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Client#: 269335 LI N ESYST
<br />ACORD- CERTIFICATE OF LIABILITY INSURANCE DATE(MMMDIYYYY)
<br />05/11/2012
<br />THIS CERTIFICATE IS ISSUED ASA 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 />3ELOW. 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 CONTACT
<br />NAME: Jennifer HOUSel
<br />Hub International PHONE 877 825-2681 FAx
<br />{arc, No Ext): _ we No 951 231-2572
<br />HUB Int'I Insurance Serv. Inc. noo lless: CaLCPU@hubinternational.com
<br />4371 Latham St, IZn4te 1 INSURER(S) AFFORDING COVERAGE NAIC#
<br />r•n oocna —...— ------
<br />INSURED
<br />Linear Systems
<br />Chris Parsons dba:
<br />8403 Maple Place
<br />Rancho Cucamonga, CA 91730
<br />INSURER A: Federal Insurance Company 120281
<br />INSURER 13: Beazley Insurance Company, Inc._ i 37540
<br />INSURER c: General Insurance Company of Am ',24732
<br />INSURER D:
<br />INSURER E :
<br />C()VFRAr;FR CFRTIPWATF NIIIMRFR• oo�ncrnr.i �ni.eorn.
<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 CONTRACTOR 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, LIMTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR
<br />LTR
<br />ADDLISUBR.
<br />TYPE OF INSURANCE INSR
<br />IWVD POLICY NUMBER
<br />POLICY EFF
<br />MMIDD
<br />POLICY EXP
<br />MM/DD(YYYY LIMITS
<br />A
<br />GENERAL LIABILITY 35785104WUC
<br />4125/2012,04/25/201
<br />EACH OCCURRFNCE S1 000,000
<br />X COMMERCIAL GENERAL LIABILITY
<br />?REMISES ERa ecu D nce) 1,000,000
<br />- i CLALNIS-MACE X OCCUR
<br />,
<br />i MED EXP (Ary one person) ,.$ 10,000
<br />F_
<br />PERSONAL & ADV INJURY $ 1,000,000
<br />''.
<br />GENERAL AGGREGATE tf$2,000,000
<br />1 GEN'L AGGREGATE LIMIT APPLIES PER:
<br />PRODUCTS - COMPIOP AGG ($1,000,000
<br />ElPOLICY �I,
<br />JRO- LOC
<br />$
<br />AUTOMOBILE LIABILITY
<br />24CC2790372 4/25/2012 04125/2013 COMBINED SINGLE DMII 51,000,000
<br />ANY AUTO
<br />I
<br />BODILY INJURY (Per person) S
<br />OWNED
<br />ALL SCHEDULED
<br />AUTOS � AUTOS
<br />NON-OW
<br />x NED
<br />X
<br />I
<br />BODiLY INJURY accident) $
<br />_....._._.
<br />PROPERTY DAMAGE
<br />F1%TnU
<br />hi!F:LD ALf iOS I AUTOS
<br />(?er $
<br />,
<br />_
<br />UMBRELLA LIPB OCCUR
<br />EACH OCCURRENCE $
<br />EXCESS LIAB CLAItd S -MADE
<br />= AGGREGATE $
<br />DED RETENTION$ _ _
<br />$
<br />A WORKERS COMPENSATION I 1371735541
<br />fiO3/01/2012�.'03l01/2013 X WC STA TU-OTH-
<br />AND EMPLOYERS' LIABILITY Y (N
<br />NiSJ ----
<br />ANY PROPRIETOR'PARTNE, (EXECUTIVE
<br />OFFICERWEMBER EXCLUDED? N/A'
<br />E.L. EACH ACCIDENT $1.000,000
<br />Mandatory B
<br />',
<br />EL. DISEASE -EA EMPLOYEE $1,000000
<br />if yes, descbe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. D!SEASE - POLICY LIMIT $1,000,000
<br />B Professional V10217210031 12/11/2011 12111/2012:$1,000,000
<br />Each Claim
<br />Liability
<br />$1,000,000 Aggregate
<br />$5,000 Deductible
<br />DESCRIPTION OF OPERATIONS] LOCATIONS/ VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
<br />Certificate holder is additional insured in regards to the general liability policy per the attached
<br />endorsement form 80-02-2367 08/04. General liability policy is primary per the attached endorsement form
<br />80-02-2653 04/01.
<br />APP"
<br />.
<br />��rtr,rwra�cnv�ucrt i — CANCELLATION
<br />City of Santa Ana - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />1".';it THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />20 CIVIC Center Plaza ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Santa Ana, CA 92701
<br />AUTHORIZED REPRESENTA I IVE
<br />O 1988-2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD
<br />#S1673387/M1673311 JM43
<br />
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