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.� <br />A►" r�hP CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MMCDDfYYYY) <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />1/26%2016 <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(les) 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 Pam A erle AIMS <br />NAME: <br />PHO�AICNNO Ext�(805)585-6737 AIC No): (SOS)SOS-5837 <br />Tolman & W11Cer Insurance Services LLC #0E52073 <br />E-MAIL a*�eileti71lt4clrka)7{w]�1 er. CCfffi <br />ADDRESS: <br />196 S. Fir Street <br />Piz Box 1388 <br />INSURER(S) AFFORDING COVERAGE MAIC # <br />Ventura CA 93002-1388 <br />_......-...... _ ........ ............ -- -- - <br />INSURER A: Travelers Prop Cas Co of Amer 025679.__...... <br />....... <br />INSURED <br />INSURERB;TOrUs National Ins Co25496 <br />INSURER C <br />Rineon Consultants Inc. <br />INSURER D: <br />INSURER E : <br />180 N. Ashwood Ave. <br />INSURER F: <br />Ventura CA 93003 J <br />COVFRAGFS CERTIFICATE NUMBER:15/16 AU/WC 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 HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITION'S OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />... ........ - <br />ILTR ADDL SUER PdLICIf EFF POLICY EXP <br />TYPE OF INSURANCE....... POLICY NUMBER MMIDD LIMITS <br />PO Bax 1988 M-26 <br />COMMERCIAL GENERAL LIABILITY <br />AUTHORIZED REPRESENTATIVE <br />Santa Ana, CA 92701 <br />EACH OCCURRENCE. j $ <br />DAMAGE TO RENTED <br />CLAIMS -MADE OCCUR <br />PREMISES IEa occurrence) $ <br />MED EXP (Any one person) 1 $ <br />_ <br />PERSONAL. & ADV INJURY $.. <br />.._... ............. _ <br />GENT AGGREGATE AGGREGATE LIMIT APPLIES PER: <br />...... ...._.._ <br />GENERAL AGGREGATE $ <br />POLICY LOC <br />'PRODUCTS - CO ACG, <br />-d <br />$ <br />OTHER: <br />AUTOMOBILE LIABILITY <br />COMBINED SINGLE LIMCT Ea accident)$ 1, 000, 000 <br />ANY AUTO <br />BODILY INJURY (Per person) 5.... <br />A <br />ALL OWNED SCHEDULED <br />AUTOS <br />BA,-SG112538-15-CAG <br />12/17/2015 <br />12/17/2016 <br />..,_.,_,._._ <br />BODILY INJURY (Per accident) $ <br />AUTOS <br />— NON -OWNED <br />...._...- _ <br />PROPERTY DAMAGE $ <br />HIRED AUTOS AUTOS <br />(Per_accu,_dant <br />UMBRELLA LIAR <br />OCCUR <br />E,hCH OCCURRENCE $ <br />EXCESS LIAR <br />CLAIMS -MADE <br />AGGREGATE $ <br />DEO RETENTIONS <br />$ <br />WORKERS COMPENSATION,... <br />PER OTH <br />X STATUTE_ ER.- <br />AND EMPLOYERS' LIABILITY Y I N <br />ANY PROPRIET7RIPARTNERIEXECUTIVE <br />E.L. EACH A 1,000,000 <br />B <br />(Mandatory in NH) <br />NIA A <br />x10160329 <br />2/1/2016 <br />2/1/2017 <br />. .,__ .. <br />E . DISEASE- EA EMPLOYEE <br />!I yes, describe under...— <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMf`I $ 1 000 OU0 <br />DESCRIPTION OF OPERATIONS P LOCATIONS I VEHICLES IACORD 101., Additional Remarks Schedule, may be attached If more space Is required) <br />AUTO: Certificate Molder is Additional Insured as respects to operations of the Named Insured per form <br />CAT4740215 which applies only as required by written contract during the policy term. <br />n-neco14-e�AIrTr ` o <br />�5= <br />CERTIFICATE HOLDER CANCELLATION <br />ACORD 25 (2014101) <br />IN S025 (201401) <br />1988-2014 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />City of Santa Ana Housing <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />and Neighborhood Development Department <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />PO Bax 1988 M-26 <br />AUTHORIZED REPRESENTATIVE <br />Santa Ana, CA 92701 <br />David Shore/PAMELA <br />ACORD 25 (2014101) <br />IN S025 (201401) <br />1988-2014 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />