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DATE (MM/DD/YY) <br />ACORD CERTIFICATE OF LIABILITY INSURANCE DECOO3 <br />TM. <br />PRODUCEI~ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />BACCARELLA INSURANCE SERVICES, INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />6864 INDIANA AVE. # 201 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />RIVERSIDE CA 92506 ALTER THE COVERAGE AFFORDED BY ]'HE POLICIES BEL )W. <br />PHONE: 877-587-4999 <br />FAX: 866-307-6352--/~/- ~)..~ ~- /, _.~ INSURERS AFFORDING COVERAGE NAIC # <br />INSURED ,NSURER A: MT HAWLEY INSURANCE COMPANY <br />ADA CONSTRUCTION SERVICES CO. INSURER B: <br />CIO ARCHITURAL DESIGN ASSOC AND CONSTRUCTION <br />SERVlES INSURER C: <br />1320 D EAST ST. ANDREW PLACE INSURER D: <br />SANTAANA CA 92705 INSURER E: <br /> <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICYPEI~IOD INDICATED, NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRAQT OR OTHER DOCUMENT WITH RESPECT TOWHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED B'f THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALLTHE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS <br /> <br />INS TYPE OF INSURANCE POLICY NUMBER POLICy EFFECTIVE POUCY EXPI RA31ON LIMITS <br />L3~ DATE {MMIDDtYyI DATE <br /> <br /> GENERAL LIABILITY AC20003021 MAR 3 03 MAR 3 04 EACH OCCURRENCE 1,000,000 <br /> DAMAGE TO REN~D <br /> ~- COMMERCIAL GENERAL LIABILITY PREMISES lea_ oc~umnceI 100,000_ <br /> CL^,MSM E CUR ' EDEX__* yO Pe D.> 1o,ooo <br />A PERSONAL & ADV INJURY --i ,000,000 <br /> GENERAL AGGREGATE 2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODU CTS-COMP/OP AGG. 1,000,000 <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> ANY AUTO (La accident) <br /> ALL OWNED AUTOS BODILY INJURY <br /> SCHEDULED AUTOS IPer person) <br /> HIRED AUTOS BODILY INJURY <br /> NON-OWNED AUTOS ~er accident) <br /> PROPERTY DAMAGE <br /> GARAGE LIABILITY AUTO ONLY EA ACCIDENT <br />  ANY AUTO OTHER THAN EAACC <br /> AUTO ONLY: <br /> I A~ i <br /> <br /> EXCESS / UMBERELLA LIABILITY EACH OCCURRENCE <br /> I OCCUR [] CLAIMSMADE AGGREGATE <br /> DEDUCTIBLE $ <br /> RETENTION $ <br /> WORKERS COMPENSATION AND 1705264-02 OCT 31 02 OCT 31 03 I TORy LIMITS I I O~IER <br /> EMPLOYERS' LIABILITY <br />B ANy PROPRiETO~JPARTNEPJEXECUTIVE E.L EACH ACCIDENT ..... 1,000,000 <br /> OTHER: <br /> <br />DESCRIPTION OF OPERATIONSILOCATIONIVEHICLESIEXCLUSIONS ADDED ENDORSEMENT/SPECIAL PROVISIONS <br />'16 DAY NOTICE FOR NON PAYMENT OR NON REPORTING OF PAYROLL* <br />CITY OF SANTA ANA, ITS OFFICERS, AGENTS & EMPLOYEES ARE NAMED AS ADDITIONAL INSUREDS PER ENDORSEMENT ATrACHED. <br /> <br /> CERTIFICATE HOLDER SURED; INSURER LETTER: __ <br /> <br />SANTA ANA REGIONAL TRANSPORTATION CENTER <br />1000 E. SANTA ANA BLVD. #300 <br />SANTA ANA, CA 92701 <br /> <br /> CANCEL[ ATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />--XPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ~ TO MAIL 30 <br />3AYE WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, B~ <br /> <br />~UTHORIZED REPRESENTATIVE <br /> <br />Attention: CAROLYN FULLERTON <br /> <br /> ACORD 25 (2001/08) Certificate # 9789 <br /> <br />John Baccarella 0371933 <br /> <br /> <br />