|
A
<br />r,7 .
<br />1 C,
<br />COPLOG1 OP ID: DI
<br />A vera CERTIFICATE OF LIABILITY INSURANCE
<br />DAT 08101D/YYYY)
<br />08/01112
<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 T4T4JTE pc)ccMTR19P1WTWEEN 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 gndorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement: A stk(Aoent on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsement(s). -
<br />PRODUCER 410-228-6464
<br />RPS ISG International
<br />204 Cedar Street 410-228-7645
<br />CONTACT
<br />NAME: Diann CrltZer
<br />AIC. o Ell: 410-901-0743 aC No ; 410-228-7645
<br />_
<br />ADDRESS: SS: Diann Critzer RPSins.com
<br />-
<br />Cambridge, MD 21613
<br />Jacque Brohawn
<br />SPP6175202
<br />08/01/12 08/01/13
<br />INSURER(S) AFFORDING COVERAGE NAIC #
<br />INSURER A : Great American of New York 22136
<br />MED EXP (Any one person) $ 10,000
<br />INSURED Coplogic Inc
<br />INSURER B: Beazley USA Services, Inc.
<br />231 Market Place #250
<br />San Ramon, CA 94583
<br />INSURER C :
<br />INSURER D:
<br />INSURER E:
<br />INSURER F:
<br />COVFRAGFS CFRTIFICATF NI IMRFR• RFvmintd til IMRPR•
<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 />I
<br />LTR TYPE OF INSURANCE
<br />I
<br />POLICY NUMBER
<br />EXP
<br />MMIDD/YYYY LICY EFF 1 MM(LDDY/YYYY
<br />LIMITS
<br />GENERAL LIABILITY
<br />A X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE X OCCUR
<br />X
<br />SPP6175202
<br />08/01/12 08/01/13
<br />EACH OCCURRENCE $ 1,000,000
<br />DAMAGE TO RENTED
<br />PREMISES Ea occurrence $ 300,000
<br />MED EXP (Any one person) $ 10,000
<br />PERSONAL & ADV INJURY $ 1,000,000
<br />GENERAL AGGREGATE $ 2,000,000
<br />PRODUCTS - COMP/OP AGG $ 2,000,00
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />X POLICY PE� LOC
<br />$
<br />AUTOMOBILE LIABILITY
<br />A — -. ANY AUTO
<br />SPP6175202
<br />08/01/12
<br />08/01/13
<br />COMBINED SINGLE LIMIT 1,000,000
<br />Ea accident $
<br />BODILY INJURY (Per person) $
<br />u' ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />BODILY INJURY (Per accident) $
<br />X '!. HIRED AUTOS X1 NON -OWNED
<br />1 AUTOS
<br />PROPERTY DAMAGE $
<br />Per accident
<br />$
<br />'. X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />'�.
<br />EACH OCCURRENCE $ 5,000,000
<br />A
<br />EXCESS LIAB
<br />CLAIMS-MADEI
<br />SPP6175202 08/01/12
<br />08/01/13
<br />AGGREGATE $ 5,000,000
<br />DED X ''. RETENTION$ 01
<br />$
<br />I
<br />A
<br />WORKERS COMPENSATIONWC
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANY PROPRIETORIPARTNERIEXECUTIVE
<br />OFFICERIMEMBER EXCLUDED?
<br />NIA I
<br />WC7576127
<br />08/01/12
<br />08/01/13
<br />STATU- CT'-
<br />-
<br />1 X I TORY LIMITS' ER
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L. DISEASE - EA EMPLOYE
<br />$ 1,000,000
<br />(Mandatoryin NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 1,000,000
<br />B
<br />Errors & Omissions
<br />& Network Security
<br />IV1 5TTR1 10301
<br />CLAIMS MADE & REPORTED
<br />i
<br />08/01/12 08/01/13
<br />�'.
<br />Ded$25k 1,000,000
<br />Included
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
<br />City of Santa Ana, CA is added as additional insured on the General �S, 'to s
<br />Liability coverage subject to the policy limitations, conditions `t D
<br />and exclusions.V
<br />RCK Y
<br />S� o ey �
<br />01kO
<br />t-trc I II -16A I t NUL.ULK CANCELLATION
<br />CITYOSA
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />Ci of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE
<br />©1988-2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
<br />
|