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CERTIFICATE OF LIABILITY INSURANCE F DA-E(MM0D1YYYY)
<br />ANY REOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT
<br />05/28/10
<br />PRODUCEROA99520 1-619-234-6848 -
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br />Cavignac & Associates
<br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br />450 B Street, suite 1600
<br />San Diego, CA 52111-6005 C it
<br />cr ztificatesgcavgnacgm . _ ... ..
<br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />INSURERS AFFORDING COVERAGE NAIC #
<br />1,Ns€,priEl�
<br />_ . _ _-
<br />The Sohagi Law Group, PLC
<br />INSURERA TRAV13LERS CAS INS CO OF AMER 19046
<br />S 2.000,000
<br />INSURERS TRAVELERS PROPERTY CAS CO OF AMER 25674
<br />11995 San Vicente Blvd., #154
<br />°..5A1AA- dtT6 kEN---#D_
<br />NSURRC:TRAVELRRS CAS CO OF CT _ _ 3b170
<br />Los Angeles, CA 90049-5136
<br />NSURERD:UNDERWR1TRRS AT LLOYDS LONDON rsaa�
<br />COVERAGES
<br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING
<br />ANY REOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT
<br />TO WHICH THIS CERTIFICATE
<br />MAY BE ISSUED OR
<br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO
<br />ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
<br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />__. ___ ..,,_.M_ _.
<br />POLICY NUMBER POLICY EFFECT€YE POL CY EXP€RAT.ON
<br />v LsMITS
<br />A
<br />X GENERAL UAWLITY j6805482NS46 06/01/10
<br />06/01/11 ' EACHOCCuRRENeE
<br />S 2.000,000
<br />E COMMEROAL GENERAL L"ourY $
<br />°..5A1AA- dtT6 kEN---#D_
<br />��
<br />PREMISES IE rren 1
<br />3 300,000
<br />1 CLAIMS MADE f._ x OCCUR
<br />I
<br />MED EXP I Any one person)
<br />i 51.000
<br />X No Deductible
<br />'Separation }
<br />PERSONALfSAD4'INJURY
<br />$2,000,000
<br />X of Inaured
<br />GEN RAIL
<br />-- _
<br />;4,000,000
<br />+;ENR. AGGREGATELIMIT APPLIEr- 11S PER,
<br />-.w..,
<br />_. ,
<br />ComPioP AGG
<br />14,000,000
<br />CPRODUCTS
<br />PRO- X LOC
<br />I POLICY
<br />..._..
<br />.,..,�.
<br />B
<br />-AUTOMOBILE LAWS irY HA5483N924 i 06/01/10 '
<br />06/01111
<br />COMBINED SINGLET L1MCT
<br />X ANY AU TO
<br />-
<br />(Eaacadent)
<br />31,000,000
<br />ALL OWNEO AUTOS (—
<br />SCHEOULEO AUTOS I
<br />BODILY INJURY
<br />(Par parson)
<br />;
<br />t ', HIRED AUTOS
<br />NOhf•ONtNEDAIiT()S , �
<br />-BODILY INJURY
<br />(Pavatr.dcni)
<br />1
<br />PROPERTY DAMAGE
<br />_. :
<br />; (Por acrxiprtf)
<br />i"xARAGELiABIt.ITY
<br />AU"IOONLY- EAACCIDE.NT
<br />$
<br />ANY auTt7
<br />--
<br />.._ _
<br />. _
<br />I
<br />OTHER THAN EA ACC
<br />S _._._ __.._..m._..
<br />: AUTO ONLY: AGG
<br />;
<br />B
<br />EXGESSIUVEIRELLAI,AWL 1TY %CUP62SON45A
<br />1 06/01/10
<br />06/01/11 -EACH OCCURRENCE
<br />;2,000,000
<br />X ;OCCwJR CWMSAp.40E I
<br />AGGREGATE2,000,000��
<br />_
<br />�
<br />____T
<br />i
<br />DEDiIC'IBL£
<br />._ _�.._
<br />.._.......
<br />S
<br />X '; RETENTION S -0-
<br />C
<br />WORKERS COMI-ENSATtON
<br />JiiS5483N824
<br />AND EMPLOYERS' L€ABILITY Y1►i' QS/02/10
<br />Y
<br />46/01/13 X€ RCIBItT OTR
<br />ANY PERNE TORIPXCCLUEE+EXE.C4�7tvE
<br />ER EXCLUDE[)'
<br />OFFICElwy
<br />E L. EAC'i ACcow
<br />S1,000,000
<br />(Mandatary In NH)
<br />t
<br />iyes descrtw aufe
<br />E.L. DISEASE- EA EMPLOYE
<br />5 1, 0DO, 000
<br />SPEGWL. PROY§SFONS be7w ?
<br />DISEASE, POLICYPOLICYLIMIT
<br />S 1, 000, 040
<br />OTHER
<br />D :Professional
<br />Liability ibU595,800700702009 12/31/09
<br />05/01/11 Each Claim
<br />2,000,000
<br />Claims made, defense casts
<br />included within limit I
<br />Aggregate
<br />2,000,040
<br />DESCRIPTION OF OPERAT'ONS I LOCATIONS t VEHICL:� i EXCL USIONS ADDEO BY ENDORSEMENT I SPECIAL PROVIwNS
<br />%- --
<br />Certificate holder is additional insured with respect to general liability
<br />per attached.J
<br />s
<br />�f
<br />CFRTIFICATF 14ni nf=0 ...... �.. . _. ..
<br />_
<br />-av ass mut: tor non-payment of premium.
<br />SHOULDANY OF THEABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPtRATION
<br />City of Santa Ana DATE THEREOF, THE tSSLANG INSURER WILL E 7tXXN CMAIL 30• DAYS WRITTEN
<br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.,
<br />20 Civic Center Plaza
<br />lflJiiiyCXiCX X
<br />P.O. Box 1988 XX xxx=
<br />Santa Ana, CA 92702 AUTHORIZED REPRESENT IVT
<br />urufhj Amundson
<br />ACORD 25 (2009101) Harvey CJ 1988-2009 ACORD C TION- All rights reserved.
<br />15974724 The ACORD name and logo are registered marks of ACORD
<br />- d16 ''
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