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Y�1 LAURA -1 OP ID: SH
<br />A�co�R° CERTIFICATE OF LIABILITY INSURANCE F DAT 10 /10D/YYYY)
<br />10/10/12
<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 />$ LOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />:PRESENTATIVE 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 endorsemer 1.
<br />PRODUCER
<br />949- 253 -8000
<br />CONTACT y
<br />NAME: Shell Hehner
<br />Friedmann 8 Friedmann Ins Svcs
<br />CA License #0759373
<br />949- 253 -8009
<br />- -
<br />AIC,No E , t),949- 417 -2641 �a 253 -8009
<br />3990 Westerly Place Suite 100
<br />- ,NO);949- _
<br />EWAIL : certificates @fandfins.com
<br />ADDRESS
<br />Newport Beach, CA 92660
<br />- - -- - -- -- - - --
<br />LaverneFriedmann
<br />$ 1,000,000
<br />_ INSURER(S) AFFORDING COVERAGE NAICp
<br />MMERCIAL G ENERAL LIABILITY
<br />X
<br />INSURER A, Philadelphia Indemnity Ins. Co
<br />116056
<br />INSURED Laura'siioursei
<br />10111113
<br />INSURER B:
<br />- OAMAGE70RENTED-
<br />PREMISES I Ea occurrence)
<br />999 Corporate Drive, Suite 225
<br />OCCUR
<br />tX
<br />-
<br />Ladera Ranch, CA 92694
<br />INSURER C_: -- -- -.
<br />MED I(My one person)
<br />$ 10,000
<br />q
<br />_INSURER D:
<br />$3,000,0001$1,000,000
<br />INSURER E:
<br />10/11/13
<br />PERSONAL B ADV INJURY
<br />$ 1,000,000
<br />INSURER F
<br />ual /Phys Abuse
<br />-- __
<br />COVERAGES CERTIFICATE NUMBER- RFVICInM MIMncG-
<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 />INSR -- - ADDLSURR POLICY EFF POLICY EXP
<br />LTR TYPE OF INSURANCE POLICY NUMBER MMIDD/YYYY MMIOD LIMITS
<br />GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />•
<br />MMERCIAL G ENERAL LIABILITY
<br />X
<br />PHPK932233
<br />j 10/11/12
<br />10111113
<br />$ 16,000
<br />- OAMAGE70RENTED-
<br />PREMISES I Ea occurrence)
<br />OCCUR
<br />tX
<br />MED I(My one person)
<br />$ 10,000
<br />q
<br />$3,000,0001$1,000,000
<br />10/11/12
<br />10/11/13
<br />PERSONAL B ADV INJURY
<br />$ 1,000,000
<br />q
<br />ual /Phys Abuse
<br />-- __
<br />$1,000,0001$1,000,000
<br />10/11/12
<br />10/11/13
<br />GENERAL AGGREGATE
<br />$ 3,000,000
<br />PRODUCTS - COMP /OP AGG
<br />GENT AGGREGATE LIMIT APPLIES PER
<br />$ 3,000,000
<br />POLICY PRO- LOG
<br />_
<br />$ -�
<br />AUTOMOBILE LIABILITY
<br />I EOMaBINdEEDtSINGLE LIMIT
<br />1,000,000
<br />$
<br />A
<br />AUTO
<br />!PHPK932233
<br />10/11112
<br />10/11/13 BODILY INJURY(Par person)
<br />$
<br />_X'ANY
<br />ALLOWNED 1 SCHEDULED
<br />AUTOS AUTOS
<br />BODILY Per accident)
<br />( i
<br />$
<br />_ -�
<br />NON OWNED
<br />X HIRED AUTOS X
<br />PROPERTY DAMAGE
<br />$
<br />AUTOS
<br />(Per accidI _
<br />$
<br />X
<br />UMBRELLA LIAR X OCCUR
<br />EACH OCCURRENCE $ 1,000,00
<br />A
<br />EXCESS LIAR. _._ CLAIMS -MADE
<br />PHUB399387
<br />10111/12
<br />10/11/13 AGGREGATE $ 1,000,000
<br />DED X RETENTION$ 10,000
<br />$
<br />WORKERS COMPENSATION
<br />WCSTATU I OTH-
<br />ANDEMPLOYERS'LIABILITY YIN
<br />TORYLIMITS. ER
<br />_ _
<br />E.L. EACH ACCIDENT
<br />ANY PROPRIETORJPARTNERIEX
<br />$
<br />OFFICEWMEMBER EXCLUDED ?ECUTIVE
<br />❑
<br />N /A
<br />E.L. DISEASE - EA EMPLOYE
<br />(Mandatory, 1n NH)
<br />$
<br />If yes, describe under
<br />- - - -- -
<br />— —
<br />'DESCRIPTIONOFOPERATIONSbelow
<br />E.L. DISEASE- POLICYUMIT
<br />$
<br />q
<br />Crime
<br />PHPK932233 10/11/12 10/11/13 ',Emp Theft 200,000
<br />Forgery 200,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Aftach ACORD 101, Additional Remarks Schedule, if more space is required)
<br />The City of Santa Ana Community Development Department M -25, its officers,
<br />employees, volunteers, agents and representatives are included as Additional 1aNj
<br />Insured per wording incorporated into the policy forms.
<br />'To
<br />R�a .
<br />0C
<br />LISA E' ttoWey
<br />CITYS -8
<br />City of Santa Ana Community
<br />Development Department M -25
<br />20 Civic Center Plaza, 6th FI
<br />Santa Ana, CA 92701
<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 />AUTHORIZED REPRESENTATIVE
<br />© 1988.2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
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