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178504 Servando Varela dba XV Solutions Certificate of Insurance (page 1 of 1) 01/19/2015 08:23:11AM -� Ar CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDfYYYY) 1/19/2015 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 BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pol'icy(ies) must be endorsed. If SUBROGATION' IS WAIVED, subject to the terms and conditions of the 'policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Techlnsurance mom®° 1301 Central Expy. South, Suite 115 .0: Tech Insurance Allen, TX 75013 NAME: NAME: PHONE 800-668-7020 Nma,Ext)' a C Ngo : (877).. 826-9067 E-MAIL DSS„ PRODUCER _ CUSTOMER ID If. INSURERIS) AFFORDING COVERAGE MAIC 9 INSURED ..- Servando Varela dba XV Solutions 344 Orange Blossom Irvine. CA 92618 INSURER A:. Sentinel Insurance Company,Limited 11000 INSURERB: Hartford Fire Insurance Company 19682 INSURER C: INSURER D ;. INSURER E: INSURER F: rnircDAr:r-CZ r`-K'aT'IMrATF NIIMRFR^ 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 MAY HAVE BEEN REDUCED BY PAID, CLAIMS. I'.. INSR LTR � TYPE OF INSURANCE -M5 _DL IMS SU POLICY NUMBER POLICY EFF MM1DDIYYYY POLICY B.XP MMIQD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 COMMERCIAL GENERAL LIABILITY DAMAGE T RENTED 1,000,000 PREMISES fEa occumenceJ $ MED EXP (Any one person) $ 10,000 CLAIMS -MADE � OCCUR PERSONAL & ADV INJURY $ 2,000,000 A Yes 46SBMUV8485 912812014 9/28/2015 _.. GENERAL AGGREGATE $ 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPJOP AGG $ 4„000,000 $ 7,/ POLICY I PE LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) . ANY AUTO BODILY INJURY (Per person) $ _. RLL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE m (Per accident) $ NON -OWNED AUTOS S UMBRELLA LIAR L1CLAIMS-MADE. OCCUR EACH OCCURRENCE $ '.... AGGREGATE $ EXCESS LIAB . DEDUCTIBLE _ $ _. $ RETENTION $ V¢ORKERS COMPENSATION WC STA'rT- IJ Y LIMITS R AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERtEXECUTIVE ._..__ E.L. EACH ACCIDENT Is E.L.. DISEASE - EA EMPLOYEE, $_.... OFFICERIMEMBER EXCLUDED? (Mandatory in NH) N 1 A _.... ..- E.L. DISEASE - POLICY LIMIT I S If yes, describe under DESCRIPTION OF OPERATIONS below B Professional Liability (Errors and Omissions) 46TE028B286 1/13/2015 1'.11312016 Oceurrenca f Aggrsgale $1,000,0001$1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule.,, if more space is required) Operation's pertaining to named inured for certholder, Dty of Santa Ana and its Officers, agents, representatives, volunteers, & employees are additional insured 0 prim wrd as respects gen'I liab per end''ts CG7158 12/03&CG7253 9105"30 day Should any of the above described policies be cancelled before the expiration date, the issuing insurer will endeavor to mail 30 days Written notice (10 days notice if due to non-payment) to the certificate holder named below, but failure to do so shall impose no obligation or liability of any kind upon the insurer, Its agents or representatives. CERTIFICATE HOLDER CANCELLATION @ 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 Civic Center Plaza ACCORDANCE WITH THE POLICY PROVISIONS. Santa Ana, CA. 92701 AUTHORIZED REPRESENTATIVE @ 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD