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ACc>RhP CERTIFICATE OF LIABILITY INSURANCE
<br />°o6oiio B YY
<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 INSURERkSI, AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: if the cortlikeate holder Is nit ADDITIONAL INSURED, tiro pollcy(las) most 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 center rights to the
<br />certificate holder In boa of such ork orsomant s .
<br />PRODUCER
<br />Marsh Risk& Insurance SaRBSOPHOE
<br />CONTA T
<br />rvaME; --- .--
<br />17001 Von Annul Avenue 61100
<br />010,N )�
<br />(949) 399-5800 Llcome ll043710
<br />EMAIL
<br />6PURCes•
<br />Irvine, CA 92614
<br />INSURERISI APFOR01113COVERAOE NAICN
<br />INSURER A; Naponal Union FIR suranes Ca of Plttabwuth PA 19445
<br />319360•kttOR-PL1.15 M1fi
<br />INSURED �— ..`INSURERS:
<br />Le%sgYninsuram:B tympany 4437
<br />HIS! American Fhandai Corpnreeff
<br />FhN American TWO insurance Company
<br />INSURE, c: Hartford Fire lnaurmwe CO 19662
<br />INSURER D ; NIA NIA
<br />1 First American Way
<br />Santa Ana, CA 92707
<br />7rumtaull Insurance Company 27120
<br />INSURER E; p` y
<br />INSURER F; NIA NIA
<br />COVERAGES CERTIFICATE NUMBER: LOS 001661119.04 REVISION NUMBER: 15
<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 MICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRISED HEREIN IS SUBJECT TO ALL, THE TERMS,
<br />EXCLUSIONS AND CON_OITIO_NS OF SUCH POLICIES, LIMITS SHOWN M_AY HAVE BEEN REDUCED BY PAID CLAIMS,
<br />IN SR TYPEOFINBURANCE JAW.AN $'wvl 06 POLICYNU MBER PMIDIP C MOLppY Y P LIMITS
<br />C GENERAL LIABILITY
<br />720BER3291
<br />04119120' 5
<br />0010112016
<br />EACH OCCURRENCE
<br />S 1,000,000
<br />56 (Ea cecl rrsncdl
<br />51,00Q000
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS.Muf r� OCCUR
<br />MED EXP An one disc,
<br />a NIA
<br />PERSONAL&ADV INJURY
<br />S i,Wk},M0
<br />---
<br />GENERAi. A4GREGATE :$
<br />�..- 7,000,fX70
<br />GEN'L AGGREGATE
<br />LIMIT APPLIES PER;
<br />PRODUCTS - COMPIOP AGO
<br />$ 2,00D,000
<br />$ --
<br />X POLICY
<br />P LOG
<br />C AUTOMOBILE LIABILITY
<br />%20SER32909
<br />0411912016
<br />QGI011201G
<br />EO SNGL LIMIT
<br />3,000,000
<br />OOOLY INJURY(Parpraon)
<br />&
<br />X ANY AUTO
<br />ALLOWNED SCHEDULED
<br />HIRED AVt03 NOROWNED
<br />_..... AUTOS
<br />;DOILY INJURY(Persc100$v
<br />?RQP[RTY ARAM—
<br />a • .-11
<br />S
<br />...�
<br />A X UMBRELLA LIAR
<br />X
<br />OCCUR
<br />0E24250560
<br />0411912015
<br />061012016
<br />EACH OCCURRENCE
<br />$ 6,000,000
<br />AGOr4EGATE
<br />$ $,090000
<br />EXCESS LIAO
<br />CLAIMS MADE
<br />BED RETENTIONS,_
<br />E WORKERS COMPCNSAUON
<br />E AND EMPLOYERS' LIABILITY YIN
<br />ANY PROPRIETOR,PARTNCRADOICUTIVE O
<br />OFEICERtMEMEER EXCLUDED'!
<br />Whadatory In NH)
<br />72WNR329
<br />72WNR32908
<br />NIA
<br />04119120 G
<br />0409112016
<br />041112016
<br />081011201E -
<br />X arAIATU- OTH
<br />tQftxlw an
<br />E.L. EACH ACCIDENT
<br />$ 1,0Og000
<br />IE^L, D15 EASE EA EMPLOYCd
<br />S� '.
<br />it yaa aoscloe+a,dor
<br />OESCRIPTIOlV OF OPERATIONS P.I.
<br />S.L. DISEASE POLICY LIMIT
<br />I,5 i.,000
<br />8 Intomel LlebllllylCybor RIM
<br />01,146-54-03
<br />081012014
<br />0610112916
<br />EeOh CIRIm 10,000,000
<br />91,000,000 61R
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACDRO 101, Additional Rdcmrks ScM1eaule, If maid apace Is required)
<br />Sea Atealod - Page 2
<br />Ceruleats Mesa IsInd des as eddusped Insured where Nquirid by annual can3ac(1V41 Teapsol to Games ai/d INAAL, UaNdy,,
<br />FIRST AMERICAN TITLE COMPANY REVIEWED BY: EUNICE HEREDIA (PG 1 OF 9)
<br />City of Sams
<br />20 ao Canter Plus
<br />Ssnin Ana, CA 92701
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL Be DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRRSENTAI'WE
<br />of Marsh Rlak & Insurnnco Services
<br />Use J. Chatellier `L.'' mFtfCdtFP./lutr
<br />OACORD
<br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
<br />
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