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w SOUTH -5 OP ID: SF 14k. --- ° CERTIFICATE OF LIABILITY INSURANCE ° "T 021181nYYY' 0211.8115 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE 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?^ TJE THE IS�jll f�(a [AS RER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. LL'' JJ 33 .'-f $r +-} D IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject t° the terms and conditions of the policy, certain policies may require an endorsement. A t10 t th(s �ealr):i 1 ateAdppg not confer rights to the certificate holder in lieu of such endorsoment(s). f" E t !-�j_la i �`� A PRODUCER 949.583 -0300 Salomon & Solomon Ins Brokers 949 - 951 -9342 Lic 4OC30562 23332 MITI Creek Dr Ste 135 La Una Hills, CA 92653 Kathy Shoffeltt CONTACT AH' No EA AIC No: EMAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAICM INSURERA: Hartford Insurance Co. 22357 INSURED South Coast Lighting & INSURERB:Oak River Insurance Company 34630 Design, Inc. 1391 CalleAvanzado INSURER C: EACH OCCURRENCE INSURER D: PREMISES Ea occurrence San Clemente, CA 92673 INSURER E : - X COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR F1�OD ®\ 30� INSURER F: 725BAAH4279 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES 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 MAYHAVE BEEN REDUCED BY PAID CLAIMS. LLTR TYPE OF INSURANCE g POLICY NUMBER MMIDDIYWY MMIODIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurrence $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR X X 725BAAH4279 11114/14 11/14/15 MED ERE (Any one person) $ 10,000 PERSONAL &ADV INJURY $ 1,000,000 GENERAL AGGREGATE If 2,000,000 GEN'LAGGREGATE LI MIT APPLIES PER'. PRODUCTS - COMPIOP AGG $ 2,000,000 X POLICY PRO LOG $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident) -_ $ 1,000,000 BODILY INJURY (Per person) $ A ANY AUTO 72UECJH2698 03/23/14 03123/15 ALL OWNED SCHEDULED AUTOS X AUTOS X HIRED AUTOS X NON -OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ It UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN OFFICERWEMBER EXCLUDED? (Mandatory In NH) NIA 2200062195141 08/03/14 08/03/15 X WCSTAII OTH- TORY LI ITS ER EL. EACH ACCIDENT If 1,000,000 E.L. DISEASE- EAEMPLOYEE $ 1,000,000 If yes, describe a rider DESCRIPTION OF OPERATIONS below EL .DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) City of Santa Ana and its officers, agents and employees are he tab named yovo as additional insured per the Business Liability Coverage form, MOOS TO (additional insured and waiver of subrogation In regards to general liability pages 16-24)attached workers s the ensation policy. Waiver of subrogation applies to workers compensation per to form WC990410A 4` to CgyOP tp neYX i C CERTIFICATE HOLDER CANCELLATION CITYSAN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 1988 M -21 Santa Ana, CA 92702 AUI'HORIZEO REPRESENTATIVE.y OO 1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010 /05) The ACORD name and logo are registered marks of ACORD . E� 440-