CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MM/DD/YYYY)
<br />F,2/8/11
<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(ies) 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
<br />Kathleen A. Hennessy
<br />230 Sugartown Road, Ste. 230
<br />P.O. BOX 277
<br />Wayne PA 19087
<br />NAMEACT Cadwalader & Associates, Inc.
<br />pHO"E 610 964-8970 o : 610 964-9280
<br />A
<br />E-MIL . khennessy@cadwaladerassoc.com
<br />PRODUCERUS 245
<br />INSURERS AFFORDING COVERAGE
<br />NAIC #
<br />INSURED
<br />Schultz & Williams, Inc.
<br />Suite 700
<br />325 Chestnut Street
<br />Philadelphia, PA 19106
<br />INSURER A: The Hartford Insurance Company
<br />19682
<br />INSURERB: Maxum Indemnity Company
<br />INSURER C :
<br />INSURER D :
<br />INSURER E :
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER: 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 />INSR
<br />LTRPOLICY
<br />TypE OF INSURANCE
<br />ADDL
<br />SUB
<br />NUMBER
<br />POLICY EFF
<br />POLICY EXP
<br />LIMITS
<br />GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 2,000,000.
<br />DAMAGE TO RENTED
<br />000,000.
<br />A
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE OCCUR
<br />44SBACW7363
<br />1/7111
<br />1/7112
<br />MED EXP An one person)$
<br />10,000.
<br />PERSONAL & ADV INJURY
<br />$ 2,000,000.
<br />_
<br />GENERAL AGGREGATE
<br />$ 4,000,000.
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />PRODUCTS - COMP/OP AGG
<br />$ 4,000,000.
<br />$
<br />POLICY F7 PRU LOC
<br />IFCT
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />ANY AUTO
<br />44SBACW7363
<br />1/7/11
<br />117/12
<br />COMBINED SINGLE LIMIT
<br />(Ea accident)
<br />$ 2,000,000.
<br />BODILY INJURY (Per person)
<br />$
<br />ALL OWNED AUTOS
<br />BODILY INJURY (Per accident)
<br />$
<br />SCHEDULED AUTOS
<br />HIRED AUTOS
<br />NON -OWNED AUTOS
<br />33
<br />.l iw_rT\� 1:j1 '�"'t,�7�
<br />11
<br />t� f'��1Z
<br />i
<br />PROPERTY DAMAGE
<br />(Per accident)
<br />$
<br />X
<br />X
<br />$
<br />$
<br />UMBRELLA LIAB
<br />HCLAIMS-MADE
<br />OCCUR--
<br />/
<br />/
<br />EACH OCCURRENCE
<br />$ --
<br />EXCESS LIAB
<br />_ _
<br />I c a i ityl`,I{u'
<br />CCI'q
<br />AGGREGATE
<br />$
<br />DEDUCTIBLE
<br />$
<br />A <,IS[a,Ii (.Siy A
<br />toj'TiC`{
<br />$
<br />RETENTION
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETOR/PARTNER/EXECUTIV Y / N
<br />OFFICER/MEMBER EXCLUDED?
<br />(Mandatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below I
<br />N / A
<br />44SBACW7363
<br />1/7111
<br />1/7/12
<br />WC STATU- x OTH-
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000.
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,000.
<br />E.L. DISEASE -POLICY LIMIT
<br />$ 1,000,000.
<br />B
<br />Professional Liability
<br />PFP601212701
<br />2/23/11
<br />2/23/12
<br />Each Claim $1,000,000.
<br />Aggregate $1,000,000.
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
<br />The City of Santa Ana, its officers, agents and employees are listed as additional insureds. This policy also includes primary/
<br />not contributory language and a separation of insured's clause. A 30 day notice of cancellation also applies.
<br />CERTIFICATE HOLDER CANCELLATION
<br />City of Santa Ana
<br />Parks, Recreation and Community Service Agency
<br />26 Civic Center Plaza
<br />Santa Ana, CA 92701
<br />Attn: Silvia Cuevas
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />©1
<br />TION All rinhte rotor arl
<br />ACORD 25 (2009/09)
<br />The ACORD name and logo are registered marks of ACORD
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