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<br />LEXIP•1 OP ID: CL
<br />A�oRD CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MMIDD)YYYY)
<br />09116/2014
<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 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 endorsament(s).
<br />PRODUCER
<br />Associates, Inc.
<br />st Wacker Dr Suite 1730
<br />303 East
<br />303
<br />cnitegD, IL 60601
<br />Bruce Scodro
<br />NTACT
<br />NAME.
<br />PHONE 372.856.9400 I i c Not. 312.856-9425_____
<br />E-MAIL
<br />ADDRESS: _ _ --
<br />-
<br />MSURER(S) AFFORDWGCOVBRIIGE MAIC/ _
<br />INSURER A Sentinel Insurance Company '11000
<br />Santa Ana Police Department
<br />INSURED Lexipol Holding Company
<br />Lexipol, LLC
<br />6 S Liberty, Ste 200
<br />Allan Viejo, CA 92656
<br />INSURER 5: Hartford Insurance Group
<br />I __
<br />INSURER C � Hiscox Insurance Co. Inc.
<br />GENERAL AGGREGATE $ 2.090,09
<br />INSUREIR 0.*
<br />INSURER 1.
<br />----
<br />INSURER F:
<br />E
<br />N IN L LINT
<br />aaitlent $ +,099,99
<br />BODRYINJURYIPer1.1 $
<br />ERTi FICATE NUMBER: REVISION NUMBER.
<br />COVERAGES C
<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 POLICES 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 />LTR TYPE OF INSURANCE
<br />A XICOMMEROIALGENERALUASILRY !,
<br />CLAMS -MACE IK OCCUR
<br />'—j—
<br />SANTAAN
<br />POLICY NUMBER LIC
<br />1
<br />63 SBA IM3110!, 0812012014
<br />P LOIYYYY
<br />0812012015FaoR
<br />LIMITS
<br />URRENCE 8 1,090,00
<br />oa �e $ 1,000,00
<br />My mepmson) $ +B•BDBADV
<br />tERS
<br />INJURY $ 1,000,90
<br />Santa Ana Police Department
<br />20 Civic Center Plaza
<br />AUTHORIZED REPRESENTATIVE
<br />Santa Ana, CA 92702
<br />GENERAL AGGREGATE $ 2.090,09
<br />IGENL AGGREGATE LIMIT APPLIES PER:
<br />X I POLICY FL7 JECT PRO- ❑ LW
<br />OTHER:
<br />AUTOMO&LE LIABILITYEa
<br />!
<br />PRODUCTS-COMPMPAGGS 2,000,00
<br />E
<br />N IN L LINT
<br />aaitlent $ +,099,99
<br />BODRYINJURYIPer1.1 $
<br />A UT_ ANY Auro
<br />F ALL OWNED SCHEDULED
<br />83 SBA IM3110 '0812012014
<br />0812012015
<br />BODILY INRIRY (Per d<citleM) $
<br />AUTOS AUTOS
<br />I X MIRED AUTOS X NON -OWNED AUTOSPer
<br />PROPERTY DAMAGE
<br />aced nl $
<br />$
<br />AEXCESS
<br />X
<br />UMSRELLAUAB
<br />we
<br />X
<br />OCCUR
<br />Clur,Is
<br />83 SBA IM3110
<br />0812012014
<br />0812012015
<br />EACH OCCURRENCE !, $ 5,999,99
<br />AGGREGATE $ 5,000,00
<br />E
<br />X gTATUTE ERN
<br />!. DED RETENTK)NS
<br />WORKERS COMPENSATION
<br />B
<br />ANO EMPLOYERS' WBa.ITY YIN
<br />ANY EMPLOYPROPME
<br />OFFCSRMVVSER EXCLUDED? ❑NIA
<br />(Mandatory N NH)
<br />Nyynn tleecADe unbar
<br />OESGRIPrION OF OPERATIONS below
<br />83 WE BV6469
<br />9812112014
<br />9812012015
<br />ELEACHACCIDENT $ 1.00U•00
<br />EL. DISEASE• EA EMPLOYEE $ 1,999.99
<br />El. DISEASE - POLICY UNIT 1 $ 11009,00
<br />C
<br />Professional Llabf,.
<br />US UUA 2688184.14
<br />0812012014
<br />0812012015
<br />Ea Claim 2,000,00
<br />'Multimedia LIES
<br />Aggregate 2,000,00
<br />DESCRIPTION OF OPERATIONSILOCATIONS I VEHICLES (ACORD 101, Aditw* RamaAs S miule. mey Ina chad V mon apace is r ulnd)
<br />The City of Santa Ana and Senta Asa police Department, their officers,
<br />employeesagents and volunteers are Additional Insureds as respects General
<br />Liability ae required by a written contract or written agreement. APPROVED AS TO7F�ORM
<br />Laura A. Rossini
<br />CANCELLATION ���'�•^"• """✓ ""---'
<br />CERTIFICATE HOLDER
<br />SANTAAN
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />City of Santa Ana
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Santa Ana Police Department
<br />20 Civic Center Plaza
<br />AUTHORIZED REPRESENTATIVE
<br />Santa Ana, CA 92702
<br />®1985-2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
<br />
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