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<br />ACORDTM CERTIFICATE OF LIABILITY INSURANl;1: <br /> <br />UPA #07-0range County <br />6562 Trotter Drive <br />Huntington Beach, CA 92648 <br />. (2.1 ,~ ol Cax~ <br /> <br />!\/ - ø1ðD3- /iL 4 <br /> <br /> <br />INSURERS AFFORDING <br />INSURE:R A: The <br /> <br />PRODUCER <br />USI of Southern California <br />Lic# 0351162 *** 818-906-3350 <br />PO Box 9004 <br />Van Nuys, CA 91409 <br />INSURE:]) <br /> <br />INSURER B: <br />INSURER C: <br /> <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 HE P ICV PERIOD INDICATED. NOlWITHSTANDING <br />ANV REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WlTli RESPECT TO WHICH THIS CERTlflCATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BV THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH <br />rOLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />POLICY EFF¡;CTlVE POLICY EXPIRATION <br />D <br /> <br />TYPE OF INSURANCE <br /> <br />POLICY NUMBER <br /> <br />UMITS <br /> <br />I <br />LTR NSR <br /> <br />X PD Ded:250 <br /> <br />MED EXP (MY one person) <br />PE:RSONAL & ADV INJURY <br />GENERAL AGGREGATE <br />PRODUCTS - COMP/OP AGG <br /> <br />$1 000000 <br />$50 000 <br />$10 000 <br />$1000000 <br />$3 000 000 <br />$1 000 000 <br /> <br />A <br /> <br />GENERAL LIABILITY <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE ~ OCCUR <br /> <br />MXC8040883107 <br /> <br />07/01/04 <br /> <br />07/01/05 <br /> <br />EACH OCCURRENCE <br />DAMAGE TO RENTED <br /> <br /> <br />LOC <br /> <br />COMBINED SINGLE LIMIT <br />(Eo accident) <br /> <br />$ <br /> <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br /> <br />BODILY INJURY <br />(Per person) <br /> <br />s <br /> <br />HIRED AUTOS <br />NON..oWNED AUTOS <br /> <br />BODILY INJURY <br />(Per accident) <br /> <br />$ <br /> <br />PROPERTY DAMAGE <br />(Per accident) <br /> <br />EXCESSIUMBRELLA LIABILITY <br />OCCUR 0 CLAIMS MADE <br /> <br /> <br />I/r <br /> <br />AUTO ONLY - EA ACCIDENT $ <br /> <br />GARAGE LIABILITY <br />ANY AUTO <br /> <br />EACH OCCURRENCE <br />AGGREGATE <br /> <br />EA ACC $ <br />AGG $ <br />$ <br /> <br />OTHER THAN <br />AUTO ONLY: <br /> <br />DEDUCTIBLE <br />RETENTION <br /> <br />"fn fNAfy" ~l~ M ~i.J <br /> <br />$ <br />$ <br /> <br />$ <br /> <br /> <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br /> <br />~~~~litS~~ÔJ'I~~NS I <br />A OTHER <br /> <br />Pollution Cleanup <br /> <br />E.L. EACH ACCIDENT <br />E.L. DISEASE - EA. EMPLOYEE 1& <br /> <br />MXC8040883107 <br /> <br />07/01/04 <br /> <br />07/01105 <br /> <br />E.L. ClSEASE - POLICY LIMIT $ <br />$5,000 Limit <br /> <br />DESCRIPTION OF OPERATIONS I LOCATIONS ¡VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPI,CIAL PROVISIONS <br />Excludes Non-owned & Hired Automobile Liability *30 day notice of canc:ellation; 10 day <br />non-payment of premium. <br />RE: Brandon Young <br />Certificate Holder is amended to Include Santa Ana Regional Transportation <br />(See Attached Descriptions) <br /> <br />CERTIFICATE HOLDER <br /> <br />CANCELLATION <br /> <br /> SHOULD ANY OF TIiE ABOVE DeSCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATtON <br />Santa Ana Regional DATE "[HEREOF. THE ISSUING INSURER WILL ~Rø MAIL ~ DAYS WRITTEN <br />Transportation Center, etal NOTIC:. TO THE CIiRTIFICATE HOLDER NAMED TO THE LEFT._J:~ <br />1000 E. Santa Ana Blvd. #300 M'ØII:JI~JtII:XØIUIX~~~xx <br />Santa Ana, CA 92701 <br /> AUTHORIZED REPRESENTATIVE <br /> ~ /(. ~ <br /> <br />ACORD 25 (2001/08) 1 of 3 <br /> <br />#M251000 <br /> <br />$LD <br /> <br />@ ACORD CORPORATION 1988 <br /> <br />~-d <br /> <br />1 ~Eq 1.1 <br /> <br />d6v:~0 VO 90 ~n~ <br /> <br />