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<br />. <br />. CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDfYYYY) <br />'A(;OR[)~ OP ID B9 08/25/04 <br />FPLAS-l <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Wood-Gutmann Insurance Brokers ONLY ANO CONFERS NO RIGHTS UPON THE CERTIFICATE <br />License #0679263 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />14192 Franklin Ave., Suite 200 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Tustin CA 92780-7044 <br />Phone:714-505-7000 Fax:714-573-1770 INSURERS AFFORDING COVERAGE NAIC# <br />INSURED A-;W03 -17.2/3 INSURER A: U. S. Fidelitv & Guarantv <br /> INSURER B Everest National Insurance <br /> FPL and Associates, Inc. INSURER c: Continental Casual tv 20443C <br /> 10 Corporate Park, Ste 310 INSURER 0: <br /> Irvine CA 92606 <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. NOT'v\'lTHSTAND!NG <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO VllHICH 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 SHOVv'N MAY HAVE BEEN REDUCED BY PAID CLAIMS <br /> <br />LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM/DDNY DATE MMfDDNY LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE .1,000,000 <br />A X COMMERCIAL GENERAL LIABILITY BK01883824 09/01/04 09/01/05 PREMISES (Ea occurence) . 300,000 <br /> CLAIMS MADE [!J OCCUR MED EXP (Anyone person) ' 10,000 <br /> PERSONAL & ADV INJURY .1,000,000 <br /> GENERAL AGGREGATE .2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG .2,000,000 <br /> PRO- LOC <br /> JECT <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT .1,000,000 <br />A ANY AUTO BK01883824 09/01/04 09/01/05 (Eaaccident) <br /> ALL OVv'NED AUTOS BODILY INJURY <br /> (Per person) . <br /> SCHEDULED AUTOS <br /> X HIRED AUTOS BODILY INJURY <br /> (Per accident) . <br /> X NON-O\^INED AUTOS <br /> PROPERTY DAMAGE . <br /> (Per accident) <br /> GARAGE LIABILITY AUTO ONLY. EAACCIDENT . <br /> ANY AUTO " OTHER THAN EAACC ' <br /> AUTO ONLY. AGG . <br /> EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE .1,000,000 <br />A X OCCUR D CLAIMS MADE BK01883824 09/01/04 09/01/05 AGGREGATE .1,000,000 <br /> . <br /> DEDUCTIBLE . <br /> RETENTION . . <br /> WORKERS COMPENSATION AND X TORY LIMITS ER <br />B EMPLOYERS' LIABILITY 3900031544-041 05/01/04 05/01/05 .1,000,000 <br />ANY PROPRIETOR/PARTNER/EXECUTIVE E,L. EACH ACCIDENT <br /> DFFICERlMEMBER EXCLUDED? E.L.DlSEASE-EAEMPLDYEE $1,000,000 <br /> ~~Ëtl~tS~~bdv~s?åNS below E.L. DISEASE - POLICY LIMIT .1 000,000 <br /> OTHER <br />C Professional Liab MCA1l4132312 09/01/04 09/01/05 $5,000,000 <br /> <br /> <br /> <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br />*10 Days notice of cancellation for non payment of premium. Certificate <br />holder is named as additional insured per attached CLBF26090903 along with <br />Primary wording, as their interest may appear. XXX <br /> <br />CERTIFICATE HOLDER <br /> <br />CANCELLATION <br /> <br /> SANT040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />City of Santa Ana DATE THEREOF, THE ISSUING INSURER WILL E.:II&1ii .:;'A. .0 MAIL 30' DAYS WRITTEN <br />Public Works Agency NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, ¡¡LJT r"lb"R~ T'Q P? liB BII..LL <br />Attn: Ruth Smith IMPg$~ ..,... -8LIB^"RifJ BR 1;.1..ØIt:.I~;f' AtJU IUfJB \frill TilE IIJBtI"'~R,IT6 "¡¡¡¡¡fiTS ¡R <br />20 Civic Center Plaza, M43 <br />Santa Ana CA 92701 8EP'Il.,,"I:; .'I'O.IIV"". <br /> AUTHORIZED REPRESENTATIVE ~ ~~ <br /> (I "" Z, <br /> <br />ACORD 25 (2001/08) <br /> <br />@ACORDCORPORATION 1988 <br />