RICHARDS, WATSON & GERSHON 3A - 2012

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RICHWAT -01 JCAMOMILE CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YYYY) 10/25/2012 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 endorsement(s). PRODUCER CONTACT NAME: Peter C. Foy & Associates Insurance Services Inc. PHONE 818 703 -8057 Fax 818 703 -0935 21650 Oxnard St. Arc No EXt : ( ) (arc, No): ( ) Suite 1900 E -MAIL Woodland Hills, CA 91367 ADDRESS: INSURED INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Chubb Insurance Company 41386 _ INSURER B: Federal Insurance Company 20281 INSURER C: INSURER D Richards, Watson & Gershon 355 S. Grand Avenue, 40th Floor Los Angeles, CA 90072 -3101 INSURER E 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. INSR TYPE OF INSURANCE AD L UBR POLICY EFF • POLICY EXP LTR INSR WVD POLICY NUMBER MM /DD/YYYY MM /DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY X 35293250 10/1/2012 10/1/2013 pREMISES KLNI occurrence) $ 1,000,000 tU CLAIMS -MADE � OCCUR MED EXP (Any one person) $ 10,000 _ PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER : PRODUCTS - COMP /OPAGG $ Included POLICY PE X LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 B ANY AUTO 74967929 1011/2012 10/1/2013 BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY Per accident $ AUTOS _ AUTOS ( ) X HIRED AUTOS X NON -OWNED PROPERTY DAMAGE AUTOS PERACCIDENT $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ �r DED RETENTION $ $ WORKERS COMPENSATION - WC STATU- OTH- AND EMPLOYERS' LIABILITY Y / N X TORY LIMITS ER B ANY PROPRIETOR /PARTNER/EXECUTIVE 71726476 10/1/2012 1011/2013 E.L. EACH ACCIDENT $ 1,000,000 OFFICER. /MEMBER EXCLUDED9 � N /A (Mandatory in and — E.L. DISEASE - EA EMPLOYEE; $ 1,000,000 If yes, describe under — __ DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate Holder is named as Additional Insured as their interest may appear. Subject to policy terms, conditions and exclusions. Coverage is considered primary & non - contributory. 10 days notice doff cancellation applies for non-payment of premium. CERTIFICATE HOLDER E� Sisl , CANCELLATION City of Santa Ana Office of the City Attorney Twenty Civic Center Plaza Santa Ana, CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUT�HORIIZE,D' REPRESENTATIVE © 1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD