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CERTIFICATE OF LIABILITY INSURANCE 2 )201M" """"I
<br />031
<br />2 512 01 5
<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(5)T AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: if the certificate holder is an ADDITIONAL INSURED, the policy(ios) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statemont on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsement(s). - - -
<br />PRODUCER
<br />INDiCA7_O. NOTVATH TANDING ANY REQUIREMENT, TERM OR CONorno T4 OrANY CONI`SACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />W.B. Adams Company
<br />EXCLUStONS AW) CONDITIONS QP SUC&i POLICIES. LIMITS SIJOV,04 PRAY HAVE BEEN REDUCED BY PAID CLAIMS,
<br />General Insurance`
<br />14737 SW' Milliken Way
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<br />Beaverton OR 97006
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<br />SeloctronTechnologies, Inc.
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<br />12323 SW 66th Ave.
<br />, ;y L•C£IA-11ENCE.,^__S
<br />e,+liAGE to RENTED
<br />REWSESALe.1iLWLetlL +LL—
<br />Portland, OR 57223
<br />1000000
<br />T1 _..c..._......._,.-
<br />COVERAGES
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE IIJSUR €D NAMED ABOVE FOR T HL- POLICY PERIOD
<br />INDiCA7_O. NOTVATH TANDING ANY REQUIREMENT, TERM OR CONorno T4 OrANY CONI`SACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE P.Wf BE ISSUED OR MAY PERTAIN, 1HY INSURANCE AFFORDED BY THE POLICIES DESCRIBED HERCIN IS SUBJECT TO ALL THE TERMS.,
<br />EXCLUStONS AW) CONDITIONS QP SUC&i POLICIES. LIMITS SIJOV,04 PRAY HAVE BEEN REDUCED BY PAID CLAIMS,
<br />BNSR. -� ��tADnLySVBH' PCLiC'l cFF POLICY Fk& e
<br />TY'JE Gr'II 9URAPIr ri kl P LIG'Y P +erAaF,F - 1b4D�nrriVVlS �� LIMITS
<br />A
<br />GENERAL
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<br />LIA.90LITY
<br />1CP1t5ERt iAI_G6NEA!VI_LIi.31LIlY
<br />c„mns MnDt } X OcCUP.
<br />711013743 -0001
<br />01131!2015
<br />01a'112016
<br />, ;y L•C£IA-11ENCE.,^__S
<br />e,+liAGE to RENTED
<br />REWSESALe.1iLWLetlL +LL—
<br />_
<br />1,060.000
<br />1000000
<br />T1 _..c..._......._,.-
<br />n rxp Swjy�,._p V}
<br />s10,000
<br />Prkg1,)NSL,',_A VINIURY
<br />s1A00or040
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<br />XI
<br />DedsO
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<br />GFfIrRALA4oRQr ATE
<br />�,20�ud,00Q._v-
<br />YS.UO11C4S- {hf?T}P .g a_
<br />.,,,e_
<br />S2600y000
<br />GEN'L AGGREC;ATEiIMIT APPItr PrR�
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<br />S
<br />IAAITOMMILE
<br />LIABILITY
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<br />f GY+re INF( ? :?,NCit L 119T
<br />i'000,000
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<br />X
<br />ANY AWO
<br />I.
<br />PUI'11LY IN.IURY lPa PU q
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<br />ALL OWNEO ��eoULEO
<br />ALTOS NCIN O mro
<br />HRE1i 40TOS
<br />111013743.0001
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<br />01/3112015
<br />01/3112016
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<br />e1152HLLLa Lrne
<br />CXGCS. LIAa
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<br />E
<br />711013743.0001
<br />01/3112015
<br />01;3112016
<br />CAIH7CCURRENCE
<br />S5,006.00e
<br />5,000.000
<br />! •+� RrrmlTniN s
<br />; p
<br />�
<br />111
<br />6
<br />t WORKERS COMPENSATION
<br />1 AND RO LOYERS LIAniurt
<br />Ar1Y PROI RIETr PR�.TNER!E %F,1„":,frMt?Y —F N7
<br />OFFICCIXAMM Excl
<br />AItjol'Ul �1
<br />Ieu eaCary rieNH)
<br />1
<br />urAi
<br />iS2Y1/BC01303eJ
<br />i
<br />01f31;2015
<br />O'tf3172016r
<br />1X xC21P.� I LR
<br />'7
<br />cI {A,¢i_CmC 11
<br />hL U1_5Y*C FA r'WLCYC'
<br />1 000,00
<br />1;,0
<br />{1 000.000
<br />it es, daupbr Ltdf
<br />GC.,CRIFTIG]N rr Or R.TCN'. P - >.�
<br />FI n15s ASr P[]I IGY LIfAR-
<br />P1000,000
<br />A
<br />Technology Services E & O
<br />--
<br />Agg:. $1,000,000 Dad: $19,000
<br />Retroactive Data O113U2002
<br />1711013743.0001
<br />003112015
<br />01;3112016
<br />Each Claim $1,000,000
<br />G£StiIRiPTION VF OPEAATIQNS f LOGAMWS! YGAICLCS 4AttacM1 ACORO W, A.111wgoaa .=L-"A., iP,mnrm zpnce N vn9wlr�}
<br />City of Santa Ana is additional insured as respecting General Liability perwritten contract.
<br />Insurance is Prilo ry and Noncontributory as par written contract.
<br />City of Santa Ana SHOULD ANY OF THE AEOVB OCECRIDED POLICIES HE CARCEU,ED OESORC
<br />THE EXPIRATION BATE THEREOF, NOTICE WILL Be DELIVERED IN
<br />20 Civic Center. Pla2u ACOORDANCG WITH THC POUCY PROVISIONS,
<br />Santa Ana, CA 02701 j A0WOR1ZED
<br />ACORD 25 (2010105) The ACORD name and loge are registered marks
<br />
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