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11
<br />INTEHOU -03 MYCHAN
<br />A °' CERTIFICATE OF LIABILITY INSURANCE
<br />oA 215 014
<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 GOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZEC
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the poliey(les) must be endorsed. If SUBROGATION I8 WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsoment. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsement($),
<br />PRODUCER
<br />AnhurJ, Gagag9hor & Go. insurance Brokers of CA., Inc.
<br />$05 N Brand 8tvd, Suite 600
<br />Glendale, CA 91203
<br />CON AA T
<br />P .818 536.2366 ( Nac {S1 S} 539.2301
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<br />tNOUREWSI AFFORDINGCOVE0409
<br />NAJD0
<br />INSURER A:R(vo ort Insurance Com an
<br />36684
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<br />Interval Hoag$
<br />P.O. Box 3356
<br />Beef Beach, CA 90740
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<br />wsuseaa ;New York Marina And General Insurance Cc
<br />16608
<br />INSURER C:
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<br />EACH OCCURRENC$
<br />INSURERer �.._.�..... ~.
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<br />INSURER P:
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<br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE 6EENISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT NATH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY TH£ POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITION$ OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
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<br />TYP$9PmSURANCE
<br />OU Y NUM !E
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<br />LIMITS
<br />OENEAAL LIABILITY
<br />EACH OCCURRENC$
<br />I 1,000,00
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<br />X profeaslonai tiab.
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<br />RIQOD13255
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<br />101112013
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<br />1011/2814
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<br />5 100,80
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<br />PERSONAL &AOVINJURY
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<br />1,000,00
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<br />GENERAL AGGREGATE
<br />$ 3,000,00
<br />GEN'L AGGREGATE UMIT APPLIES PER:
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<br />PRODUCTS• COMPIOP AGO
<br />t 3,000,00
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<br />AGORraATE
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<br />S 2,000,00
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<br />WORKER$ COMPENSAMON
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<br />G2D1400000946
<br />21112014
<br />211/2015
<br />Stntu.
<br />SLEACHACCMeNT
<br />8 1000,$0
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<br />e.t. DISEASE• EAEMPLOV
<br />S 1,000,000
<br />E.L. DISEASE•POUCY LIMIT
<br />LA00,D0p
<br />A
<br />Employee DisPPhoneary
<br />RIC0a13255
<br />IOI V2013
<br />101112014
<br />Deductible $1,000 300,0001
<br />A
<br />Forgery & Alteration
<br />RICOD13255
<br />101112013
<br />101112014
<br />Deductible $1,000 200Ap0,
<br />0200FUPnONOPOPRRATIONSILOCAT IONSIVEHICLa9 SAWaN ACORp tOi, AtldlDarul Remak >SvEVdulq Omoroop00o lv roqulredl
<br />City of Santa Ana, its officers, agents, employees and volunteers are named additional Insured with respect to the General Liability policy of the named
<br />Insumd, Such Insurance is primary and noncontributory, CO2026 Endorsement attached.
<br />CanIsrA; Blanket Building Coverage Llmft: $4,339,2041 Sp"tai Form t Deducmdo $1,000 t affective 10 -01.2013 to 10 -01 -2014
<br />CaMorA: Blanket Business Contents Limit: $645,0041 Special Form t Deductible $1,0001 effective 10 -01.2013 to 10 -01.2014
<br />CERTIFICATE HOLDER GAAtCFi I. ATUIN
<br />City of Santa Ana Administrative Services Division
<br />20 CIVIC Canter Plaza, M•25
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEUVEReO iN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Santa Ana, CA 92701
<br />_
<br />AUTNORaaO REPRS6aNTATIVa
<br />@ 1988.2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2010109) The ACORD name and logo are registered marks of ACORD
<br />
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