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COw CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (/10 /2014
<br />12. /xo /zo14
<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 poiicy(les) 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 Hou of such andorsement s .
<br />PRODUCER
<br />NCOIT C
<br />McLure Insurance Brokerage, Inc.
<br />17671 Irvine Blvd, Ste. 101
<br />PHONE A%
<br />E-MAIL
<br />Tustin CA 92700
<br />- -'"- " "'—'
<br />1/9/2016
<br />EACHOCCURRENCE
<br />_ ___„ INBURER(1AFPORDINO COVERAGE,_____ _
<br />__ NAICq
<br />� Ag,(Egyp ce_
<br />INSURER A: Colony Insurance company
<br />.._
<br />INSURED
<br />Amiran Construction
<br />INSURERS:
<br />PERSONAL&ADVINJURY
<br />.S ___5,000
<br />S 1,000,000
<br />INSURERC:
<br />GENERALAGGREGATE
<br />_
<br />INSURER DI
<br />PRODUCTS- COMPIOP AGO
<br />15145 Woodlawn Ave. # 200
<br />INSURER EI,.,,_,_,,,,N,_
<br />$
<br />Tustin CA 92780
<br />-„__,
<br />LIABILITY
<br />ANYAUTO
<br />ALL OMEp F7 SCHEDULED
<br />AUTOS I NOTRO-OMCD
<br />HIRED AUTOS AUTOS
<br />COVERAGES CERTIFICATE NUMBER: Cart TD 261 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 />EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />BR
<br />TYPE OF INSURANCE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />R
<br />POLICYNUMSER
<br />PO
<br />OIU E P
<br />PO O EXP
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE E OCCUR
<br />Y
<br />OL4074853
<br />1/9/2015
<br />1/9/2016
<br />EACHOCCURRENCE
<br />$ 1,000,000
<br />� Ag,(Egyp ce_
<br />100,000
<br />F.. %Pm— oneiLeren9L
<br />,5
<br />PERSONAL&ADVINJURY
<br />.S ___5,000
<br />S 1,000,000
<br />_
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />![ITPOLICY ❑jP� CI LOG
<br />HER:
<br />GENERALAGGREGATE
<br />$ 2,000,000
<br />PRODUCTS- COMPIOP AGO
<br />$ 1,000,000
<br />$
<br />AUTOMOBILE
<br />a
<br />LIABILITY
<br />ANYAUTO
<br />ALL OMEp F7 SCHEDULED
<br />AUTOS I NOTRO-OMCD
<br />HIRED AUTOS AUTOS
<br />EaaBai tlEG i G ELIMIT
<br />o
<br />$
<br />BODILY INJURY(Perpmamd
<br />5
<br />BODILY INJURY(Per.ddem)
<br />GROPERTY pAMAGE
<br />(P�t- Eg91d401t
<br />$
<br />S
<br />UMBRELLA LIAB
<br />EXCESS LIAB
<br />I _
<br />OCCUR
<br />CLAIM S MADE
<br />EACH OCCURRENCE---
<br />5_
<br />AGGREGATE _
<br />5
<br />OED I I RETENVON S
<br />$
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY ANY PROPRIETOR /PARTNSWEXECUTIVE Y/ ❑N
<br />OFFICER /MEMBER EXCLUDED?
<br />(Mandatory In NHt
<br />If Yyea tl.acdbe under
<br />OE5d ;PTION OFOPERAT10NS telow
<br />NIA
<br />STR UTE FOR
<br />E.L. EACH ACCIDENT
<br />$
<br />E_,L DISEASE_EA EMPLOYE-
<br />$
<br />E.L. DISEASE - POLICY LIMIT
<br />S
<br />DESCRIPTION OF OPERATIONS ?LOCATIONS /VEHICLES (ACORD 181, Addltimai Remarks Schadule, may Ua anaomad if more apaco Ia mgmrod)
<br />THE CITY OR SANTA ANA,ITS OFFICERS, EMPLOYEES, AV9KT3,VOLUNT3ER3
<br />AND REPRESENTATIVES ARE NAMED AS ADDITIONAL INSUREDS.
<br />AMIRAN CONSTRUCTION AGR # TBD REVIEWED BY: EUNICE FIEREDIA (IGGA OF 2)
<br />CERTIFICATE BOLDER CANCELLATION
<br />Q 1gIIS -2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 26 (2014(01) The ACORD name and logo are registered marks of ACORD
<br />Page 1 of 1
<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 />THE CITY OF SANTA ANA
<br />f;
<br />20 CIVIC CE14TLR PLAZA
<br />AUTHORIZED REPRESENTATIVE
<br />BANTA ANA CA 92701
<br />I
<br />Q 1gIIS -2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 26 (2014(01) The ACORD name and logo are registered marks of ACORD
<br />Page 1 of 1
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