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Client#c 39436 <br />2ALl AFAI ??? <br /> <br />?4COa?®n. CERTI?IC??TE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) <br /> o7/os/zo12 <br />THIS CERTi FICATE t3 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATNELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />E3ELOW. THi3 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, fhe pD)Icy(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 oa this ceNiffcate does not confer rights to the <br />certll-icata holder In Ifeu of such ondorsemen! s). <br />PRODUCER NONTACT KIT LO BZ <br />AAMM EE <br />Willis Insurance Services of Cellf. Inc. 5-1225 <br />o eXI • 949-930-1773 Arc No : 949_88 <br />a? <br />LIG#0371719 _ <br />1 <br />ss: kimberly.lopez Illis.com <br />18101 Von Kerman Ave. 6tlt Floor <br /> /NSVRER S AFFORDING COVERAGE NAICA <br />Irvine, CA 92612 T <br />l <br />C <br />P <br />C <br />f A <br />i 36 <br />1 <br /> raVa <br />erB <br />TOp <br />AS <br />o o <br />mer <br />c <br />INSV RERA• 16 <br />rNSUtzeD ____ <br />INSURERS: Fireman's Fund Ins- Company <br />--- 21873 <br />- <br />Fiesta Marketplace Partners <br />maDRERC:Preferred- Employers Ins. Co. - <br />- <br />1090 <br />0 <br />Fiesta Marketplace 1 & 11 _ _? _ <br /> INSVRERDi <br />P O Box 10728 ______ <br /> INSV RER E- <br />Costa Mesa, CA 92627 <br /> INSV RER p' <br />COVERAGES CERTIFICATE NUMBERe REVIRirlN?N11MRE R: <br />THIS IS 70 CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN iSSUGD YO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDiNQ ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH 7HlS <br />CERTIFICATE !ANY 8E ]SSUEO OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBEb HEREIN !S SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED SY PAID CLAIMS. _ <br />ptI <br />LT TYPE OF INSURANCE ADSDL UB ___pOLIGY NV/d6ER MM/ ID MM/ D L4111T5 <br />_ <br />____ <br /> <br />A <br />GENERAL LIABILITY <br />X __ <br />6306770P193 <br />3!01/2012 <br />03101/201 _ <br />___ <br />FACH OCCURRENCE _ <br />$1 OOD ODO ?- <br />J_?L. <br /> X COMMERCIAL. GENERAL LIABILITY R?7?F? ENTEO g1 OO OOO <br /> CLAlAfS-MADE ? OCCUR fdEO EXp (An one ereon) $5.000 <br /> - PERSONAL & ADV INJURY 51 00 <br />1000 <br /> _ GENERAL AGGREO <br />A <br />TE _ <br />$2,DOO OOO <br /> OENL AGGREGATE UMIT APPLIES PER _ <br />_ <br />PRODUCTS-COMP/OP A00 52.000 OOO <br /> X POLICY PRO- ? LOC _ _ $ -- <br />A AVT OMOBILE LIABILITY 8106770P193 3/01!2012 03/D1l201 ??? $1,000,000 <br /> X ANY AVTO BODILY INJUfiY (Per peraen) S <br /> ALL OWNED <br />AUTOS SCHEDVLED <br />ALTOS BODILY INJURY (Per eccl6enq 5 <br /> X HIRED AUTOa X A?[OSWNED PROPER ADAr.1AG $ <br /> _ 5 <br />$ UetBRELLA LIAe J( OCCUR 33E57708885 3/01/2012 03/01/2!)1 FACW OCCVRRENCE 525,000,000 <br /> )( EXCESS LIAB CWMS-MADE AGGREGATE $25 OOD OOO <br /> DED X RETEN KJN O S <br /> <br />G. <br />WO <br />AND <br />RKERS COMPENSATION <br />EMPLOYERS' LIABILITY __ <br />WKN1409161 <br />7!16/2012 <br />07/1 G/2013 <br />X WC 9TAT l/- -f -OTH- <br />Z4L2Y-LIIe ITS J- lit3--- __ _ <br />?- <br /> ANk'PROPRIETOFVPARTNERIEXECUTIVE /N <br />OF IC EMBER EXG <br />VDEEDT <br />N/A E.L. FJICH ACCIDENT S1,000,ODO <br /> I <br />N <br />(Mandatery In NH) E1_ DISEASE - EA EMPLOYEE 1 OOO OOO <br /> Ify ea. dosc+ibe under <br />OESC I T NOFO ERA710N3lwlocv <br />E.I.OISEASE-POLICY LIMIT <br />$1 DOOODD <br /> <br />DESCRIPTION OF OPERATIONS/ LOCATIONS / YEHICLES IAlteth AGGRO t0 t, Addlllonal Romarks SchodVlo, I/ more epaco Is rogVirad) <br />City of Santa Ana is named addit[onel insured with respect to general tlability per policy form CG D2 47 OS ?11?• <br />Ds attached. ApY???Ep AS .xq '!"Cl <br />Y` FtCK f <br />t_?SA { Csy Attorney <br />(:CH I IFII:A l t HCILUCR t:ANG CLLR fIVN <br />City of Santa Ana THEU EXP RATOIONH DATE V THEREOF, E NOTICEI WILL CBE DELNEREDOIN <br />20 Civic Center Plaza ACCORDANCE WITH THE POLICY PROVIBIONS. <br />Santa Ana, CA 92701 <br />AUTHORIZED REPIR-ES'ENTATIVE yY?? ?/ <br />?" brV??.2d"!V Q^V1ni4J <br />© 1986-2010 ACORD CORPORATION. Alt rights reserved. <br />ACORD 25 (2010105 1 pf 1 Tha ACORD name and logo era registered marks of ACORD <br />#5952543/M 52537 2KLOP