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Policy Number: 6DS503396 Date Entered: 12/7/2013
<br />ACC °R° CERTIFICATE OF LIABILITY INSURANCE
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<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />12/7/2013
<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 ondom°m°nt(s).
<br />PRODUCER
<br />Nike Rodgick Insurance
<br />CONTA
<br />N.AMgke Rodgick
<br />- --
<br />196 Technology Drive, Suite 8
<br />(8jn ff m(949)753 -9555 1L .NJ (949)753-9559
<br />EMAIL
<br />Irvine, CA 92618
<br />_ ___ mm_INSVRERIBI PFFORDING COVERAGE ,__ NNCH
<br />______.
<br />IN§URGRAaaru`ers Insurance Exchange 21652_______
<br />.._
<br />INSURED Santa Ana Business Council, Inc.
<br />_ _
<br />State compensat%.on Ifl-- a E'und
<br />INSURER 8,
<br />35076
<br />OBr10e Madriles
<br />--
<br />Travelers - " "-S31.19
<br />INSURER C ":_._ _ _.. . ___- __..... _......._ -__..
<br />" ---
<br />31194
<br />400 E. 4th Street
<br />INSURER D:
<br />Santa Ana, CA 92701
<br />INSURERS:
<br />INSURER F:
<br />MvVERAGEn RCM I W iUA I B NUMBER: AGVICVINI AUTA%meC,
<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 CF 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 />mn ____ .....__ -IADO BBeR _ -.— __� ___......
<br />LTRI TYPE INSUILINCS IN�LTOY EFF�pOL7CY E %P -
<br />N. fM1 POLICY NUMBER MMIDOIYYPV MwDOIYYYY I LIMITS
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />(��`��`GEyyJNIIIfiRAL UABIUTY
<br />✓�'GOh9MERCIALUENERAL LIABILITY
<br />i�ss
<br />iy
<br />Attn: Risk Management - prize Morales
<br />605503396
<br />2/0711013
<br />2.107/2014
<br />EACH OCCURRENCE
<br />OP�ES(EB
<br />$1,000,000
<br />''---- ��Iili
<br />awrt4aM
<br />$100,000
<br />,. CLAIMS hNDE f� °CCUR
<br />MEDERP(Any Bnaporsan)
<br />.__
<br />§10,000
<br />PERSONAL B ADV INJURY
<br />51,000,000
<br />--
<br />GENERAL
<br />GENERAL AGGREGATE
<br />521000 000
<br />GEN' AGGREGATE LL1411T APPLIES PER.
<br />COMPICP AGO
<br />$1,000,000
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<br />POLICY ( lOC�
<br />AUTOMOBILE LIABILITY
<br />pM L
<br />IFp Bamunp
<br />S1,000,000
<br />A
<br />ANY AUTO
<br />605503396
<br />2/07/2013
<br />2/07/2014
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<br />BODILY INJURY (PBY PBr50nl
<br />ALL OWNED SCHEDULED
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<br />AUTOS AUTOS
<br />So, Ly,
<br />BODILY INJURY (Ppl BCdtl¢fA)
<br />$
<br />NONOWNED
<br />j HINZD AUTOS AUTOS
<br />PROPERTY
<br />5 -
<br />1
<br />�
<br />a1DAf.1AGE
<br />PergctlU6n9__
<br />$
<br />UMBRELLALIAS OCCUR
<br />EACH RRENCE
<br />.-E OC
<br />ACH._.CU_..
<br />$
<br />EXCESS LIAR CLAIMS MADE
<br />AGGREGATE,
<br />$ -
<br />DED F7 RETENTION §
<br />S
<br />I
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS'LUUlILItt
<br />I W00TATU- TII
<br />L70BYLIMS6�_ E_R
<br />B IOFFICERIMEMBER
<br />ANY PROPRIETORRARTNERIEXECUTIVE YIN
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<br />NIA
<br />9081384 -13
<br />I�
<br />µ2/l0/2013
<br />2/10/2014
<br />--
<br />E. L. EACH ACCIDENT
<br />§1/000 00077 -
<br />IIVs6Rq
<br />E.L. DISEASE EA EMPLOYEE I
<br />S 1,000,000
<br />bNN)
<br />DESCRIPTION OF OPERATIONS below
<br />-
<br />E. L. DI 6 VLIMIT 51,000,000
<br />C I
<br />I
<br />Fidelity Bond
<br />106032311
<br />?/07/2013
<br />0 7/2014
<br />5,0 500,000
<br />C i
<br />D &O
<br />106032311
<br />2/07/2013
<br />2/07712014
<br />�2/
<br />SIR 1,000,000
<br />C IEpL
<br />j
<br />106032311
<br />L2/07/2013
<br />2 /07/2
<br />, Sl 1,000,008
<br />DESCRIPPDNOFOPERAnONSILOCAnONSIWHICLES IAIIAGN ACORD 1bT, AQQIlional RPm%Ma BehpUPlo,ihnum ®Pi6A is r0
<br />The City of Santa Ana, its Officers, agents and employees are nam a, nal insureds for General
<br />Liability purposes. -
<br />iO
<br />id
<br />CERTIFICATE HOLDER CANCELLATION
<br />City of Santa Ana
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />20 Civic, Center plaza
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Santa Ana, CA 92702
<br />Attn: Risk Management - prize Morales
<br />AUTHONRED REPRESENTATIVE
<br />(0 1966.2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2010 /06) The ACORD name and logo are registered marks of ACORD
<br />PrW'4CM u%ing Fcros Boy% Pluz oBiM3M mvw-r= 13053 Com', ImPm6%IVO Publohing 000708-1877
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