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WITTENT -01 <br />A'c`'°''� °� CERTIFICATE OF LIABILITY INSURANCE <br />DATE% S�ZO;;1ry' <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 eertlflcate holder Is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and condltlons of the policy, cartaln pollcles may raqulra an endorsement. A statement on this cartiflcata does not confer rights to the <br />certificate holder In Ilau of such andorsement(s). <br />PRODUCER Wells Fargo Insurance $eNICBS USA, InG. <br />NAMEACT Tracy Dolan <br />PHONE g'I6 23'1 -'1757 aG No , 9'16 231 -'1868 <br />CA DOI Lic. #OD08408 (916) 231 -1741 <br />1'10'17 Cobblerock Drives, Suites 1l)lJ <br />E -MAIL [rac Bolan wellsfar o.com <br />ADDRESS: y� @ 9 <br />Rancho Cordova, CA 95670 -6049 <br />INSURERS AFFORDING COVERAGE <br />NAIC A <br />Hartford Casual Insurance Com an <br />INSURER A : � p y <br />29424 <br />INSURED Wittman Enterprises, LLC <br />INSURER B : National FIrO Insure nca Company of Hartford <br />20478 <br />INSURER c : Evanston Insurance Company <br />35378 <br />PO Box 269'1'10 <br />INSURER D <br />INSURER E <br />Sacramento, CA 95826 <br />INSURER F <br />COVERAGES CERTIFICATE NUMBER• 2875443 REVISION NUMBER• Sea hBlDw <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADOL <br />SUER <br />POLICY NUMBER <br />MM /DD /VVYY <br />MM /DD�YYYY <br />LIMITS <br />A <br />GENERAL LIABILITY <br />X COMMERCIAL GENERAL LIABILITY <br />57S BAAT6490 <br />07/0'1/20'1 i <br />07/0'1/20'12 <br />EACH OCCU RRENGE <br />$ 2.000.000 <br />DAMA NTED <br />PREMISES Ea occu rrenca <br />$ 300,000 <br />MED EXP Any one parson) <br />$ 10,000 <br />CLAIMS -MADE � OCCUR <br />PERSONAL 8 ADV INJURY <br />$ 2,000,000 <br />GENERAL AGGREGATE <br />$ 4,000,000 <br />GE N'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMP /OP AGG <br />$ 4,000,000 <br />X POLICY PRO LOC <br />$ <br />B <br />AUTOMOBILE <br />LIA9ILITY <br />840'12487490 <br />07 /oi /201 "1 <br />07/O'I/20�2 <br />COMBINED SINGLE LIMIT <br />(Ea accitlanU <br />1,000,000 <br />X <br />_ <br />BODILY INJURY (Par person) <br />$ <br />ANY AUTO <br />ALL.OWNED SCHEDULED <br />AUTOS AUTOS <br />BODILY INJURY Per accident <br />( ) <br />$ <br />X <br />NON -OWNED <br />HIRED AUTOS X AUTOS <br />PROPERTY DAMAGE <br />Per accitlant <br />$ <br />A <br />X <br />UMBRELLA LIAB <br />X <br />,JCCUR <br />57S BAAT6490 <br />07 /O� /20'1 'I <br />07/0'1/20'12 <br />EACH OCCURRENCE <br />$ 2.000,000 <br />AGGREGATE <br />$ 2,000,000 <br />EXCESS LIAB <br />CLAIMS -MADE <br />OFD X RETENTION 10,000 <br />$ <br />WORKERS COMPENSATION <br />AS <br />WC 9TATD- OTH- <br />AND EMPLOYERS' LIABILITY Y / N <br />E.L. EACH ACCIDENT <br />$ <br />ANY PROPRIETOR/PARTNE WEXEGUTIVE <br />OFFICER/MEMBER EXCLUDED? � <br />(Mandatory In NH) <br />N / A <br />�— /�� <br />"'� <br />E.L. DISEASE - EA EMPLOYE <br />$ <br />If yes, tlaseriba under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT <br />$ <br />C <br />Prof Liability <br />E084 M� <br />/0'1/20'12 <br />$1,000.000/$2,000,000 <br />C� <br />DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) <br />Certificate holder named additional insured par attached form SS0008 04/05, pages 18 -20. <br />x'10 day notice applies if cancelled for non - payment of premium. <br />CERTIFICATE HOLDER CANCELLATION <br />The ACORD name and logo are reglatarad marks of AcoRD ©'1988 -20'1 O ACORD CORPORATION. All rights reserved. <br />ACORD 25 (20'10/05) 1 1111111 III 1111111 I'll IIII 111111 IIII VIII VIII VIII VIII IIII VIII VIII VIII VIII IIII I'II 'CYBOtAl S000]3B/0205 /WO /O /O' <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />City of Santa Ana <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />'1439 Broadway <br />Santa Ana, CA 9270'1 <br />AUTHORIZED REPRESENTATIVE <br />9�-- -- <br />The ACORD name and logo are reglatarad marks of AcoRD ©'1988 -20'1 O ACORD CORPORATION. All rights reserved. <br />ACORD 25 (20'10/05) 1 1111111 III 1111111 I'll IIII 111111 IIII VIII VIII VIII VIII IIII VIII VIII VIII VIII IIII I'II 'CYBOtAl S000]3B/0205 /WO /O /O' <br />