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A!eo® CERTIFICATE OF LIABILITY INSURANCE
<br />DAT
<br />11/S/2014Yv)
<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 endorsement(s).
<br />PRODUCER Wood -Gutmann & Bogart/11113
<br />940 Calle Negocio, Ste. 240
<br />San Clemente, CA 92673
<br />CONTACT
<br />PHONE 049 542-7800 ac No; 949 542-7804
<br />E-MAIL
<br />ADDRESS:
<br />INSURERS AFFORDING COVERAGE NAIC N
<br />36001513
<br />INSURER A: Federal Insurance Company A++ XV 20281
<br />www.lntegrityint.com
<br />INSURED
<br />Swift Eng, Inc.
<br />1141 - NaA ViCal lI
<br />INSURER a : Hartford Fire Insurance Company A XV
<br />INSURER C:
<br />INSURER D:
<br />San Clemente CA 92673
<br />INSURER E:
<br />PERSONAL &ADV INJURY $ 1,000,000
<br />INSURER F:
<br />GENERAL AGGREGATE $ 2,000,000
<br />COVERAGES CERTIFICATE NUMBER: 22251611 REVISION NUMBER:
<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 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 />IR
<br />LT
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDLSUBR
<br />AUTHORIZED REPRESENTATIVE
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM DD YY
<br />POLICY EXP
<br />MM/DDIYYYY
<br />LIMITS
<br />A
<br />GENERAL LIABILITY
<br />CL AIMS -MAGE OCCUR
<br />✓
<br />✓
<br />36001513
<br />4/1/2014
<br />4/1/2015
<br />EACH OCCURRENCE $ 1,000,000
<br />�COMMERCIAL
<br />DAMAGE TO RENTED
<br />PREMISES Ea occurrence $ 1,000,000
<br />GEN'L
<br />MED UP (Any one person) $ 10,000
<br />PERSONAL &ADV INJURY $ 1,000,000
<br />AGGREGATE LIMIT APPLIES PER:
<br />POLICY ❑ PRO- ❑ LpC ECT
<br />OTHER:
<br />GENERAL AGGREGATE $ 2,000,000
<br />PRODUCTS - COMP/OP AGG $ EXCLUDED
<br />Em .Benefits $ 11000,000
<br />A
<br />AUTOMOBILE
<br />✓
<br />✓
<br />LIABILITY
<br />ANYAUTO
<br />ALL OWNEDSCHEDULED
<br />AUTOS AUTOS
<br />NON -OWNED
<br />HIREOAUTOS V, AUTOS
<br />73583614
<br />4/1/2014
<br />4/1/2015
<br />CM
<br />Ee accident SINGLE LIMIT $ 1,000,()00
<br />BODILY INJURY (Per person) $
<br />BODILY INJURY (Per accident) $
<br />PROPERTY DAMAGE $
<br />Per accIdent
<br />Como/Coll Ded 1000 $
<br />A
<br />UMBRELLA LIAR
<br />EXCESS LIAR
<br />,/
<br />OCCUR
<br />CLAIMS -MADE
<br />79690517
<br />4/1/2014
<br />4/1/2015
<br />EACH OCCURRENCE $ 51000,000
<br />AGGREGATE $ 5,000,()00
<br />DED ✓ RETENTION$10,000
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />EMPLOYERS' LIABILITY
<br />ANY PROPRIETOR/PARTNERIEXECUTIVE YIN
<br />OFFICERIMEMBER EXCLUDED? F�
<br />(Mandatory In NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />NIA
<br />72WEEX7404
<br />7/1/2014
<br />7/1/2015�/
<br />STATUTE ETH
<br />AND
<br />E.L. EACH ACCIDENT $ 1,000,000
<br />E.L. DISEASE -EA EMPLOYE $ 1,0oo,()OO
<br />EL.DISEASE - POLICY LIMIT 1 $ 1,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
<br />Certificate holder, its officers, agents, and employees are named as Additional Insuerd with respect to General Liability per the attached carrier
<br />endorsement. �9 A
<br />*60 Day Notice of cancellation (20 Days for Non -Payment of premium), .� � /�10
<br />yam' Jam( ri/
<br />CERTIFICATE HOLDER CANCELLATION _ 71
<br />Cit of Santa Ana
<br />City an
<br />Attn: Purchasing Department
<br />20 Civic Center Plaza
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Santa Ana CA 92701
<br />AUTHORIZED REPRESENTATIVE
<br />Dan Gorman
<br />©1988.2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
<br />CER'P NO.: 22231611. Vail Brady Roe 11/5/2014 10:29:26 AM (PST) Page 1 of 1
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