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<br />A�Ra CERTIFICATE OF LIABILITY INSURANCE
<br />ATEDD/YYYY}
<br />DA TE (MMP
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREON IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />THIS CERTIFICATE, IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONIFERS 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 policy(ies) 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 endorsement(s).
<br />PRODUCER
<br />CONTACT Cath Stanns
<br />:i
<br />NAME: '.,i _
<br />Daly Merritt Insurance
<br />PHONNE (734)283-1400 Na (739)263-1197
<br />E-MAIL
<br />ADDRESS: Cathy.Stannis@dalymerri.tt.com
<br />3099 Biddle Avenue
<br />INSURER 5 AFFORDING COVERAGENAIC#
<br />X
<br />INSURERA:Hanover America _ 36064
<br />Wyandotte M1 48192
<br />INSUREDINSURERB-AJ
<br />lmeFinancial Benefit 41840
<br />rlca n
<br />FARC Inc. *� C) K�
<br />INSURERC The Hanover Ins Co .._.-., 22292
<br />12.29 Oak Valley Drive is
<br />INSURER D:
<br />INSURER E
<br />INSURER F:
<br />Ann Arbor MI 48108-9675
<br />COVERAGES CERTIFICATE NUMBER:CL1742713074 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 HEREON IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />............
<br />INSR
<br />A®DL
<br />SUBR
<br />.. .......�...-MOLICY
<br />EFF POLIO
<br />EXP
<br />Dept
<br />LTR TYPE OF ONSURANCE..Y..-
<br />P.O. Box 1981
<br />POLICY NUMBER
<br />AUTHORIZED REPRESENTATIVE
<br />�
<br />LIMITS
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />Kyle O'Malley/STANNI
<br />EACH OCCURRENCE $ 1,000,000
<br />A
<br />1
<br />CLAIMS -MADE � x..1 OCCUR
<br />DAMAGE TO RENTED 1,000,000
<br />PREMISES Fa occurrence
<br />MED EXP (Any one person) $ 10,000
<br />ZZH-D238395-00
<br />5/1/2017
<br />5/1./2018
<br />PERSONAL & ADV INJURY $ 1,000,000
<br />GENT AGGREGATE. LIMIT APPLIES PER:I
<br />GENERAL AGGREGATE $ 2,000,000
<br />POLICY �I PE 0 7 LOC
<br />PRODUCTS - COMPIOP AGG $ 2,000,000
<br />Employee Benefits $ 1,000,000
<br />OTHER:
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINEentQ SINGLE LIMIT $
<br />Fa accid1,000,000
<br />BODILY INJURY (Per person) $ 1,000,000
<br />X
<br />ANY AUTO
<br />B
<br />AAUTOSLOVdNEQ SCHEDULED
<br />AUTOS AUTOS
<br />'..AWIB-D23911.5-00
<br />5/1/2017
<br />5/1/2018
<br />BODILY INJURY�(Peraccident) $
<br />X
<br />NON -OWNED
<br />PROPERTY DAMAGE $
<br />HIRED AUTOSX AUTOS
<br />Per accident
<br />Propeqy damage Bu back $
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />EACH OCCURRENCE $ 8,000,000
<br />AGGREGATE 5 8 000 000
<br />C
<br />EXCESS LIAB
<br />....CLAIMS
<br />-MADE,
<br />DFD RETENTION
<br />$
<br />*UHB-D238396-00
<br />5/1/2017
<br />5/1/2018
<br />WORKERS COMPENSATION
<br />X ' PER OTH-
<br />AND EMPLOYERS' LIABILITY YIN
<br />.....-.
<br />.._F.IL.EACHACCIDENT
<br />ANY PROPRIETORPARTNEREXECUTIV'E
<br />$ 500,000
<br />OFFICEMMEMBER EXCLUDED?
<br />N I A
<br />C (Mandatory in NH)
<br />WHH-D217136-00
<br />5/1/2017
<br />5/1/2018
<br />E.L D€'SEASE - EA rmpLoyrE $ 500,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMBI $ 500,000
<br />C Professional Liability
<br />LHB-D238397-00
<br />5/1/2017
<br />8/1/2018
<br />Um4 1,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 1 @1, Additional Remarks Schedule, may be attached if more space Is. required)
<br />The certificate holder is listed as additional insured with respects to the General Liability as required
<br />by written contract. GST
<br />Q '
<br />CERTIFICATE HOLDER
<br />CANCELLATION
<br />ACORD 25 (2014101 )
<br />IN 5025 0014011
<br />1388-201,4 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />psemel.sberger@Santa-ana.or
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City of Santa
<br />Ana
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />Attn : Police
<br />Dept
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />P.O. Box 1981
<br />AUTHORIZED REPRESENTATIVE
<br />Santa Ana, CA 92701
<br />Kyle O'Malley/STANNI
<br />ACORD 25 (2014101 )
<br />IN 5025 0014011
<br />1388-201,4 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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