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<br />YLV�✓RD.n CE'RTIF'ICATE OF LIABILITY INSURANCE tlATE {MM10TdYYYYI
<br />0412412013
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIPICATE HOLbER. THIS
<br />CERTIPICATE DOES NOT AFFIRMATIVELY OR NBOATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED DYTHE 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 />1MPORTAN t if thS caNlNcafe holder son DDITIO AL INBURED, lice pollcy(las) munt ae en orsed.lf SU BROGATIOIJ IS WAIVED, suhJmtto
<br />the terms and conditions of the policy, eonnin pollolas may require an andorsamam. A Statement On this certificate does not confer righta to Zhu
<br />Certificate holder in lieu of such oodorsomant s .
<br />PRODNCeR
<br />Hub Intornatlonal
<br />HUB Latham Insurance 5101 Inc.
<br />4371 Latham St, Ste #101
<br />Riverside, CA 02501 ��IUSUSEaA;Cttlzens
<br />ennifer Housal
<br />--- Jut--. -
<br />.877 825.2Cs81 a; 951 231.2872
<br />_ _
<br />a I s, CEII,GPU hubihternatlenal.com
<br />R4e1@IMEAPFORDINO COVERAGE
<br />NAIr0
<br />Insurance Company etA
<br />31534
<br />INSURen
<br />Llnear3ystams
<br />Chris Paracha Cher;
<br />__
<br />w3URSRe IAlmarlca Financial Benefit Iris
<br />4T8 0
<br />Nsuaen at Boazley Ina urance Company, Inc,
<br />37540 _..
<br />INSURERS!
<br />$1009000
<br />8403 Maple Place
<br />Rancho Cueamongu, CA 81730
<br />^
<br />INSU9aRa1
<br />9100Q0
<br />e11RPR Pe
<br />it 50000
<br />THIS IS TO
<br />D. NOTWITHSTANDING THE POLICIES UI 1MENT. )RANCE
<br />INDICATED. ANY OR CE
<br />TER LISI OR CONDITION HAVE. BEEN ISSUED TOTHG HER DOCUMENT b NAMED ABOVE FORTHE POWHICH THIS
<br />0DED ANY OTHER WITH RESPECT TO WHICH THIS
<br />ANY BE ISSUEID PERT IN, TH INS AFF HE FOLIC'I'OR
<br />CERTIPICATE MAY 86 ISSUED OR MAY PERTAIN, THE INSURANCE SHOW AFFORDED BY THE EDUCED Y PAID HERERJ IS SUBJECT 70 ALL }'yE 7EgN,S,
<br />D HER
<br />EµXCLUatONa AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN 9Y PMD CWMS.
<br />4TR
<br />_ Tymor INSURANCE �__
<br />,a „L1,W
<br />U
<br />1'MICY NUMEER
<br />pRpELC�UyCgEppD
<br />MIA[1dYYYYY�
<br />Mn01[I FYV
<br />LIMS7a_`_-
<br />A
<br />(ENCRALLMIJILITY
<br />_CAMM[RdALOENERALLUaI.rrY
<br />CIAIlNRJ.IADF. 'F:�lcomN
<br />OB398981315
<br />D412612019
<br />04125/2014
<br />VKHOOCURRENCE
<br />$1009000
<br />� RPNI; vo a
<br />MED f &P (Myone aeio0>n,
<br />s3DD000
<br />9100Q0
<br />PERSONAL k wV IN.1nny
<br />it 50000
<br />_„_.........,..... -..
<br />OENERALAMPRIATE
<br />g2yp BU 0
<br />eF.R'L
<br />AafbHRUAIE
<br />",VY
<br />LIhIRMPLlEB PER!
<br />Pa I.00
<br />PRODUcle- MIANOPAGO
<br />�-
<br />$1 SIR) 000
<br />B
<br />AUTOMORILCLIABINY
<br />X
<br />X
<br />AWAUIO
<br />ALLOWNED fSCHPCULEb
<br />AAMW IMITes
<br />IIIR(:D AeR)R X NON'GWNEDF�ITHP2
<br />AWIDS
<br />AW390968090U
<br />4f25l201304125l201
<br />N.I enuO. —.... ,,,._•.
<br />SCDLY INJURY(Porporson)
<br />ixD00,000___
<br />$
<br />RODS.Y INJURY(POraWtInn0
<br />$
<br />—Rirvy--
<br />aLpml,tlo_nt�__
<br />$
<br />_-
<br />0
<br />UMaRELLAL1Alt
<br />EXCESS LIAR
<br />OCCUR
<br />MAIM3NRADC
<br />[l�CII f1CCURREHCE
<br />ACCHECA}P
<br />$
<br />4
<br />S
<br />WCNUHe 301APENSATION
<br />AND EMPLOYERS- LUIRILPV
<br />AN PIICr +IiiETf7NPPRTtIE.Ah'XECIIrNE YIN
<br />CY ICa ME lrcn C EO ®NIA
<br />raandoiaryb, NHI
<br />n w,aauvi>o u,aar
<br />U aCRIPi UN (IP gPERATIDN3 Mw
<br />W73957155400
<br />310112013
<br />____
<br />03!017201
<br />WCaTATU- ollb {.
<br />X
<br />"-
<br />ol.. EACH ACLIDM'iL
<br />1D0DD00
<br />E.L.DaI[ASn�F.A F:FnI?LOYFE
<br />0_06( },000
<br />EL, DISPABC -POLICY LIMN
<br />&1000,000
<br />C
<br />ProfasslOna)
<br />V702F2930401
<br />3/01/2013
<br />03/0112014
<br />$1,0601000 Eech Olairn
<br />Liability
<br />$1,000,000 Aggregate
<br />S10 000 Ded"PetlUle
<br />09SCRIPTION OP OPERATIONS? WI,A }1eN61 Va111OLn81Allnah AoORO tai, Adeslmf Romoten eohedole, vn,.M son. b m ni,,dl
<br />Certificate holder Is additional Insured In rogards to the gansral liability policy per the attached
<br />endorsement form 3914006 08109 fi1f110Ya1_II,Tt11Ll1V ppli0y-JS 1"15 the attached endorsement Term
<br />4..77 VV ��;,AUU EE99..��5 AA lVJ rrC�c^
<br />-"-' .
<br />Laura A, Rossini
<br />City of Santa Ana SHOULD ANY OF THE MOVE DESOM= POLICIES 13E CANCELLED bt-- ORE;
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL he DELIVL7tE0 IN
<br />20 Civic Center Plara ACCORDANCE WITH THE POLICY PROVAIDNa,
<br />Santa Ann, CA 92701
<br />Aunloalxrn HNPREeanrATma _
<br />R 1949.2010 ACORD CORPORATION, All r10hts murvad,
<br />ACCRD 29 (7010109) 1 Of 1 Tha AOORO Hama and latlo are Yaglslered itfalits W ACORG
<br />#32214473IM2214455 JMA3
<br />
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