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A�Ro® CERTIFICATE OF LIABILITY INSURANCE
<br />SyZD"a""
<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 />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([") must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies 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 Phone (3101478 -5041
<br />Fax 13 10)379 -8777
<br />M.G. Skinner & Associates
<br />COME: --
<br />PHONE AX No)_ __,
<br />11030 Santa Monica Blvd.
<br />E-NAIL
<br />ADDRESS:
<br />INSURERS ) AFFORDING COVERAGE
<br />NAM#
<br />Suite 207
<br />INSURER A: Zurich American IUSUMIKC Com anY
<br />16535
<br />Los Angeles, California 90025
<br />_
<br />INSURED
<br />INSURER s: American Guarantee And Liability Insurance Corn
<br />126247
<br />INSURER C: Ace American Insurance Company
<br />22667
<br />The Act i Group, Inc., dba: ATIMS
<br />P.O. Box 19048
<br />Glendale, CA 91209 -9048
<br />INSURER D:
<br />-
<br />INSURER E:
<br />PERSONAL B ADV INJURY ,$
<br />INSURER F:
<br />QjQf_Ldbllllt
<br />COVERAGES CERTIFICATE NUMBER: ATIMS06 -1 REVISION NUMBER:
<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 />INSRf - - - - --
<br />LTA TYPE OF INSURANCE
<br />A
<br />20 Civic Center Plana
<br />POLICY NUMBER
<br />PO YEFF POLfCY EXP
<br />M
<br />- - ----- _- _-- -___ --
<br />uMR9
<br />GENERAL WBUTY
<br />�I MA 9698691 -02
<br />4/1/2014
<br />4/1;201$
<br />EACH OCCURRENCE S 3,000000
<br />DAMAGET�RENTED ' E 1300
<br />�'I
<br />A ✓h COMMERCIAL GENERAL LIABILITY
<br />hOOO
<br />PREMI ;E$fEe acwerenw) _ __
<br />CLAIMS -MADE OCCUR
<br />MEOEKP Anywepanon) E 10,000
<br />PERSONAL B ADV INJURY ,$
<br />3,000000
<br />QjQf_Ldbllllt
<br />GENERAL AGGREGATE
<br />PRODUCTS- COMPIOPAGG
<br />LE 3 000 000
<br />! E 3,000,000
<br />GEN'L AGGREGATE
<br />LIMIT APPLIES PER
<br />V1 POLICY
<br />E Pf°0- LOG
<br />I s
<br />AUTOMOBILE LABILITY
<br />PRA 9695691 -02
<br />4/112014
<br />471/ ^_015
<br />COMBINE INGLE LIMIT
<br />a cant
<br />1,000,000
<br />A
<br />80DILY INJURY
<br />S
<br />ANY AU -0
<br />(Per person)
<br />ALL OWNED �, SCHEDULED
<br />- ✓ AUTOS I`�II NON-0NMED
<br />i I
<br />BODILY INJURY (Per actldeM)�i
<br />PROPERTY DAMAGE --
<br />Perewdent
<br />- -- --
<br />E
<br />l HIRED AUTOS AUTOS
<br />3
<br />UMBRELIALMB
<br />i
<br />OCCUR
<br />UMB 946721902
<br />'i, 4/1,2014
<br />4/1/2015
<br />i EACH OCCURRENCE
<br />$ 10,000,000
<br />B
<br />EXCESS LMa
<br />CI-AIMS-MADE
<br />! AGGREGATE
<br />E 10,000,000
<br />OED ✓' RETENTION$ n
<br />�'—
<br />i
<br />C
<br />WORKERS COMPENSATION
<br />WLRC47987069
<br />4/1/213 I4
<br />4/I /2015
<br />Y/ WC STATU- 13TH
<br />1TORY LIMBS ER
<br />AND EMPLOYERS' LIABILITY ylN
<br />MY PROPRIETOR/PARTNERIE)(ECUTIVE
<br />EL. EACH ACCIDENT
<br />$ 1,000,000
<br />OFFICEMIn NER EXCLUD O
<br />(MandMOry le NH)
<br />NIA
<br />EL DISEASE FA EMPLOYE
<br />E 1.000,000
<br />It yeM de=`a wder
<br />DESCRIPTION OF OPERATIONS SNOW
<br />E.L. OIBEABE - POLICY LIMIT
<br />E 1,000,000
<br />A
<br />Crime(3rd Party)
<br />PRA 9699601-02
<br />411/2014
<br />`.4/1,2015
<br />Each M,tm,na 3,000,000
<br />wnn 3,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES (AUnh ACORD 101, Ado ll IMMINA SchrePN, K more VOM Y m Wnd)
<br />City of Santa Ara, its officers, employees, agents, volunteers and representatives are additional insureds under the
<br />General Liability policy. Primary and Nan - Contributory coverage clause will apply. Separation of insureds clause
<br />applies under the General Liability pol ipy, l�t}FPipG„Capr�7,�,tj.ggp}p3q>; General Liability: 30 days / 10 days for
<br />non - payment of premium. HiY1Cl/V11,176111. 1111'�JK., 1V1
<br />�ewdVil I"t' i`�CYa' -JLLti�
<br />CFRTIFICATF Hrll nFR __ .CANCELLATION
<br />Holder, Nature of Interest _ Additional Insured
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />City of Santa Ana
<br />tY
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plana
<br />AUTHOKEED REPRESENTATME Mth
<br />Santa Ana, CA 92701
<br />01988 -2010 ACORD CORPORATION. All rights rd#a,,d.
<br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
<br />
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