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Client#: 1259431 305CORDOCOR
<br />ACORD.. CERTIFICATE OF LIABILITY INSURANCEDATE(MMIODIYYYY)
<br />1/1712014
<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($), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />"IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(iss) 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 ondorsement(s1.
<br />PRODUCERNAME�yI
<br />Christy Mata
<br />BB&T Insurance Services
<br />PHONe714 578 7370:FAX
<br />LAIC_No Ext)
<br />of Orange County
<br />„-_,"_.,_.,_._m
<br />E.MAII. CMata�bb----- om �
<br />680 Langsdorf Drive Suite 100
<br />ADpagss „
<br />[51,000,000
<br />pn A�E,ip RENTED
<br />lSrs(EA oycurr.,.1 3300,000
<br />COVERAGE NAICM
<br />Fullerton, CA 92831INSURER(S)AFFORDING
<br />INSURER A: Travelers Property Casualty Co 125674
<br />..
<br />-- .. --._.. .._... ........
<br />INSURED
<br />Cordoba Corporation
<br />INSURER B .._- --- ---j __
<br />1.11,11 1.1 --------
<br />1401 N. Broadway
<br />INS
<br />':. wsURER c:__
<br />Los Angeles, CA 90012INSURERD_.____,..,__._.__._...__=.____.._,.._
<br />_GD
<br />X' POLICY PRO- —I L.0
<br />COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR 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 />TRR TYPE OF INSURANCE NSR NND POLICY NUMBER MMMOIYYYY MMIPIPIYYYY LIMITS
<br />A GENERAL LIABILITY , 630OC82815114
<br />DI12012014 01/20/2015 EACH OCCURRENCE
<br />X COMMERCIAL GENERAL LIABILITY
<br />[51,000,000
<br />pn A�E,ip RENTED
<br />lSrs(EA oycurr.,.1 3300,000
<br />.,J CLAIMS -MADE r" XOCCUR
<br />-Pfi
<br />tAED E%P (A y,nln peropn} s$ ODO
<br />(PERSONAL &ADV INJURY ISI,000000 _
<br />GE DRALAGGREGATE 0,009,000__
<br />L AGGREGATE LIMIT APPPJES PER ',
<br />(PRODUCTS-CODPOP AGG s2,000,000
<br />_GD
<br />X' POLICY PRO- —I L.0
<br />--.. S
<br />A I AUTOMOGILE LIABILITY 8106C82815114
<br />h04101NED SIN LE LIMIT I
<br />01/20/2014-01/20I2015(Eaeccdenfi $1,UOO,000 --
<br />( XI ANY AUTO
<br />CBODILY IWl1ftV {Parte x,r) 5
<br />ALL PUNNED1 AUTOS AUTOSSCHEDULED
<br />; AUTOS .
<br />_..I '..
<br />BODILY IN URY (Per eckEn0 S
<br />OWNED
<br />��IRED X
<br />PPJJPERTY pA'ACE
<br />AU OS AU
<br />-JPe aced t)
<br />3
<br />pX UMBRELLA UAa X OCCUR ICUP6C82815114
<br />01/20/2014.01/2012016,EACHOCCURRENCE 510000000
<br />EXCESS LIAR < LAIMS�MAOEAGGREGATE
<br />151.0 -Apo poo
<br />DED_ RETENTIONS I_
<br />S
<br />-=t __-.._.._._
<br />WORKERS COMPENSATION 1
<br />,UB6C87099214
<br />A AND EMPLOYERS' LIABILITY
<br />WCSTATLJ UfH
<br />O1/2O/2014_,Oi/20/201$- rggyylMLT. a _
<br />YIN
<br />NNY PR PRIETOWPARTNEFIEX_CUTIVE' "'
<br />OFPIOEM(MEMBEREXCLUOE01 p11 NIA
<br />EA EACH ACC`IUENi FaI QQQ QQQ
<br />— —
<br />(MandatoryinNy) �E.L.
<br />DISEASE EA EMPLOYEE! $1,000,000 _
<br />ffBF (BSOnnO !hider
<br />- _ ATIONS below
<br />DESCRIPTION Of OPER_
<br />EI. DIuFASE- POLICY LIMIT S1,000i00Q
<br />_
<br />: 9 � AJ-{ 6,
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AUach ACORD 101, Additlaral Remarks Schnflule, if mace Space Is ragUl[eE) —_
<br />Certificate Holder is named as Additional Insured, as respects General Liability, as required by written
<br />contract per the attached form CGD4140408 pg 1 and 2 of 2.
<br />Additional Insured amended to include the following: The City of Santa Ana, 20 Civic Center Plaza, Santa
<br />Ana, California 92702; its officers, employees, agents and volunteers are named as additional insureds with
<br />regard to liability and defense of suits arising from the operations and uses preformed by or on behalf of
<br />the named insured.
<br />City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />20 Civic Center Plaza ACCORDANCE WITH THE POLICY PROVISIONS,
<br />Santa Ana, CA 92702.1988
<br />AUTHORIZED REPRESENTATIVE
<br />@ 1988-2010 ACORD CORPORATION, All rights reserved,
<br />ACORD 25 (2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD
<br />#S11695431/M11693870 LXMCN
<br />
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