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SIERRA OP ID: I -C <br />A��r�„ CERTIFICATE OF LIABILITY INSURANCE <br />D02121120Y7 <br />TYPE OF INSURANCE <br />02/2112017 <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 />Wright, Finnegan &Garter <br />Insurance Associates <br />23001 La Palma Ave 4100 <br />Yorba Linda, CA 92887 <br />CONTACT <br />NN AME: Certificates <br />F <br />AIC No Ext: 714-283-1999 (Ac No: 714-283-1897 <br />ADDRESS: CertlflCateS WiSins.COm <br />INSURERS) AFFORDING COVERAGE NAIC # <br />John Carter CIC <br />INSLRERA: National Fire Insurance Co of <br />04/2012017 <br />INSURED Sierra Cybernetics Inc. <br />Suite 201 <br />114SURERB: Hartford AXV <br />MED EXP (Any ane person) $ 10,00 <br />5140 E. La Palma Ave. <br />INSURERC: <br />INSURERD: <br />Anaheim Hills, CA 92807-2069 <br />INSURER E : <br />$ <br />INSURER F : <br />AUTOMOBILE <br />X <br />COVERAGES CERTIFICATE NUMBER: REVISION NLIMFdPR• <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 />L <br />SUBH <br />POLICY NUMBER <br />POLICY EFF <br />MMIDD <br />POLICY EXP <br />MMIDO <br />LIMITS <br />A <br />GENERAL LIABILITY <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE OCCUR <br />X <br />1034949260 <br />04/20120'16 <br />04/2012017 <br />EACH OCCURRENCE $ 1,000,00 <br />PREMISES Eaaccurrence $ 300,00 <br />MED EXP (Any ane person) $ 10,00 <br />PERSONAL & AUV INJURY $ 1,000,00 <br />X $0 - Retention <br />GENERAL AGGREGATE $ 2,000,00, <br />GERL AGGREGATE LI MIT APPLIES PER: <br />X POLICY PRD LOC <br />PRODUCTS - COMPIOP AGO $ 2,000,00 <br />$ <br />A <br />AUTOMOBILE <br />X <br />LIABILITY <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />NON-OWNEDPROPERTY <br />HIRED AUTOS X AUTOS <br />1034949260 <br />04120/2016 <br />04/20/2017 <br />COMBINED SINGLE LIMIT <br />(Ea accident)$ 1,000,00 <br />EODILY INJURY (per person) $ <br />BODILY INJURY (Per aroident $ <br />) <br />DAMAGE <br />(PER ACCIDENT $ <br />UMBRELLA LAB OCCUR <br />EXCESS LIAR CLAIMS-�AADE <br />EACH OCCURRENCE $ <br />AGGREGATE $ <br />DEQ RETENTION $ <br />$ <br />WORKERS COMPENSATION <br />EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETORFARTNER!EXECUT€VEE.L. <br />OFRCERIMEMBER EXCLUDED? ❑ <br />(Mandatory In NH) <br />It yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />N I A <br />WC STATU- 'ER' <br />TORY LIMITS ER <br />EACH ACCIDENT $ <br />E.L. DISEASE- EA EMPLOYEE $ <br />E.L. DISEA'SE- POLICY LIMIT $ <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORO 101, Additional Remarks Schedule, if more space Is required) <br />THE CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES ,AGENTS & REPRESENTATIVES ARE <br />NAMED AS ADDITIONAL INSURED I. PRIMARY WORDING APPLIES PER THE BLANKET <br />ADDITIONAL INSURED ENDORSEMENT ATTACHED TO THE POLICY - AS REQUIRED BY <br />WRITTEN CONTRACT. 30 DAY WRITTEN NOTICE OF CANCELLATION WILL BE PROVIDED TO <br />THE CITY OF SANTA ANA, 20 CIVIC CENTER PLAZA, SANTA 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 />THE CITY OF SANTA ANA ACCORDANCE WITH THE POLICY PROVISIONS. <br />FINANCE & MGMT SERVICES AGENCY <br />20 CIVIC CENTER DRIVE AUTHORIZED REPRESENTATIVE <br />10 9 <br />M-16 - PO BOX 1988 <br />DR\ITA Ai,R AA M1M-l'APo <br />p 19SS-2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD <br />