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<br />PRODUCER (949)857-4500 <br />Millenni..ii1 Risk Management <br />L;cense ,# OC13480 <br />5530 Trabuco Road <br />Irvine, CA 92620 <br />INSURED <br /> <br />FAX (949)857-4800 <br />& Insurance Services <br /> <br />DATE (MMIDDIYY) <br />12/06/2007 <br /> <br />THIS CERTIFiCATE is ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE C. If', <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR L Il/ <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> <br />ACORDm C~RTIFICATE OF LIABILITY INSURANCE <br /> <br />R. J. Noble Co. <br />P. O. Box 620 <br />Orange, CA 92856-9020 <br /> <br />INSURER A: <br />INSURER B: <br />INSURER c: <br />INSURER 0: <br />INSURER E <br /> <br />INSURERS AFFORDING COVERAGE <br />Travelers Property Casualty Co. of America <br /> <br />COVERAGES <br /> <br /> <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONOlTlON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR TYPE OF INSURANCE POLICY NUMBER P8k~~:~~g8;W\E PgkW/~~~~N LIMITS <br />LTR <br /> ~NERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> X COMMERCIAL GENERAL UABIUTY EXGL5273Cl6707 07/01/2007 07/01/2008 FIRE DAMAGE (Anyone f;ra) $ 300,000 <br /> I CLAIMS MADE [!] OCCUR MED EXP (Anyone person) $ 5,000 <br />A f-x SIR PERSONAL & ADV INJURY . 1,000,000 <br /> $50,000 GENERAL AGGREGATE $ 2,000,000 <br /> f-- 2,000,000 <br /> ~'L AGG:ffiE UMIT AP~tIPER PRODUCTS - COMP/OP AGG $ <br /> POLICY X jr2T LOC <br /> ~TOMOBILE LIABILITY COMBINED SINGLE LIMIT . <br /> ~ ANY AUTO CAP9322B42607 07/01/2007 07/01/2008 (Eaaccidant) 1,000,000 <br /> ALL OWNED AUTOS BODlL Y INJURY <br /> ~ (Per person) $ <br />A - SCHEDULED AUTOS <br /> - HIRED AUTOS IL Y INJURY <br /> <tO~ (Peraccidant) . <br /> NON-OWNED AUTOS <br /> - ~ ~ DAMAGE <br /> f--- h1-~~ $ <br /> ,eraccldent) <br /> ~~GE LIABILITY O'll ~~ Au:J4l ONLY - EAACCIOENT $ <br /> ANY AUTO .~~~JJ . )\,. $ <br /> OTHER THAN EA ACC <br /> .." "!'- ~'(':\'I.'l ':. AUTO ONLY: AGG $ <br /> EXCESS LiABILITY Y'i ~\~'I.~) Y EACH OCCURRENCE . <br /> ~-OCCUR D CLAIMS MADE AGGREGATE . <br /> / . <br /> ~ ~EDUCTIBLE I \ . <br /> RETENTION . . <br /> WORKERS COMPENSATION AND X [ro~m,ws I [UJt <br /> EMPLOYERS' LIABILITY UB4786C3107 07/01/2007 07/01/2008 E,L. EACH ACCIDENT . l,OOO,O()~ <br />A <br /> EL DISEASE - EA EMPLOYEE $ 1,000,000 <br /> EL DISEASE - POUCY LIMIT . l,OOO,OOC <br /> OTHER <br />DESCRIPTION OF OPERATIONSflOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Liablility per endorsement <br />Certificate Holder is named as Additonal Insured as respects General <br />attached. <br />RE: RJN Job# 91132, proj #06-1717 and #06-1019, Fourth St. Rehabilitation: 1-5 Fwy to SR-55 and <br />ustin Ave. Rehabilitation:17th St. to North City Limit Fed Proj. No. 's STPL-5063(108) & STPL-5063(110) <br />*10 day notice of cancellation in the event of non-payment of premium. <br />CERTIFICATE HOLDER I I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> City of Santa Ana, Public Works EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ~~ MAIL <br /> Department of Transportation ~':30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br /> Attn: William Albright ~IlKI0OOCOOIIXJlOOliItll)(KIl(IIIl1l0i1tJ@llXl1iX~XX <br /> 20 Civic Center Plaza <br /> Ross Annex (M-22) IOOOOOOt>X)IIIl( K1@tIVX<<XXXXXXXX <br /> Santa Ana, CA 92701 AUTHORIZED R:;~AT1VE v_c- L.A .L. /".... <br /> Leonard Z f~' /\ <br />ACORD 25-S (7/97) , -iJfACORD CORPO~I/:JN 1988 <br />