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01/23/2003 14:14 71454929d9 <br />ACORD CERTIFIC <br />ULER (714)979-6S43 FA <br />igmere Insurance Agency, Inc. <br />license •0811959 <br />'.970 Harbor Blvd, 021S <br />:ast♦ Mesa. CA 92626 <br />sM ED Sher. Our Selves <br />1SSO Superior Ave. <br />Costa Mtsa, CA 92627 <br />(714)549- <br />C 4 r <br />INSURER B: <br />INSURER C: <br />INSURER O: <br />INSURER E <br />PAGE 02/02 <br />DATE(MM(DD" <br />01/23/2003 <br />R. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />INSURERS AFFORDING COVERAGE <br />Travelers Pr.verty Casaalty <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />M.AY 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 />TR <br />TYPE Of INSURANCE <br />POLICY NUMBER <br />CATE(MwD00'Y) <br />OATE(MMT)OIYTI <br />U1,117S <br />GEHERALLIABIUTY <br />X COMMERCIALGENERALLIABILTY <br />CLAIMS MADE ElOCCUR <br />3OX43SO <br />01/26/2003 <br />01/26/2004 <br />EACH OCCURRENCE <br />S 1,000.000 <br />FIRE DAMAGE(APy a ore) <br />S 100,000 <br />MED UP (My oneD ) <br />$ S,000 <br />PERSONAL B AM' INJURY <br />S 1.000.000 <br />GENERAL AGGREGATE <br />S 2.000,000 <br />GENL AGGREGATE LIMIT APPLIES PER: <br />POLICY jECO-y LOC <br />PRODUCTS -COMPTOP AGO <br />s 2, 000, 000 <br />A <br />AUTOMOBILE <br />LIABILITY <br />ANYAUTO <br />ALL OWNED AUTOS <br />ACKE)ULED AUTOS <br />HIRED ALTOS <br />NON-OWNEOAJTOS <br />r8o <br />01/26/2003 <br />01/26/2004 <br />COMBINED SINGLE LIMIT <br />S <br />1,000,000 <br />BODILY INJURY <br />(PmPMan) <br />s <br />% <br />X <br />BODILY INJURY <br />(Pvno:Wen0 <br />% <br />PROPERTY DAMAGE <br />(Per.c dtnQ <br />s <br />GARAG£LIABILITY <br />ANY AUTO <br />AUTO ONLY -EA ACCIDENT <br />S <br />OTHERTHAN EA ACC <br />AUTO ONLY: AGO <br />' <br />S <br />EXCESS LIABILITY <br />OCCUR El CLAIMS MADE <br />DEDUCTIBLE <br />RETENTION S <br />- For, <br />lri <br />EACH OCCURRENCE <br />S <br />AGGREGATE <br />S <br />S <br />S <br />S <br />WORKERS COMPENSATION AND <br />EMPLOYERS'LIABIUTY <br />,L i' 1" K �I <br />A• <br />�,/ <br />Jf <br />,� ��„ <br />TORY UMRS ER <br />E.L. EACH ACCIDENT <br />S <br />E.L. DISEASE - EA EMPLOYE <br />5 <br />EL. DISEASE -POLICY LIMIT <br />S <br />OTHER <br />OCR RIPTION OF OPERATIONSILOCATION9NEHICLE3lEJfGLU510N3 ADDED BY ENDORSEMENTISPECIAL PROVISIONS <br />_ITY OF SANTA ANA, ITS OFFICERS, AGENTS, EMPLOYEES, AND VOLUNTEERS ARE NAMED AS ADDITIONAL INSURED AS <br />IESPECTS THEIR INTEREST IN CONECTION WITH THE NAMED INSURED. <br />10 DAYS NOTICE OF CANCELLATION FOR NON PAYMENT OF PREMIUM. <br />-11 .,.—I I I ADDITIONAL IN9UREO: INHIIRFR I FTTFR LIANGCLLA I IUN <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILLR?,P )njW MAIL <br />CITY OF SANTA ANA <br />IB_DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />ATT: LUCY FLORES <br />P�T%-7a�N)♦�ii4C7MQkN!n1fk(Q72R9G41A'0.'17PQX-11�, X <br />P,O. BOX 1999 <br />Q6(�A0QX+7pfi1fQ4i SC?klkXx�.4a�x+r, %6I1rane�Rirxr x�%XXXXXX <br />SANTA ANA, CA 92702 <br />AUTHORIZED REPRESEN ATNE <br />Yi mo th Wi more/0114 <br />reA: LY1A)b47}_6549' ,vns.vrsv s.�rtrvrtrlwn ,aoo <br />