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ACORD CERTIFICATE OF LIABILITY INSURANCE <br />TN .ATE(MMIDDIYYYY) <br />09/12/2013 <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 NCONTACT <br />AME: Dana O'Malley <br />Leavitt Group #OF13098 PpIONH°E,t:714-210-7903 AIC,N°I.714.569.3099 <br />PrideMark-Everest Ins Serv Inc L <br />ADDRESS: <br />1820 E. First Street, Ste 500 INSURER(S) AFFORDING COVERAGE NAICp <br />Santa Ana, CA 92705 INSURER A: Insurance Company Of The West 027847 <br />INSURED Shamrock Supply Company, Inc. INSURER B: <br />DBA: Single Point Alliance INSURER C: <br /> INSURER D <br />3366 East La Palma Avenue INSURER E: <br />Anaheim, CA 92806-2814 INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 13-14 WC 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 />WEIR <br />LTR <br />TYPE OF INSURANCE AUDI- <br />INSR SUBIR <br />MD <br />POLICY NUMBER <br />MMIODIYYYY <br />MMIDDIYYYY <br />LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ <br /> COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $ <br /> CL IMB-MADE [:] OCCUR MED EXP(Any one person) $ <br /> PERSONAL B ADV INJURY $ <br /> GENERAL AGGREGATE $ <br /> GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ <br /> POLICY PRO- F7 LOC <br />JECT $ <br /> AUT OMOBILE LIABILITY <br />His accident) <br />$ <br /> ANY AUTO BODILY INJURY (Per person) $ <br /> A OWNED <br />AUTOS S SCHEDULED <br />OS <br />AUT <br />BODILY INJURY (Per accident) <br />$ <br /> <br />HIRED AUTOS <br />UTOS <br />NON-OWNED <br />AUTOS (Per accident) $ <br /> <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DEC) RETENTIONS $ <br /> WO <br /> <br />AN RKERS COMPENSATION <br /> <br />D EMPLOYERS' LIABILITY WSD50210130 04/04/2013 04/0412014 X <br />TORY LIMITS <br />ER <br />A MY PROPRIETORPARTNERIE <br />OFFICERIMEMBER EXCLUDED%ECUTIVF? NIA E.L. EACH ACCIDENT $ 1,000,000 <br /> (Mandatory in NH) E. L. DISEASEFA EMPLOYE $ 1,000,00 <br /> If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT <br />$ 1,000,00 <br /> <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) <br />E: Operations of the Named Insured as on file with the insurance carrier. <br />APYRUVll AS 'C(> C)KNi <br />CERTIFICATE HOLDER ' ,.. y CANCELLATION <br />Lau" <br />1 Iii1? <br />A.SSlslOnt L1LV <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 AUTHORIZED REPRESENTATIVE sy] <br />4th Floor, Room 429 <br />Sa to Ana, CA 92701-4058 Gar Wells/DANAO <br />ACORD 25 (2010105) <br />©1988-2010 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD