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i-� IDMODEL-01 BRITTANYHA
<br />,acoRO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY)
<br />�--� 12127/2017
<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(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br />PRODUCERNAMEACT Brittany Hale
<br />NFP Property & Casualty Services, Inc. acc°Nri , Ext): (714) 505-5550 FAX ne¢(714) 975.8966
<br />1551 North Tustin Avenue E-MAIL -- -
<br />Suite 500 ADDRESS:
<br />Santa Ana, CA 92705 ,......
<br />INSURED
<br />ID Modeling, Inc.
<br />55 E Huntington Suite 130
<br />Arcadia, CA 91006
<br />1'-f1VFRARFS OFRTIFICATF NIIMRFR- REVISION NLIMRER:
<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 HEREIN IS SUBJECT TO ALL THE TERMS,
<br />AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />_EXCLUSIONS
<br />/NSR TYPE OF INSURANCE
<br />j,Sp eyjyp POLICY NUMBER
<br />PLTR MUCOY EFF
<br />POLIICOY EXP NyyYj
<br />LIMITS
<br />A LX COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE If 11000,000
<br />CLAIMS -MADE �X OCCUR
<br />X X 172SBABA9623
<br />O1IO6I2O1S'
<br />0110 612 01 9 DAMAGE TO RENTED 1,000,000
<br />PREMISES fE. occurrence $
<br />MED EXP (My one erson $ 10,000
<br />PERSONAL S ADV INJURY $ 1,000,000
<br />GEML AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE $ 2,000,000
<br />X POLICY ::] j88T [:] LOC
<br />PRODUCTS-COMP/OPAGG $ 2,000,000
<br />I OTHER:
<br />$
<br />B
<br />AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT i 1,000,000
<br />Ea accident $
<br />X ANYAUTO 172UECPX8358 01/06/2018 01/06/2019. BODILY INJURY Perperson) s
<br />OWNED SCHEDULED
<br />AUTOS ONLY_ AUTOS BODILY INJURY Per accident $
<br />OHIgqEE�� NON -OWNED I PROPERTY DAMAGE
<br />TEOS ONLY AUTOS ONLY (Per accident) $
<br />A
<br />X
<br />UMBRELLA LIAB X OCCUR
<br />EACH OCCURRENCE
<br />$ 2,000,000
<br />$ 2,000,000
<br />EXCESS LIAB CLAIMS -MADE 72SBABA9623
<br />01/06/2018 01106/2019AGGREGATE
<br />$
<br />DED X RETENTIONS 10,000
<br />WORKERS COMPENSATION PER OTH-
<br />AND EMPLOYERS' LIABILITY —_. .. YIN STATUTE. OR
<br />PROPRIETOR/ PARTNERIEXECUTIVE - E.L. EACH ACCIDENT
<br />(MPandatory In NHS EXCLUDED? N I A
<br />We E.L. DISEASE - EA EMPLOYEE
<br />$
<br />$
<br />$
<br />If yes, describeunder
<br />DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT
<br />C Professional Liabili E000002663204
<br />08/30/2017 08/30/2018 Per claim limit 1,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />If required by written contract, The City of Santa Ana its agents, officers, volunteers, representatives and employees are included as Additional Insureds and
<br />Primary/Non-Contributory wording applies as respects General Liability per endorsement SS00080405 attached. *CANCELLATION: 10 -days Notice for
<br />Non -Payment of Premium andlor Non -Reporting of Payroll or 30 days for all other reasons.
<br />The City of Santa Ana; its officers, employees
<br />agents, volunteers & representative
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92704
<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 REPRESENTATIVE
<br />r
<br />ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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