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<br />'~rerk~ <br /> <br />Pro-Form Insurance Services <br /> <br />15 Allstate Parkway, SUite 220 <br />Markharl, On:acio L3R 5B4 <br />c'hme 905-305-1054 <br />TDII Free 1-800-361 -9CJ80 <br />Fax 9CJ53CJ51 CJ93 <br /> <br />Insurance . Financial Services <br /> <br />www.hubontario.com <br /> <br />A~:4JOS - I d- 7 <br />A- MD3-/7ZA <br /> <br />This is to certifY to: <br /> <br />Clerk of the City Council <br />City of Santa Ana <br />20 Civic Center Plaza (M-30), P.O. Box 1988 <br />Santa Ana, CA 92702-1988 <br /> <br />This is to certifY that on the date below the following described insurance policies are in full force and effect. <br /> <br />NAMED INSURED: <br /> <br />181 GROUP, and other insureds who may be identified in the policy <br /> <br />230 Richmond Street W., 5th Floor <br />Toronto, ON M5V 1 V6 <br /> <br />ADDRESS OF INSURED: <br /> <br />DESCRIPTION OF OPERATIONS TO <br />WHICH THIS CERTIFICATE APPLIES <br /> <br />P' 12 1055 <br /> <br /> ro ect - <br />Class Description of Coverage Limits of Liability Company Policy No. Expiry Date <br /> mm/dd/yy <br />Liability Commercial General Liability XL Insurance USOOO08537 04/30/07 <br /> America Inc. Ll OM <br /> Bodily Injury/Property Damage Each US$I,OOO,OOO <br /> Occurrence <br /> General Aggregate US$I,OOO,OOO <br /> Products-Completed Operations US$I,OOO,OOO <br /> Non-Owned Automobile US$I,OOO,OOO <br /> Personal and Advertising , US$I,.OOO,OOO <br /> Injury <br />Excess Commercial General Liability CDN$I,OOO,OOO XL Insurance CAOOOO0956 04/30/07 <br /> (In excess of underlying limits) Company Limited Ll 06A <br />Other N/A I <br /> <br />Note: "City of Santa Ana" is added as additional insured but only with respect to the liability arising out of the operations ofthe <br />Named Insured. The Insurer will provide the Certificate Holder with thirty (30) days written notice of cancellation of the policy. <br /> <br />The insurance afforded is subject to the terms, conditions and exclusions of the applicable policy. This Certificate is issued as a <br />matter of information only and confers no rights on the holder and imposes no liability on the Insurer nor on Pro-Form Insurance <br />Services.) FO- <br /> <br />May 17,2006 <br />181.098 <br /> <br />, ;./!J^,-~__l_~Lft_ __ 'Jz <br />f'9// (, .... <br /> <br />" ~.. - <br /> <br />... l \' /\1 <br /> <br />PRO-FORM INSURANCE SERVICES <br /> <br />................~ <br /> <br />Authorized Representative <br /> <br />~-j. <br /> <br />Pro-Form Insurance <br />Services <br /> <br />