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CERTIFICATE OF LIABILITY INSURANCE <br />-H (%V4 DD YYYY) <br />2x17/2017 <br />_ <br />THIS CERTIFICATEIS 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 this <br />certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />PAYCHEX INSURANCE AGENCY TNC/PHS <br />CONTACT <br />NAME: <br />EFaX <br />APHONlc� N., (888) 443-6112 <br />210756 P: F: (888) 443-6112 <br />E-MAIL <br />ADD RESS <br />PBX 3 <br />O O 3015 <br />INSURERS} AFFORDING COVERAGE NAIC# <br />SAN AN ONTO TX 78265 <br />INSURER A Hartford Accident and Indcmnity 2'357 <br />INSURED <br />INSURER R <br />INSURER C <br />CLAIMS-MADE_7 —1 OCCUR <br />F <br />HADRONEX INC DBA SMART COVER SYSTEMS <br />INSURERD. <br />2067 WINERIDGE PL ST E <br />INSURERS <br />ESCONDIDO CA 92029 <br />INSURERF. <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 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 <br />TERMS,EXCLUS IONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAWS. <br />TYPE OF INSITANCE <br />-IDDI. <br />SI/BR <br />POLICYNUVIIER <br />POLICYEFF <br />OLWDIVY 11), 12 <br />POLICYL.VP <br />ry <br />LL1117S <br />COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE <br />CLAIMS-MADE_7 —1 OCCUR <br />F <br />DAMAGE to RENTED <br />PREMISES (Ea occurrence) <br />MED EXP (A" rave pe,sup) <br />PERSONAL & ADV INJURY <br />GEN"I_ AGG REGATE U MIT APPLIES PER: <br />GENERAL AGGREGATE <br />POLICY -1 PROF—] - LOC <br />F JECT <br />PRODUCTS - COMPIOP AGG <br />OTHER: <br />AUTOMOMILE LIABILITY <br />COMBINED SINGLE LIMIT <br />(Ea accident) $ <br />BODILY INJURY IPer parson) <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />BODILY INJURY pear accident) <br />HIRED NON -OWNED <br />PROPERTY DAMAGE <br />AUTOS ONLY AUTOS ONLY <br />(Per accdent) <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE <br />EXCESS LIAB <br />d <br />CLAIMS -MADE <br />AGGREGATE <br />DEI IRETENTION 3 <br />IVORKERS CO 141'"ENS I T10,N1 <br />(AD UPLOYERLY'LIASILITY <br />X IPER 07H <br />STATUTE ER <br />EL EACH ACCIDENT 11,000,C00 <br />A <br />ANY PROPRIETORIPARTNEWEXECUTIVE YIN <br />OFFICERIMEMBER EXCLUDED? <br />(Mandatory In NH) <br />NIA <br />76 YIEG GH3220 <br />10/01/2016 <br />1 <br />0 C <br />,1/ 2 (3— 7 <br />EL DISEASE- EA EMPLOYEE SI 000 0100 <br />If yes, describe under <br />DESCRIPTION' OF OPERATIONS below <br />E L. DISEASE.- POLICY LIMIT 1 000, 0100 <br />DESCRIPTION OF OPERATIONS /LOCATIONS fVEHIrLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />Those usual to the Insured's Operations. <br />CERTIFICATE HOLDER CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br />BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE <br />DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. <br />CITY OF SANT' ANA AUTHORIZED REPRESENTATIVE <br />20 CIVIC CENTER PLZ # M-21 <br />SANTA ANA, CA 92701 <br />07 1 988-201 5 ACORD CORPORATION. All rights reserved, <br />ACORD 25 (2016103) The ACO,RD name and logo are registered marks of ACORD <br />J -0 <br />