officers and Employees SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORIZED REPRESENTATIVE Attn: Samantha Lambert 20 CIVIC CENTER PLZ # M-41 SANTA ANA, CA 92701 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD