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<br /> <br />..--.""'\>.........,,"..,.:'l:..,~.~t_~c""-.v.... 1-'l1,-~'00JLW"r. <br />\ ..~. ." ' <br /> <br />:'j.":','f" <br /> <br />Cl:R'nn:::A" N1....R <br />1'4:l89 <br /> <br />.. . <br />_. ~..~ ._n....__......__....__...._.... ...._.. _..,_. <br /> <br />PROCUCER <br /> <br />~_AF_COVERAGE <br />COMPANY E: NIIIDneI U,,*", Fire lneurance Co. <br /> <br />Marah, Inc. <br />1188 Avenue of the Amerk:at <br />New YOrk, NY 10036 <br />T_.(212)346-8000 <br />F.. (212) 345-3413 <br /> <br />- <br /> <br />SlmplexGrtnnell, LP <br />1701 WEST SEQUOIA AVE <br />ORANGE. CA 92888 <br />United States <br /> <br /> <br />WORKERS COMPENSATION POLICIES <br /> Carrier Policy Number Effective Expiration State <br /> Date Date <br />(B) American Home Assurance Co. RMNC2981228 10/1/2003 10/112004 CA <br />(E) National Onion Fire Insurance Co. RHWC29B1229 101112003 10/l/2004 NV, OR <br />(D) Insurance Company of the State of PA RMWC2981230 10/1/2003 101112004 AR, Fl., MA, TN. VA <br />(C) Illinois National Insurance CD. RMWC29B1231 101112003 10/1/2004 11., lJ\ <br />(C) Illinois National Insurance CO. RHNC29B1232 10/112003 101112004 NY, WI <br />(Al AI South Insurance Co. RMIIC2981233 10/1/2003 10/112004 GA <br />(B) American Home Assurance Co. RMHC2981234 101112003 10/112004 All Ot:her st.ates <br /> <br />The Certificate Holder and any parties listed below this paragraph are added as an additional insured for General <br />Liability and Auto Liability. <br /> <br />The Named Insured also waives ita right of subrogation in favor of certificate holder and the parties listed below <br />with respect to General Liability. Workers Compensat.ion. <br /> <br />The insurance will be primary and non-contributory, with respect to any other insurance carried by the certificate <br />holder, but only to the extent of the Named Insured's negligence. <br /> <br />Additional Language or Endorsements: <br /> <br />Additional Insureds: <br /> <br />Project: <br /> <br />If there is a question regarding this certificate please contact Patty Lemich <br />(Email: plemich@tycoint.com Phone: 7H-a70~1010) <br /> <br /> <br />The City of Santa Ana <br />20 Civic Center Plaza <br />Santa Ana, CA. <br /> <br />,'-\" <br /> <br />',-, <br />,",--)\ <br /> <br />i-d44-. <br /> <br />Dvpl f -I~ '. . <br /> <br />'~-"~~-. <br />