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'4 °® CERTIFICATE OF LIABILITY INSURANCE Page 1 of 1 07/08 4) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS :ERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT; If the certificate holder is an ADDITIONAL INSURED, the policy(ies)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Willis Management (Bermuda) Limited 58 Par -la -Ville Road PHONE' FAX • 877- 945 -737$ 888 - 467 -2378 e -MAIL certifieatea @willia.com P. O. Box 1995 Hamilton Bermuda, HM H INSURER {S)AFFORDINGCOVERAGE NAIC# INSURERA:American unity Group Limited C0929 -001 'REAM E& Eaoccure0nce INSURED Taller San Jose INSURER B: X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR INSURERC: 801 N. Broadway Santa Ana, CA 92307 INSURER D: MEDEXP (Any oneperson) INSURER E; PERSONAL & ADV INJURY $ 2,000,000 INS JRERF; ' COVERAGES CERTIFICATE NUMBER: 21818578 REVISION NUMBER:See Remarks THIS IS TO CERTIFY THAT THE POLICIi =S OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY NAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE DD' SUB POLICYNUMBER PQLICYEFF POLICYEXP LIMITS A GENERAL LIABILITY Y UNICGL1401030 6/30/2014 6/30/2015 EACH OCCURRENCE $ 2 000 000 'REAM E& Eaoccure0nce S X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR MEDEXP (Any oneperson) S PERSONAL & ADV INJURY $ 2,000,000 .. - GENERAL AGGREGATE $ 2,000,000 TO GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS- COMPIOPAGG $ 51000,000. 1[ POLICY PRO- IECI LOC S AUTOMOBILE LIABILITY r COMBINED SINGLE LIMIT (Ea accident) $ BODILYINJURYIPerperson) $ ANYAUTC L K ALLOWNED SCHEDULED AUTOS AUTOS HIREDAUT05 NONMOWNED AUTOS �..�� �5c�!$�a �t , S1 ORC r• 10'!41 j BODILY INJURY(Per accident) 5 PROPERTY DAMAGE (Peraccidant} 5 UMBRELLALIAB OCCUR EACHOCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED RETENTION$ $ WORKERS COMPENSATION WC STA- AND EMPLOYERS' LIABILITY Y! N ANY PROPRIETOWPARTNER !EXECUTIVE❑ N!A E.L. EACH ACCIDENT $ OFFICERIMEMSER EXCLUDED? IMandatory in NH) [yes, describe under E.L. DISEASE - EA EMPLOYEE IS DESCRIPTION OFOPERAT{ONS below E.LDISEASE -POLICY LIMIT S DESCWPTION OF OPERATIONS I LOCATIONS f VEHICLES (Attach Aeord tot, Additional Remarks Schedule, If more space is required) THIS VOIDS AND REPLACES PREVIOUSLY ISSUED CERTIFICATE DATED: 6/27/2014 WITH ID: 21760957 The Certificate Holder is named as Additional Insured by endorsement to the policy subject to the teams set forth in the endorsement. Taller San Jose, Block Grant - 810 N. Poinsetta, Santa Ana, CA 92701 CERTIFICATE HOLDER CANCELLATION Santa Ana Work, Center 1000 E. Santa Ana Blvd. Suite 2000 Santa Ana, CA 92741 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Cn11:4458403 Tpl:1832054 Cert:21$18578 © 1988- 2010ACORD CORPORATION. All rights reserved, ACORD 25 (2010105) The ACORD name and [ago are registered marks of ACORD �r.