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<br />Policy Number: 605503396
<br />Date Entered: 12/7/2014
<br />DATE (MMFDDiYYYY)
<br />12/7/2014
<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 INSURERS), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE. HOLDER.
<br />IMPORTANT: if the certificate holder is an ADDITIONAL INSURED, the policy(les) 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 endor'sernont(s),
<br />PRODUCER
<br />CONTEACTMike Rodgack.
<br />Mike Rodgick Insurance
<br />r'bN(ANE - .
<br />(9491 753 9555 I FAx (949) 753 -9559 _
<br />196 'Technology Drive, Suite B
<br />-W-Pu
<br />E -MAIL
<br />Irvine, CA 92618
<br />....mm,I I
<br />CLAIMS -MADE ! ... � C,',aC'CUR
<br />{'1.
<br />6LD55D33�6 2/07/2014 2/D7/2015
<br />1NSURER(Sl A.FFORCaING C49XERACiE � NAIC a-
<br />.... ..... .._ .. .
<br />S100,000
<br />144 .800
<br />S r
<br />_...._.. -.w_ -- _.
<br />.., ..
<br />Exchange 21652
<br />INSURER A:
<br />INSURED Santa Ana Business Council, Inc. _...... ...
<br />_._. ., n .n..,.
<br />st.arerc;�m�"� s'at rrn In 'v.nd,. 135476 ...........
<br />INSURER 8
<br />Carlos Madriles
<br />Travelers 31194
<br />INSURER C! ........... .. ........... ..... .........
<br />400 E, 4th Street
<br />INSURER D:
<br />Santa Ana, CA 92741
<br />INSURER E: ;
<br />$1,0010,000
<br />INSURER F!
<br />t�arti7l�irl'r�NrL. r�ara,aylmrwurr�n�rr�irina�r sry�nl�erLe °x�u*�rrtrrrrar�:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD ii
<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 />.I LTR...�._.,..... . ,TYPE�OFIPaSUPtANCE..._..,.__,_ AGYCILISUBRg ....... .. ....OLIDVNUMDER MMYIYAPY`il'l'V MMIr?�(7PYEi'Yb�_...Y.___... LIMITS
<br />A.
<br />COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />S 1 r 444 r O'O0
<br />_.
<br />_
<br />....mm,I I
<br />CLAIMS -MADE ! ... � C,',aC'CUR
<br />{'1.
<br />6LD55D33�6 2/07/2014 2/D7/2015
<br />DAMAGE TORE NTED
<br />PREMISE, IEq,,p.,Enorrr„rrca„_
<br />_.e
<br />S100,000
<br />144 .800
<br />S r
<br />_...._.. -.w_ -- _.
<br />MED I XP IAny one pwwnl
<br />S 10 , 000
<br />PERSONAL F ADV INJURY
<br />$1,0010,000
<br />GEN'L
<br />AGGREGATE UP&T APPLHI $ PER:
<br />GENERAL AGGREGATE __S
<br />... -..... ....- ..._.. _.......... _ ...... -.
<br />2 , 404 , 000
<br />_-..._-... -.. ... ....,
<br />PGh II�`F �...,....I PRO- 0..._..I LGS ".
<br />i ..... P JEO1 A.. I
<br />r
<br />PROD�UOTwm COMP(CF AOG
<br />S 1,000,000
<br />EYTPdER.
<br />V
<br />S
<br />AUTOMOBILE
<br />OMOBILE LIABILITY
<br />COMBINED MINGLE LIMIT
<br />S l QOO 000
<br />A
<br />AN AUt0
<br />605503396 2/07/2014 2/07/2015
<br />BODILY INJURY (Per person)
<br />...- _._....,..
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<br />, ..
<br />.......
<br />ALLOV+PNE:i3 SCHEDULED
<br />BODILY INJURY $Par "Ira kienl)
<br />S
<br />"t7 "IOS AUTOS
<br />hn1NED
<br />PPeOraceRidarrl)ANi
<br />_
<br />HHIREDAUTOS ✓ . A UTOS
<br />. ,,,,, ...
<br />..
<br />UMBRELLA LIAR _..._ OCCUR
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<br />EACH OCCURRENCE
<br />8
<br />EXCESS LIAR (LA.IMS, flo A
<br />I AGGREGATE
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<br />�NFTENTION
<br />i ...._.
<br />DED S
<br />S
<br />WORKERS COMPENSATION
<br />� �........
<br />X j �_ � ERLI
<br />AND EMPLOYERS' LIABILITY Y d N
<br />„STATUTE ..
<br />} .. _... .
<br />S,1,OOO,444
<br />AI IYPRCP111CTOWPARTNEF VEXiECUCiVIr:
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<br />9'l�'E'�1384'— 41.4 '2/10/2014 2 /ltl /2p15
<br />EL EACHACCIDiENT
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<br />".. . ...,..- ,_
<br />t"�T3= IG�..Ia ER�1BFREXCLUDED?
<br />IMandalCCrory Irr Nit
<br />I
<br />I
<br />e
<br />E L. DISEASE - EA EMPLOYEE
<br />S1,000,000
<br />I If yes, Joscnba Bander
<br />`.DESG4`�t9F^ VON OF OPERATIONS buIow f
<br />� � I' f
<br />. —.. .... ._.
<br />, E #�. OISE.ASE - POk.iOY LIiMIT
<br />-
<br />: $1,000,000
<br />C 1 Fidelity Bond 1106032811 12/0712014 2/07 /2015
<br />5, 000 SIR 500,000
<br />C ID &O 106032811 12/07/2014 12/07/2015
<br />1,000 SIR 1,404,000
<br />C B'P'D 1O6t132811 12/07/2014 2/07/2015
<br />j1, 000 Slid 1,000,000
<br />DESCRWTION OF OPERATIONS I LOCATIONS P VEHICLES (ACORD 101, Addidonal RurnaOs Schedule, may be attached .4 more apace Is required)
<br />" c Ir
<br />The City of Santa Ana, its officers, agents and employees are named as additional insureds for eral
<br />Liability purposes.
<br />City of Santa Arta
<br />20 civic Center Plaza
<br />Santa Ana, CA 92702
<br />Attn: Risk Management - Briza Morales
<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 µ
<br />U 19I18 -2014 A(«t7HL) L;fJ,'I+`F'"SBh:A49C N. x,19 rlgntS* reSUrVer:I.
<br />ACORD 25 (2014101I) The ACORD name and logo are registered marks of ACORD
<br />Produced using farms Baas Plus Software. wrvwvi _ Fonn.,Ro:;,s corn, Impressive rrutflishmIy 800 -208 -1977
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