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_ <br />CERTIFICATE OF LIABILITY <br />INSURANCE <br />DATE(M, <br />8/12/ <br />MID YYY) <br />0 14 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ��iiLTER <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACTf <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must die <br />the terms and conditions of the policy, certain policies may require an endorse t: A stlatement <br />NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />THE COVERAGE AFFORDED BY THE POLICIES <br />BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />endorsed. If SUBROGATION IS WAIVED, subject to <br />on this certificate does not confer rights to the <br />certificate holder In lieu of such endorsement(s). t�9 Tq <br />PRODUCER _ ,, hi — I AME', <br />COMPLETE EQUITY MARKETS INC PHONE <br />NC No <br />Ext (847) 541 -0900 VC.NO:(947) <br />: <br />41 -0444 <br />SS: <br />1190 Flex Court / '' Y /yt MAIL <br />CI I 1 lb Jd V� 1 l�'j CDR <br />Lake Zurich, IL 60047 ( f�i (I, { <br />CLERK (II <br />' INSURER <br />INSURERISI AFFORDING COVERAGE <br />NAILA <br />A: Underwriters Er Lloyd's London <br />INSURED Mandel E. Himelstein <br />INSURER <br />B'. <br />INSURER <br />C: <br />1730 Avenida del Mundo #907 <br />INSURER <br />D: <br />Coronado, CA 92118 p f 99 J� <br />INSURER <br />E: <br />INSURER <br />F' <br />COVERAGES <br />THIS <br />INDICATED. <br />CERTIFICATE <br />EXCLUSIONS <br />wsR <br />LTR <br />CERTIFICATE <br />IS TO CERTIFY THAT THE POLICIES <br />NOTWITHSTANDING ANY REQUIREMENT, <br />MAY BE ISSUED OR MAY PERTAIN, <br />AND CONDITIONS OF SUCH POLICIES. <br />TYPE OF INSURANCE <br />COMMERCIAL GENERAL LIABILITY <br />OF INSURANCE <br />L <br />INSO <br />THE <br />LIMITS <br />sue <br />wve <br />NUMBER: <br />LISTED BELOW HAVE BEEN <br />TERM OR CONDITION OF ANY <br />INSURANCE AFFORDED BY THE <br />SHOWN MAY HAVE BEEN REDUCED <br />POLICY NUMBER <br />ISSUED TO THE <br />CONTRACT OR <br />POLICIES <br />BY PAID <br />1 POLI Y FF <br />MMI00/YYVY <br />INSURED <br />OTHER DOCUMENT <br />DESCRIBED HEREIN <br />CLAIMS. <br />POLIO EXP <br />MMIDDIVVYY <br />REVISION NUMBER: <br />NAMED ABOVE FOR THE POLICY <br />WITH RESPECT TO WHICI <br />IS SUBJECT TO ALL THE <br />LIMITS <br />EACH OCCURRENCE $ <br />PERIOD <br />I THIS <br />TERMS, <br />PREMISES Ea GAc rieno. <br />$ <br />CLAIMS -MADE CI OCCUR <br />ME DEXP(Anyoneparsonj <br />$ <br />PERSONAL &ADV INJURY <br />$ <br />GENERAL AGGREGATE <br />$ <br />A AS <br />�{ . HC1 <br />OFORM <br />li <br />"— <br />— <br />GEN'L <br />AGGREGATE LIMIT APPLIES PER: <br />POLICY CI jECT CI LOC <br />OTHER', <br />LIABILITY <br />ANYAUTO <br />ALL AUTOS OWNED gUTOSULED <br />NON - OWNED <br />HIRED AUTOS AUTOS <br />PRODUCTS - COMP /OP AGO <br />$ <br />MBINEO 7 MaTT IMI <br />Ea accident <br />$ <br />$ <br />AUTOMOBILE <br />_ <br />BODILY INJURY (Per person) <br />BODILY INJURY (Per accident) <br />$ <br />TY <br />Perac cdenl AN E <br />U(, I <br />$ <br />_ <br />EACH OCCURRENCE <br />$ <br />UMBRELLA LIAR <br />EXCESS LIAR <br />OCCUR <br />CLAIMS-MADE <br />AGGREGATE <br />$ <br />_ <br />STATUTE ER <br />DED RETENTION <br />WORKERS COMPENSATION <br />E. L. EACH ACCIDENT <br />$ <br />' <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIEYORIPARTNERIEXECUTIVE <br />GFFICERACMRER EXCL00EOa C <br />(Mandatory in NHI <br />If yes, describe u he ' r OPERATIONS <br />DESCRIPTION OF below <br />N,A <br />E.L. DISEASE - EA EMPLOYE <br />$ <br />EL DISEASE - POLICY LIMIT <br />$ <br />A <br />Professional <br />Liability <br />626687 <br />05/01./1405/01/15 <br />$1,000,000 Each C <br />$1,000,000 Aggregate <br />aim <br />DESCRIPTION OF OPERATIONS) LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may <br />be attached if more space is required) <br />This is a four page certificate. <br />i <br />I <br />i <br />CERTIFICATE HOLDER CANCELLATION <br />s <br />City of Santa Ana <br />SHOULD <br />THE <br />ACCORDANCE <br />ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br />DATE THEREOF, NOTICE WILL BE DELIVERED <br />WITH THE POLICY PROVISIONS, <br />BEFORE <br />IN <br />AUTHORIZED <br />REPRESENTATIVE <br />(51988 2014 ACORD CORPORATION. All rights <br />I 111,V1d. <br />ACORD25(2014/01) The ACORD name and logo are registered <br />marks of ACORD <br />II <br />