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DATE <br />ACORD CERTIFICATE OF LIABILITY INSURANCE <br /> <br />13/2013 <br />09/13/2013 <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 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: <br /> <br />Leavitt Group #OF13098 <br />PHONENo Ext : 714. 569. 2700 714.569.3099 <br />(A <br />A/C IC , No <br />PrideMark-Everest Ins Serv Inc D <br /> A <br />DRESS: <br />1820 E. First Street, Ste 500 <br /> INSURER(S) AFFORDING COVERAGE NAIC# <br />Santa Ana, CA 92705 INSURER A. Golden Eagle Insurance Corp. 10836 <br />INSURED Shamrock Supply Company, Inc. <br /> INSURER B: <br />dba: Single Point Alliance <br /> INSURER C: <br />3366 East La Palma Avenue <br /> INSURER D: <br />Anaheim, CA 92806-2814 <br /> INSURER E: <br />' ZD INSURER F <br />COVERAGES CERTIFICATE NUMBER: 12-13 GL, Auto, Umb REVISION NUMBER: <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 />LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER <br />(FULIUY MMIDDNYYY <br />MMIDDIYYYY <br />LIMITS <br /> GENERAL LIABILITY CBP181898 10129/2012 1012912013 EACH OCCURRENCE $ 1,000.00 <br /> X COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $ 100,00( <br /> CLAIMS-MADE OCCUR MEO EXP(Any one person) $ 5,00 <br />A PERSONAL 8 ADV INJURY $ 1 <br />000 <br />00( <br /> GENERALAGGREGATE , <br />, <br />$ 2 <br />000 <br />00 <br /> GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG , <br />, <br />$ 2,000,00 <br /> <br />PRO- <br />POLICY PRO- X LOC $ <br /> LIABILITY BA181897 10/29/2012 10/2912013 <br />accident) <br />1 <br />,000,00 <br /> X ANYAUTO <br />ALL OWNED BODILY INJURY (Per person) $ <br />A <br />AUTOS SCHEDULED <br />AUTOS <br />NON <br />OWNED <br />BODILY INJURY (Per accitlent) <br />$ <br /> X HIRED AUTOS X - <br />AUTOS (Per accident) $ <br /> $ <br /> J( UMBRELLA LIAB X OCCUR CU672786 10/29/2012 10129/2013 EACH OCCURRENCE $ 5,000,00 <br />A EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5 <br />000 <br />00 <br /> DEO X RETENTION $ 10,00C , <br />, <br />$ <br /> WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN _ A1 H <br />TORY LIMITS ER <br /> ANY PROPRIETORIPARTNERIEXECUTIV <br />OFFICER/MEMBER EXCLUDED? <br />NIA E.L. EACH ACCIDENT $ <br /> (Mandatory In NH) <br />If yes <br />descnbe under E.L. DISEASE- EA EMPLOYE $ <br /> , <br />DE SCRIPTION OF OPERATIONS below E.L. DISEASE-POLICY LIMIT $ <br /> <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORO 1f(1( Adde_tt)I1Keks Schedule, if more space Is required) <br />overing operations of`thggtkajll?Tnsured-as on file with the insurance carrier <br />lUT I <br />?,,?L'o OI C,av 111ORIC4' <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />City of Santa Ana <br />20 Civic Center Plaza <br />4th Floor, Room 429 <br />Santa Ana , CA 92701-4058 <br />AUTHORIZED REPRESENTATIVE <br /> <br />AUVKU ZO (ZVI U/UO) <br />The ACORD name and logo are registered marks of ACORD <br />V