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Ac`'I Fhf CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MMIDDIYYYY) <br />07/14/2017 <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(les) 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 />McLaughlin Brunson Insurance Agency, LLP <br />12801 North Central Expressway <br />Suite 1710 <br />00 CTNAR Jae A Bryant <br />PHONE (21,4) 503-1212 FAXNo,(214) 503-8899 <br />lint. <br />Dallas TX 75243 <br />INSURERS AFFORDING COVERAGE NAIC M <br />INSURERA; Berkley Insurance Company 32603 <br />INSURED <br />Buitt-Zollars, Inc. <br />INSURER B: <br />INSURER C; <br />1717 McKinney Avenue <br />INSURER D: <br />INSURER E; <br />Dallas TX 75202 <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: Cart ID 34371 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 />INTR <br />TYPE OF INSURANCE <br />D <br />BR <br />POLICY NUMBER <br />MMIDDY EW <br />MMIDDm P <br />LIMITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE $ <br />COMMERCIAL GENERAL LIABILITY <br />_ <br />PREM SES (Ea occurrAMAGE 70 ence)_ $ <br />MED EXP ( one person) $ <br />CLAIMS -MADE 71 OCCUR <br />PERSONAL S, ADV INJURY $ <br />GENERAL AGGREGATE $ <br />OENLAOGREOATELIMITAPPLIES PER: <br />PRODUCTS -COMP/OP AGO $ <br />POLICY JgQT F-1 PRO- LOC <br />$ <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />$ <br />ANY AUTO <br />�.®.... <br />BODILY INJURY (For person) $ <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />BODILY INJURY Per seddent $ <br />( ) <br />NON -OWNED <br />HIRED AUTOS <br />PR08ERTY DAMAGE $ <br />PP <br />$ <br />UMBRELLA LIAR <br />HCLAIMS-MADE <br />OCCUR <br />EACH OCCURRENCE $ <br />AGGREGATE S <br />EXCESS LIAR <br />DED I I RETENTION <br />$ <br />WORKERS COMPENSATIONWC <br />I OTH- <br />AND EMPLOYERS' LIABILITY Y I N <br />ANY PROPRIETORIPARTNERIEXECUTIVE <br />OFFICERIMEMBER EXCLUDED? F <br />NIA <br />LtMIT- <br />E.L. EACH ACCIDENT $ <br />E.L. DISEASE- EA EMPLOYE $ <br />(Mandatory In NH) <br />If yes, describe under <br />E.L. DISEASE- POLICY LIMIT $ <br />DESCRIPTION OF OPERATIONS below <br />A <br />Professional Liability <br />AEC -9013125-01 <br />01/23/2017 <br />01/23/2018 <br />Per Claim $ 1,000,000 <br />Annual Aggregate $ 2,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks schedule, If more space is required) <br />The claims made professional liability coverage is the total aggregate limit for all claims <br />presented within the annual policy period and is subject to a deductible. Thirty (30) days notice <br />of cancellation is in favor of the certificate holder, <br />REVIEWED EIY, EUNICE HEREDIA (PG 3 OF <br />CERTIFICATE HOLDER CANCELLATION <br />©1988-2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD <br />Page 1 of 1 <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 Public Works Agency <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 Civic Center Plaza <br />AUTHORIZED REPRESENTATIVE <br />Banta Ana CA 92701 <br />�44 <br />©1988-2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD <br />Page 1 of 1 <br />