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ACORD.. CERTIFICATE OF LIABILITY INSURANCE <br /> <br />04/16/2003 <br /> <br />PRODUCER <br /> A.T3. AGENCY, INC. <br /> 1022 NE. 65TH ST. <br /> SEATTLE, WA 98115 <br /> <br />206-522-9200 <br /> <br />THE PACIFIC INSTITUTE, INC. <br />P.O. BOX 84208 <br />SEATTLE, WA 98124 <br /> <br />THtS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> <br />INSURERS AFFORDING COVERAGE NAIC # <br />INSURERA: AMERICAN STATES INSURANCE CO. <br />INSURER B: <br />INSURER C: <br />INSURER D: <br />INSURER E: <br /> <br />COVERAGES <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 CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERT{FICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND COND T OHS OF SUCH <br /> <br />POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS <br /> PO LICY EFFECTIV~ <br /> <br /> COM M ERCIAL GENERAL LIABILIT'i' 02-CC-202232-3 02/04/03 <br /> <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br /> <br />AUTOMOBILE LIABIMT~ <br /> <br /> ANYAUTO <br /> <br /> ALL OWNED AUTOS <br /> <br /> SCHEDULED AUTOS <br /> <br /> H~RED AUTOS <br /> <br /> NON,OWNED AUTOS <br /> <br />02-CC-202232-3 <br /> <br />GARAGE L~ABILITY <br /> ANY AUTO <br /> <br />OCCUR [] CLAIMSMADE 01-SU-102425-30 <br /> <br />RETENTION $ 10,000 <br /> <br />02/04/03 <br /> <br />02/04/03 <br /> <br />POLICY EXPIRATION <br /> <br />02/04/04 <br /> <br />02/04/04 <br /> <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFiCER/MEMBER EXCLUDED? <br /> <br />02/04/04 <br /> <br />LIMITS <br /> <br />1,000,000 <br />200,000 <br /> <br /> 10,000 <br />1,000,000 <br /> <br />2,000,000 <br /> <br />2,000,000 <br /> <br />1,000,000 <br /> <br />10,000,000 <br /> <br />10,000,000 <br /> <br />1,000,000 <br /> <br /> 1,000,000 <br /> 2,000,000 <br /> OTHER <br /> APi i.~ .... .. ,',5 fO FORM <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS C_~/, .~~ ./.,, <br />CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED. "~i. )../-¢~C ? <br /> <br /> D~putv City AL orney <br /> <br />CERTIFICATE HOLDER CANCELLATION <br /> <br /> CITY OF SANTA ANA <br /> ATTN: ANNABELLE BATES <br /> 1000 E. SANTA ANA BLVD., SUITE 220 <br /> SANTA ANA, CA 92702 <br /> <br />ACORD 25 (2001108) <br /> <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> <br /> <br />