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<br />CERTIFICATE of i�IAE�II..t�`�Y INSURANCE
<br />DATE (PA 012 fYY)
<br />7,2,202
<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 an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policfes 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 />insurance Solutions
<br />License #0746539
<br />33302 Valle Rd, Suite 200
<br />San Juan Capistrano CA 92675
<br />9NI T Cheryl Jafar
<br />PHONE (949) 348 -7400 Na: (449) 348 -2373
<br />ADD Es .cherylj @ins- solut<ions.com
<br />INSURERS AFFORDING COVERAGE
<br />NAIG0
<br />INSURER A :Sentinel Ins Co. LTD
<br />11000
<br />INSURED
<br />PELLETIER & ASSOCIATES INC
<br />PO BOX 388
<br />LAfCE FOREST CA 92609
<br />€NSUPER B:Hartford Fire Ins Co
<br />19682
<br />€NSUReR0,14ount Vernon Fire Ins Company
<br />26522
<br />INSURER D:
<br />INSURERS:
<br />$ 1,000,000
<br />1 IRSURERF:
<br />$ 1,000,000
<br />r,�Iril�,l TG !11 illllOi`�.l 'J /1'{ WFVIN11 IN NI 1MK"W!
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEDr TO THE INSURE) NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHFR 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 />ILN.7R
<br />TYPE OF INSURANCE
<br />AR
<br />UB)
<br />POLICYNUMBER
<br />MrrUDYYYY
<br />POLICY Qk VYy
<br />LIMITS
<br />GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />_
<br />p GEs �a °..
<br />$ 1,000,000
<br />Co'MMLRCIAL GENERAL LIABILITY
<br />-
<br />MEOEXP (Any OnO - MW)
<br />$ 10,000
<br />A
<br />CLAVAS -PWE aOCCUR
<br />12sBATuI3130
<br />13/2012
<br />13/2013
<br />PERSONAL &AOVINJURY
<br />$ 1,000,000
<br />G> NERAL AGGREGATE
<br />$ 2,000,000
<br />GEMLAGGREGATELTARAPPLIESPER:
<br />PRODUCTS- COMPIOPAGG
<br />$ 2,000,000
<br />$
<br />X POL)CY PR0. 1.00
<br />AUTOMOBILE LIABILITY
<br />d)I_EDSINOLELIMir
<br />j 000 000
<br />ebimyiNjuRY (per pmw)
<br />$
<br />A
<br />Y AUTO
<br />AN AEI.OWNEA SCHFDULED
<br />72SSAT08130
<br />/3/2012
<br />/3/21)13
<br />BOOILYINdURY(Peroccidant)
<br />$
<br />AUTOS NON -OWNED
<br />X x'
<br />PROPERTY DAMAGE
<br />Pei went
<br />$
<br />HIRED AUTOS AUTOS
<br />UMBRELLA UAB
<br />OCCUR
<br />EACH OCCURRENCR
<br />$ _
<br />AGGREGATE
<br />$,
<br />EXCESSLIAB
<br />CLUAS -MADE
<br />DER, RETENTI0:4
<br />$
<br />u
<br />_
<br />IZSTATU- OTH_
<br />$
<br />Y14P.k R3C011,PENSATFON
<br />Y ER
<br />AND EMPLOYERS' LIABILITY YfN
<br />ANY PROPRIETORIIPARTRERIEXECUTIVE j
<br />E.L. EACH ACCIDENT
<br />$ 1,000,()00
<br />E.L. DISEASE - FA EMPLOYEE
<br />$ 1,000,000
<br />OFRCERIMEMBER EXOLLJ©507 1I
<br />IPdandalorpinNH)
<br />NIA
<br />2�g0�p3277
<br />/)./2011
<br />/1/2012
<br />E.L. DISEASE - POLICY I-WIT
<br />3 1,000,()00
<br />IPyym descrbe urw�w
<br />DaCCRIPTIAN OF OPERATIONS Wow
<br />C
<br />Errors & Omissions
<br />P 2009690C
<br />/25/2012
<br />/25/2013
<br />Um-t- $ 2,0W.000
<br />DodLtr;kW $) OW
<br />DESCRIPTION OF OPERATIONS J LOCATION$ l VEHICLES (Attach ACORD 101, Additional Remarks Sehedula, if nlara space Is required)
<br />City* of Santa Ana, 20 Civic Center Plaza, California 927011 its officers, employees, agents, volunteeze
<br />and representatives are named as additional insured per the Business Liability Coverage From 380008
<br />attached to the poli.oy.
<br />A TO
<br />Lei a:iIIaLtl_l1;.wiLwi -EL51 M
<br />City of Santa Ana
<br />Attn: Risk Management, U28
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92702
<br />RD 26 (2010106)
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES HE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />Aleasandra /PETERS
<br />O 1988.2010 ACORI) CORPORATION, All rights reserved.
<br />INS026(2otaw).o1 The ACORD name and logo are registered marks of ACORD
<br />
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