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<br />14:02
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<br />949450
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<br />3
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<br />TDIA
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<br />PAGE
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<br />03/03
<br />
<br />, '
<br />
<br />ACORD
<br />,...."- "-~"..' .... ... ""
<br />
<br />CERTIFICATE OF LIABILln' INSURANCE;o&~î D DA~~~~~~13
<br />T'.ns C ER11FICATE IS ISSUED AS A MATTER OF INFORMATION
<br />ONLY "ND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />HOLDI !R. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR
<br />AL TEF THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />INSURERS AF=FORDING COVERAGE
<br />
<br />. !>~OOUOER
<br />
<br />". :J:::-::':,:,:!:.s Insurance Agency
<br />;>;: $,:;,u.th Pointe Drive
<br />¡L~guna Hi11e CA 92653
<br />I ~hcne:949-460-B730 F~;949-460-e733
<br />l..- ..,..a___.., ... ... .... ., .
<br />',!:;3:JRI'D
<br />
<br />-. " - ...._--- --
<br />
<br />INSURER ~
<br />INSURER E
<br />
<br />Lexington In~uran~e C~~y
<br />St. Paul Fire & Marine Ins. Co
<br />"--.---.
<br />HAS Insurance - BeEv.1E!~.L.J:nC .
<br />'l'he State l'und
<br />
<br />Co~rect.ional Ma~ed Care Med
<br />p,'~tn: P.hobG:rtà E'az
<br />2040 S. Santa Cru: St., '100
<br />Anaheim CA 92805
<br />
<br />-'''''-.-'
<br />
<br />INSURER ( :
<br />INSURER ( :
<br />
<br />---------_""'H..,._.....,..
<br />
<br />INSURER E
<br />
<br />COVERAGES
<br />
<br />r ":'"1-11; PQI.ICIF.;S OF INSlJRANC¡;¡ LlSTI; ) QE~OW HAVE eE;¡¡N IS$UF-D TO THE INSUReo NAMEO A90VE FOR T Ie POLICY PERIOD INDICATED. N01'WITHStANDING
<br />.O"'V "¡~"U~EMENT, TERM OR CONDITION OF ANy CON~ACT OR O'THI:FI DOCUMENt WITH RESPECT TO NI~ICI~ HilS CIõRTIFICATE MAY e¡;¡ ISSUEO OR
<br />. 't.V ~F.!~'" ~.I!\J. 'T' ../e INSURANCe AFF(I~OeO av THe POI.ICIES OF.sc~re"'o HeReiN IS 9UBJeCT TO ALL THE tI:FlMS, EXCLUSIONS AND CONDITIONS OF SUC,",
<br />. C_' :::""'-:(5"Ë~Þ.tE LIMITS SHOWN MAy HAilE: aeEN ReDlJCED BY PAID CLAIMS.
<br />
<br />.~""E :::0:: INSURANCE
<br />
<br />POliCY NUM8ER
<br />
<br />
<br />----'--'..----'---
<br />
<br />-- ---_.~._'--- ..-.- -".-'-'--'-'-'--'--"-' ..._~._-
<br />
<br />-....--.........-
<br />
<br />I A ~ x: COMMERCIAL GENERAL lIAnlllTV
<br />I "'1 CLAIMS MADE r'.'-] OCCUR'
<br />
<br />0~114761
<br />
<br />08/01/03
<br />
<br />08/01/04
<br />
<br />LIMITS
<br />I:ACH OCCURFlENCE.. ..--- .!l:..t OC!.Q.!.Q.QQ..---
<br />.~I~~ DAMAGE (Any O.M~,~~~)- $ 5Q.LQ.~<!'.__-
<br />-~~':XP (Any one pe~~.:'~L $ 5 , OO~-_.
<br />PERSONAL & AOV IN.IlIRV $
<br />- ----'---".-
<br />GE;N!;RAL AGGReGATE.,. $ 3,000/9...1;>2__-
<br />PRODuCtS - COMplOP AGG $
<br />
<br />"~...,.~...,---....
<br />
<br />;'::"NE-:.a.lltIl,81L1TY
<br />
<br />--.. . .-._._._.--._.~.._._...-.__._----
<br />
<br />
<br />-....-..-..,-..-.---.--- '----"------
<br />
<br />lOC
<br />
<br />COMBINED SINGLE liMIT
<br />(e~ '-'l;Cldent)
<br />
<br />$ 1,000,000.
<br />
<br />C->:::-'JL::O AUTOS
<br />
<br />ElODIL Y INJURY
<br />("'" person)
<br />
<br />,
<br />
<br />-------......-...
<br />
<br />u -~_._--
<br />
<br />. '7"2': .:',:J;-'JS'
<br />
<br />BKOU97314
<br />BK01497314
<br />
<br />06/01/03
<br />06/01/03
<br />
<br />06/01/04
<br />06/01/04
<br />
<br />900ll V INJURY
<br />rF'er accident)
<br />
<br />:I.
<br />
<br />, :s ¡._JS.¡ NON-OWNßD AUTOS
<br />
<br /> i--.! ,-..-'---..'.--..-'-"'-.'.._.'_n'__.-
<br />
<br />...- ..~~_.- ---------
<br />
<br />F'~OPERTY DAMAGE
<br />(~r eccld<:Jnt)
<br />
<br />:&
<br />
<br />~RAGe UAÐll.ltY
<br />
<br />,
<br />,è','-"Y.,\tJ'''''O
<br />
<br />AUTO ONLY. EA ACCIOENT $
<br />
<br />,---.,
<br />
<br />
<br />~ . (JjZ~
<br />
<br />...., '-'-'--"-'-"--'---'-'---.-"-.
<br />
<br />OTHeR THAN
<br />AUTO ON\. Y
<br />
<br />EA ACC :&
<br />AGG' $
<br />
<br />~':I;<'$ I.IABIUTY
<br />
<br />i_J ocellI'! 1.._...1 èLAIMS MADE
<br />I
<br />
<br />EACH oCc.URlI.eNCE
<br />--------.,....,..
<br />AGGREGATE
<br />
<br />s
<br />
<br />._._--
<br />
<br />$
<br />
<br />'--.-..--------.---. ..
<br />
<br />;--: OF.OUCTIBLë
<br />
<br />i)',11;1
<br />
<br />:I.
<br />
<br />--------. .
<br />
<br />'.'''''''''----
<br />
<br />: :'c'''::>.¡::;ATlON AfoID
<br />;.q~.;.,¡;¡~s. liABILITY
<br />
<br />1490456-2003
<br />
<br />07/01/03
<br />
<br />07/01/04
<br />
<br />$
<br />'''..--.---------..'
<br />$
<br />TORV LIMitS _... ER_, ,,------_._,
<br />E,t ~~~!~~~~..._- .!.!.(OOO, °.Q.~_.__.
<br />_'::.~ISEASE. EA J¡MPlO~EE $~.tQgQ.!~
<br />ElDISEASe.F'OLlCYLiM,t $1 000 000
<br />
<br />---
<br />
<br />. -:::-::i\~""'Cf\1
<br />
<br />:I.
<br />
<br />"'è"' ..,I~~
<br />
<br />.~ . ~.~.. :'.i~. 0314761 08/01/:>3 08/01/04 Prof .Liab
<br />~_~T~1-;~d Cue B& 0 424486 08/01:)3 08/01 04 E&O Liab.
<br />I UiõSCRIi>l10N 01" OF'EMTIONSII.OCATIONSlVEHICLESlEXCLUSIOt.IS AOOEÞ BY ENDOR91:I'IENtISF'I!CIAL PI\( '\IISIOH$
<br /> *.10,~YS notiQQ for cancel1atio~ o~ ~on-~ymant ~f pJ:emium. Professional
<br />L;.êÛ).l;¡, ty and Managed. Care £&0 L;¡,ab;¡,lJ. ty 1S a cla.:uns Had@ poh.oy.
<br />,Çg:tific::ate Hold.er is lis1:ed as an ad.ditional insured tor general liability
<br />!~~~ professional liability.
<br />
<br />1mil/3mil
<br />1ml/3mil
<br />
<br />r>:::?:o-'T;:;ÇATE I-iOLDER
<br />
<br />City of Santa Ana
<br />Santa Ana City Jail
<br />Chris Laugenaur, Contracts
<br />S? Civic Cente~ P~aza
<br />.-"~~":~. Ana CA. 92702
<br />
<br /> y I ADDITIONAL INSURED; INSURER LETTE~: A.
<br />BLANKOO
<br />
<br />CANCEll ArlON
<br />9tiOULD p ~Y CW THE AElOVE Þ"$(:~18ED POLICIES !'IE CANCI;~I,.EtI BEI'OA! THE EXPIRATION
<br />DATE THE IEOF. -mE ISSUING INSUReR WILL ENbEAVOR TO MIItL _3.0..t DAYS WFlITTeN
<br />NOTice T< tHE CEIUlFICAtE HOI.DER NAMED TO THE LEI'f, 8U't FAILURE TO 1:10 SO SHALL
<br />IMPOSE NI I OIILIGATION OR LlABtUTY OF ANY KIND 1JI'0f0I 'tHE INSURI!R, ITS AGENtS OR
<br />rœf>Rf¡SEr TA.11V!S.
<br />AUTHOFlI<:E'REPRESENTATlVE
<br />
<br />I I
<br />ACORD 2~ (1/91)
<br />
<br />Don
<br />
<br />BmorV'
<br />
<br />I
<br />
<br />@ACORD CORPORATION 1988
<br />
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