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'`'� ®P CERTIFICATE OF LIABILITY INSURANCE 4122�714YY) 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 Daly Merritt Insurance 100 Maple r go13 -11D �V 0� Wyandotte MI 48192 CONTACT Cathy Stannis-REP PHONE (734) 283 -1400 FA'°XC 0:(734)283 -1197 AENAn 'ss:Cathy.8tannis @dalymerritt. com INSURERS AFFORDING COVERAGE NAIC# INSURERA:Federal Insurance Co. 20281 INSURED FAAC Inc. 1229 Oak Valley Drive Ann Arbor MI 48108 -9675 INSURERB:Great Northern Ins. Co. 20303 INSURERC:The Standard Fire Insurance Cc 19070 INSURER D: INSURER E $ 1,000,000 INSURER F: X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FxIOCCUR COVERAGES CERTIFICATE NUMBER:CL1442206788 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 SUBR POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDDIYYYY LIMITS Santa Ana, CA 92701��.+ GENERAL LIABILITY Kyle O'tlalley /STANNI EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FxIOCCUR 36000820 /1/2014 /1/2015 DANA LI U KEN TE PREMISES Ea occurrence $ 1,000,000 MED EXP(Any one person) $ 10,000 PERSONAL &ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 21000,000 GENL AGGREGATE LIMIT APPLIES PER'. PRODUCTS - COMNOP AGG $ 2,000,000 X POLICY PRO LOG JECT F-1 $ AUTOMOBILE LIABILITY OMBI EDt SINGLE LIMIT 1 000 000 X BODILY INJURY (Per person) $ B ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS 73583837 /1/2014 /1/2015 BODILY INJURY (Per accident)) $ N ED HIRED AUTOS AUTOS UTOS PROPERTY DAMAGE Per accident $ Pro etl tlame a Bu back $ 4 UMBRELLA LIAB X OCCUR EACHX OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 A EXCESS LIAB CLAIMS -MADE DED RETENTION$ $ 79877681 /1/2014 /1/2015 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ N ANY PROPRIETOR /PARTNER /EXECUTIVE (Mandatory OFFICER/MEMBER H)EXCLUDED? (Mandatory In NH) NIA CUB3D69497 -0 -19 /1/2014 /1/2015 X WC STATU- OTH- E.L. EACH ACCIDENT $ 500,000 E.L, DISEASE -EAEMPLOYEL $ 500 000 If yes, descrlbe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1 $ 500 000 DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) The certificate holder is listed as additional insured with respects to the General Liability as required by written contract. (✓Y� �C a' � �V I' VU CERTIFICATE HOLDER CANCELLATION ACORD 25 (2010/05) INS025 (201005).01 © 1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Police Dept AUTHORIZED REPRESENTATIVE Robert Breken£eld P.O. Box 1981 Santa Ana, CA 92701��.+ Kyle O'tlalley /STANNI ACORD 25 (2010/05) INS025 (201005).01 © 1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD