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OP ID: MR <br />°110i x° CERTIFICATE OF LIABILITY INSURANCE <br />�' "� <br />OA0 813 012 01 6Y) <br />0 813 0 /2 01 6 <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 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 />Combined Underwriters of Miami <br />8240 N.W. 52 Terr, Suite 408 <br />CONTACT <br />NAME: <br />(AICONro Ext): ac No; <br />Miami, FL 33166 <br />SUSAN SANCHEZ- ARMENGOL <br />E -MAIL <br />ADDRESS: <br />PRODUCER SECUR -3 <br />USTOMER 10 N: <br />INSURER(S) AFFORDING COVERAGE <br />NAICq <br />INSURED SECURITY SOLUTIONS <br />INSURERA: PENN - AMERICA INS. CO. <br />$ 1,000,000 <br />INTERNATIONAL INC <br />14300 SW 129 STREET #103 <br />INSURER S:PROGRESSIVE EXPRESS INS. <br />- PROGRESSIVE -- EXPRESS . CO. C - <br />10193 <br />19 - - -- <br />MIAMI, FL 33186 <br />INSURER C: <br />11/29/2015 <br />INSURER D: <br />DAMAGETOREN <br />PREMISES Ea occurrence <br />$ 100,000 <br />INSURER E <br />$ 5,000 <br />PERSONAL &ADV INJURY <br />INSURER F: <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 TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />D <br />INSR <br />MID <br />POLICY NUMBER <br />POLICY SEE <br />MMIDDIVYYY <br />POLICY EXP <br />MMIODIYY Yl <br />LIMITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ 1,000,000 <br />A <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE EX OCCUR <br />X <br />PAC7098932 <br />11/29/2015 <br />1112912016 <br />DAMAGETOREN <br />PREMISES Ea occurrence <br />$ 100,000 <br />MED EXP(An, ane person) <br />$ 5,000 <br />PERSONAL &ADV INJURY <br />$ 1,000,000 <br />GENERAL AGGREGATE <br />$ 2,060,000 <br />GEN'L AGGREGATE LI MIT APPLIESPER: <br />PRODUCTS - COMP_ /OP AGO <br />$ EXCLUDED <br />POLICY k PRO LOC <br />_ <br />$ <br />B <br />AUTOMOBILE LIABILITY <br />ANY AUTO <br />02353457 -2 <br />08/12/2015 <br />08/1212016 <br />COMBINED SINGLE LIMIT <br />(Ea accidenp <br />BODILY INJURY (Per person) <br />$ <br />$ 100,000 <br />ALL OWNED AUTOS <br />X SCHEDULED AUTOS <br />j HIRED AUTOS <br />BODILY INJURY (Par accident) <br />- <br />$ 300,000 <br />—' —" <br />PROPERTY DAMAGE <br />(PER ACCIDENT) <br />- <br />$ 50,000 <br />�I NON -OWNED AUTOS <br />' <br />UM - <br />$ - 2515 <br />DEDT.1,000 <br />$ <br />UMBRELLA LIAB OCCUR <br />EACH OCCURRENCE <br />$ <br />EXCESS CAB CLAIMS -MADE <br />AGGREGATE <br />$ <br />$ <br />DEDUCTIBLE <br />RETENTION $ <br />$ <br />ANO EMPLOYERS' LIABILITY <br />AND EMPLOYERS' COMPENSATION Y❑ <br />WC STATU- OTH- <br />(TORY LIMITS ER_ <br />EACH ACCIDENT <br />_ _ <br />$ <br />ANY PROPRIETORIPARTNERIEXECUTIVE <br />OFFICER /MEMBER EXCLUDED? <br />NIA <br />E L <br />..DISEASE -EA EM PLOYEE <br />- <br />$ <br />Mandate NH <br />If yes, describe under <br />E, L. DISEASE - POLICY LIMIT <br />-- <br />1 $ <br />DESCRIPTION OF OPERATIONS below <br />DESCRIPTION OF OPERATIONS) LOCATIONS I VEHICLES Attach Schedule, If 101, Additional Remarks Sche If more space is required) <br />SPECIAL FORM -80% CO- INS -1,000 DEDUCTIBLE <br />CERTIFICATE HOLDER, IT'S OFFICERS AGENTS, AND EMPLOYEES ARE NAMED AS <br />ADDITIONAL INSURED IN REGARDS TO GENERAL LIABILITY (ENDORSEMENT WILL FOLLOW) <br />10 DAYS NOTICE OF CANCELLATION FOR NONPAYMENT <br />CERTIFICATE HOLDER CANCELLATION <br />©1988 -2009 ACORD CORPORATION.. All ri. <br />ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORiU SIEp ,� 4 <br />IILV <br />�Cj �j aii- <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />CITY OF SANTA ANA <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />ATT: PURCHASING DEPARTMENT <br />20 CIVIC CENTER PLAZA <br />AUTHORIZED REPRESENTATIVE <br />SANTA ANA, CA 92701 <br />©1988 -2009 ACORD CORPORATION.. All ri. <br />ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORiU SIEp ,� 4 <br />IILV <br />�Cj �j aii- <br />