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AcoRO® CERTIFICATE OF LIABILITY INSURANCE DATE (MMIODn ) 6/20/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Hylant Group Inc -Ann Arbor 24 Frank Lloyd Wright Dr J4100 Ann Arbor MI 48105 PHONE FAX - AIC No : - E -MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC q EACH OCCURRENCE INSURER A;Travelers Indemnity Company 25658 $300,000 INSURED FAACI -1 INSURER B:Trayelers Prop Casualty Ins CQ 36161 INSURER C:Travelers Prop Cas Cc of Amer 25674 Faac, Inc. 1229 Oak Valley Drive Ann Arbor, MI 48108 INSURER D:Staodard Fire n ur n Co. 7 PRODUCTS - COMPIOP AGO $2,000,000 INSURER E $ INSURER F I AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED F7 SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS COVERAGES CERTIFICATE NUMBER: 969572432 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR UBR Me POLICYNUMBER POLICY EFF MMIODIYYYY POLICY EXP MMIDOIYYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS-MADE a OCCUR 3309237P92l 5l112013 /1/2014 EACH OCCURRENCE $1,000,000 PREMISES Ea occu ante $300,000 MED EXP (Any one person) $10,000 PERSONAL B ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE X POLICY LIMIT APPLIES PER: PRO- LOC rcT F-1 PRODUCTS - COMPIOP AGO $2,000,000 $ B I AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED F7 SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS BA9237P921 /112013 11/2014 COMBINED 1,000,000 BODILY [NJ URY(Par person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ C X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS�NIADE CUP9237P921 /1/2013 /112014 EACH OCCURRENCE $5,000,000 AGGREGATE $5,000,000 DED X I RETENTION $10,000 1 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNEWEXECUTIVE❑ OFFICERIMEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA UB9237P921 /112013 /1/2014 X WC STATU- OTH- E.L. EACH ACCIDENT $500,000 E.L. DISEASE EA EMPLOYEE $500,000 E.L. DISEASE POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Additional Insured for General Liability, as required by written contract - City of Santa Ana, its officers, employees, volunteers and agents. AYYROVED A$ TO FORM" Laura A. Rossini City of Santa Ana 20 Civic Center Plaza Santa Ana CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED RE PRESENTATIVE © 1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD