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CERTIFICATE OF LIABILITY INSURANCE
<br />OATE(MMIOOIY )
<br />n`mB1zD1B
<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($), 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 endorsement(s).
<br />PRODUCER
<br />Aon Risk Services Central, Inc.
<br />Chicago It Office
<br />CONTACT
<br />NAME:
<br />WHz',Eay, (866) 293-7122 PAX Node 76003 363 -6105
<br />200 East Randolph
<br />Chicago IL 60601 USA
<br />E-MAIL
<br />ADDRESS'
<br />INSURER(S) AFFORDefG COVERAGE
<br />NAICB
<br />0 I /ZVIJ UrA`Vc/XU14
<br />INSURED
<br />ADS Corporation and its subsidiaries
<br />(see Subsidiaryy Information Below)
<br />200 E. Randolph
<br />INSURER A: Continental Casualty Company
<br />20443
<br />INSURER B: American Casualty CO. Of Reading PA
<br />20427
<br />. —.... _._
<br />INSURER C: Transportation Insurance CO.
<br />20494
<br />Chicago IL 60601 USA
<br />INSURER O: National Union Fire Ins Co of Pittsburgh
<br />19445
<br />INSURER E:
<br />$101000
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: 570050749507 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. Limits sh nam are as requested
<br />Ral L
<br />TYPE OF INSURANCE
<br />INS ADDS
<br />POUCYNUMSER
<br />LAIMS
<br />A
<br />GENERAL LIABILITY
<br />GL. 5
<br />0 I /ZVIJ UrA`Vc/XU14
<br />EACH OCCURRENCE
<br />$1,000,000
<br />X COirbliERCiALGENERALLiAe11-7f
<br />CILAiMS'li OCCUR
<br />PREM SES Ea accurcen:s
<br />$1'000`000
<br />MED EXP {Arty one person)
<br />$101000
<br />This ceI licate revisesanIT], e
<br />a
<br />PERSONAL B ADV INJURY
<br />$1,000,000
<br />GENERAL AGGREGATE
<br />_,
<br />$2,000,000
<br />Unebrelb itihineloec
<br />IlntVrella limit hen been wnected.
<br />GEWL AGGREGATELIMIT APPLIES
<br />PER:
<br />PRODUCTS - COMPIOP AGO
<br />$2,000,000
<br />POLICY PRO- X
<br />LOG
<br />3cQ
<br />i
<br />A
<br />AUTOMOBILE LIABILITY
<br />BOA 4 yl ®
<br />Aawidenl
<br />/0
<br />COMBINEDSINGLE LIMIT
<br />$3,000,000
<br />BODILY INJURY (Per person)
<br />X ANY AUTO
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />HIRE AUTOS NON -OWNED
<br />AUTOS
<br />x
<br />*1x
<br />Q �,
<br />.A
<br />�tt�
<br />BODILY INJURY (Per accident)
<br />PROPERTY DAMAGE
<br />Per acct i
<br />D
<br />%
<br />UMBRELLA LIAIS
<br />OCCUR
<br />20562 *V
<br />06/01/2011 06 01/2014
<br />EACH OCCURRENCE
<br />$3,000,000
<br />EXCESS LIAR H
<br />CLAIMS -MADE
<br />STR ap ies per policy terns
<br />& conditions
<br />AGGREGATE
<br />$3,000,000
<br />DED
<br />I X RETENTION 510,000
<br />C
<br />B
<br />D
<br />WORKERS COMPENSATION AND
<br />EMPLOYERB'LIABIUTY YIN
<br />ANY PROPRIETOR I PARTNER I EXECUTIVE
<br />OFFICEWMEMBER EXCLUDED?
<br />(Mandatory 11, NH)
<br />NIA
<br />WC4 14 00157
<br />WC4014100059
<br />WC4014100014
<br />06/01/2013 06/01/2014
<br />06/01/2013 06/03. /2014
<br />06/01/2013 06/01/2014
<br />X WE STATU- OTH
<br />TORYUMITS
<br />E. L. EACH ACCIDENT
<br />_
<br />$1,000,000
<br />_.,
<br />E.L. DISEASEGA EMPLOYEE
<br />$1,000,000
<br />R Yes, describe Linder
<br />OF OPERATIONS below
<br />E.L.
<br />E.L. DISEASE - POLICY LIMIT
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Artech ACORD 101, Additional Remarks Schedule, if more space Is required)
<br />RE: AON F SOLUTIONS, INC. 5000 EXECUTIVE PKWY., SAN RAMON, CA 94583. CITY OF SANTA ANA, ITS OFFICERS, AGENTS, EMPLOYEES AND
<br />VOLUNTEERS ARE INCLUDED AS ADDITIONAL INSURED WITH RESPECT TO THE GENERAL LIABILITY POLICY,BUT LIMITED TO THE OPERATIONS OF THE
<br />I
<br />CERTIFICATE HOLDER
<br />CANCELLATION
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<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED REFORE THE _...a
<br />EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE
<br />POLICY PROVISIONS, qP
<br />�I
<br />CITY OF SANTA ANA AUTHORIZED REPRESENTATIVE
<br />0 C MR. JEFF STEVENS - RISK MANAGER
<br />2
<br />2U CIVIC CENTER PLAZA
<br />SANTA ANA CA 92701 -4010 USA
<br />@1988 -2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2010705) The ACORD name and logo are registered marks of ACORD
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