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4L� CERTIFICATE OF LIABILITY INSURANCE <br />47/2014 <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 INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE MOLDER. <br />IMPORTANT: N the Certificate holder Is an ADDITIONAL INSURED, the policy(les) =at be endorsed. If SUBROGATION IS WAIVED, Subject to <br />the terms and conditions of the policy, certain policies my "in an endorsement. A statement on this Certificate does not Confer rights to the <br />artifkate holder In lieu of such endonerne s). <br />PRODUCER <br />Leavitt Group #OP13098 <br />PrideMark-Everest Ins So" Inc <br />1820 E. First Street, Ste 500 <br />Santa Ana CA 92705 <br />Certificate Department <br />fflt(714)569-2710 ITlel rta-EDrE <br />.Juliana-saeeLeavitt.com <br />N RE "FORDWO COVERAGE xAC 1 <br />WwaERAHavi atOro Specialty Insurance 36056 <br />ms w <br />Desmond, Marcello E Amster, LLC <br />6060 Center Drive, Suite #825 <br />Los Angeles CA 90045 <br />Ww a : <br />INSURER C; <br />W RR ; <br />Wsuaea e : <br />BI RF; <br />COVERAGES CERTIFICATENUMBER:14-15 B a 0 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 />LrR <br />TYPE w INSURANCE <br />City Of Banta Ana <br />P RMGM <br />20 Civic Center Plaza, M-36 <br />LIMITS <br />Santa Ana, CA 92702 <br />GENERAL LMNUTY <br />Gary NsLls/MATURN <br />EACH OCCURRENCE E <br />COMAERGAL GENERAL UQ4UTY <br />i <br />CLNMS-MADE OCCUR <br />MEDEXPAn o.$a ) E <br />PERSONALAADVIN.NIRY E <br />GENERAL AGGREGATE E <br />OEHL AGGREGATE LIMIT APPLIES PER <br />PRODUCTS • COMPIOP AGO E <br />E <br />PDLICV PRO- LOC <br />AUTOMOBILE LIABILITY <br />CO INEDSINGLE UNIT <br />BODILY INJURY (PW paean) E <br />ANY AUTO <br />BODILYIwUTYIPWac w) E <br />AU ONNED SCHEDULED <br />AUTOS I AUTOS <br />NO"MED <br />HIRED AUTOS HAIJT06 <br />5 <br />(I* iogdoll <br />E <br />UMBRELLA UABOCCUR <br />EACH OCCURRENCE E <br />AGGREGATE E <br />EXCESS UAB <br />IMUL DE <br />RETENTIONSE <br />WORKERS COMPENSATION <br />viCSTATU• OTH <br />AND BMPLAYERV UASIUw <br />ANY MON ETO"OUITNERIEXECUTIVEa <br />E.L EACN ACADEMY E <br />OFFICEPneNBER EXCLUDED? <br />IsawwaMry In NN) <br />NIA <br />E.L DISEASE. EA EMKO E <br />E.L DetEASE •POLICY OMIT E <br />Nyy�ae EaM=N oFe <br />OESGRIPTXON OF OPERATIONS asvA <br />A <br />ErrorsaOmissions/Claims <br />2814UPL3952011C <br />/16/2014 <br />/15/2015 <br />S2,0KDX ..hdww $15000 de <br />Made Form <br />52.MD.= Nsiagsle <br />^a TPA <br />DEECWPTION OF OPERATIONS I LOCATIONS I VEHICLES IAaMA MOM 101, Aseeele MPRIMNe SMMWH, ff..g7enjor <br />REI operations of the named insured performed for the certificatVL\Y �il� <br />lose Sandoval <br />City Attorney <br />Assistant <br />CERTIFICATE HOLDER CANCELLATION <br />ACORD 25 (2010105) ®1988.2010 ACORD CORPORATION. All rights reserved. <br />Th. a rnan .,.......d Inns ... r.M.....H .,..I,. M ArnRn <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED W <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />City Of Banta Ana <br />Public Work& Agency, Design Engineering <br />20 Civic Center Plaza, M-36 <br />AUTHORIZED REMEBENTAnn <br />Santa Ana, CA 92702 <br />Gary NsLls/MATURN <br />ACORD 25 (2010105) ®1988.2010 ACORD CORPORATION. All rights reserved. <br />Th. a rnan .,.......d Inns ... r.M.....H .,..I,. M ArnRn <br />