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CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MM/DD/YYYY)
<br />01/06/2012
<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 />CONTACT NAME: Cadwalader & Associates, Inc.
<br />PHONE 610 964-8970 AX 610 964-9280
<br />EMAIL , khennessy@cadwaladerassoc.com
<br />PRODUCER 245
<br />INSURERS AFFORDING COVERAGE
<br />NAIC #
<br />JNSURED
<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 />INSURER B : 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 />TYPE OF INSURANCE
<br />ADDL
<br />SUB
<br />POLICY NUMBER
<br />POLICY EFF
<br />POLICY EXP
<br />LIMITS
<br />A
<br />GENERAL LIABILITY
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE � OCCUR
<br />44SBACW7363
<br />117112
<br />1/7/13
<br />EACH OCCURRENCE
<br />$ 2,000,000.
<br />DAMAGETO RENTED
<br />$ 300,000.
<br />MED EXP (Any oneperson)
<br />$ 10,000.
<br />PERSONAL & ADV INJURY
<br />$ 2,000,000.
<br />GENERAL AGGREGATE
<br />$4,000,000•
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICY PRO LOC
<br />PRODUCTS - COMP/OP AGG
<br />$ 4,000,000.
<br />$
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />ANY AUTO
<br />ALL OWNED AUTOS
<br />SCHEDULED AUTOS
<br />HIRED AUTOS
<br />NON -OWNED AUTOS
<br />1
<br />1
<br />44SBACW7363
<br />'
<br />4-,?& a oc=,c
<br />1/7112
<br />1/7/13
<br />COMBINED SINGLE LIMIT
<br />(Ea accident)
<br />$2,000,000.
<br />BODILY INJURY (Per person)
<br />$
<br />BODILY INJURY (Per accident)
<br />$
<br />PROPERTY DAMAGE
<br />(Per accident)
<br />$
<br />X
<br />X
<br />$
<br />1
<br />$
<br />UMBRELLA LIAB
<br />EXCESS LIAB
<br />OCCUR-
<br />CLAIMS -MADE
<br />�� - ��--
<br />_..,. _
<br />EACH OCCURRENCE
<br />$
<br />AGGREGATE
<br />$
<br />DEDUCTIBLE
<br />RETENTION
<br />$
<br />$
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITYFIR
<br />ANY PROPRIETOR/PARTNER/EXECUTIV YIN
<br />OFFICER/MEMBER EXCLUDED?
<br />(Mandatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />N / A
<br />44SBACW7363
<br />1/7/12
<br />117/13
<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 />2/23111
<br />2123/12
<br />Each Claim $1,000,000.
<br />A re ate $1,000,000.
<br />DESCRIPTION OF OPERATIONS / 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 />© 1988-2009
<br />N_ All rinhts rasarvart
<br />ACORD 25 (2009/09)
<br />The ACORD name and logo are registered marks of ACORD
<br />
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