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<br />Da~e' 1/2V2004 Time, 9,02 AM Tol
<br />
<br />@ 17146475421
<br />
<br />1-510-452-2193
<br />
<br />paq., 002-003
<br />
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<br />ArnRn, CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DD/YY)
<br /> 01/21/04
<br />I'RODVCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br />Dealey, Renton & Associales ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />P. O. Box 10550 HOWER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br /> ALTER THE COVERAGE AFf'ORDED BY THE POLICIES BELOW.
<br />Sanla Ana, CA 92711-0550
<br />714427-6810 INSURERS AFFORDING COVERAGE
<br />""'RED 11/. /1003 - /31p INSURER A. UnRed Slal.s Fidelity & Guaranty
<br /> Basilio Assoclales, Inc. /J- ¡)J)O¡).- 143 1",'lRER B SI. Paul Fire & Msrlne Ins. Co.
<br /> 71 Sioney Polnle INSUReR c. Security Ins. Co. of Hartford
<br /> Laguna Nlguel, CA 92677 N - dOOJ - I g,;¡... 1N"'eKD'
<br /> INSUReRE.
<br />
<br />COVERAGES
<br />DIE POLICIES Of INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR DIE POLICY PERIOD INDICATED, NOTWIDISTANDIN
<br />~~ ~~~~~~~j~~ I:~\N~ ~?~O~E~N Bo.: = pgf~~E~~ii:E~E~I~~N:UB';;i~ ~S~i" rii'E ~~. :'ri~:;'~;I~ c~¿d:~~~o~E~Ug,
<br />POLIGES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
<br />
<br />NSR
<br />T
<br />
<br />TYPED"N'VRANCE
<br />
<br />POLICY NUMBER
<br />
<br />pOLICY EFFECTIVE POLICY EXPIRATION
<br />I '
<br />
<br />LIMITS
<br />
<br />A -"'.'ERAL LIABILITY BK01473871
<br />X. ",,'t"""-L'CCNBRALLIABILITY
<br />- ---1 CLAIMS MAD' [XI OXDR
<br />
<br />09/13/03
<br />
<br />09/13/04
<br />
<br />e'CH OCCURR'NŒ
<br />
<br />'1000000
<br />$ 300 000
<br />$10 000
<br />$1 000 000
<br />$2000000
<br />'2000000
<br />
<br />""DAMAGe","!"","",
<br />MEDeXP(""IO"'~'~")
<br />,eR""AL & ADV I,"VRY
<br />
<br />4~~~;~'n ~:g 7'l ~,e;
<br />
<br />A ~OMOBILE LIABILITY
<br />- ,NY AU"',
<br />- ACLo,v,eDA'lTOS
<br />- S'Ime""'DAUT,,"
<br />lL H"", AUT,C"
<br />lL N'C,",,)WNWA'lTOS
<br />
<br />GENe",L AGGReGATE
<br />PRODUcrS ,GOMP/DCAGG
<br />
<br />BK01473871
<br />
<br />09/13/03
<br />
<br />09/13/04
<br />
<br />,Y,MBINED "NOLE LIMn
<br />""""'""')
<br />
<br />$1,000,000
<br />
<br />BODILY INJURY
<br />(f"~",,",
<br />
<br />B,)DIIXINJIJRY
<br />(1'., ."""",
<br />
<br />,"')PERTY DAMAGE
<br />(f",".,~oI,
<br />
<br />"'l":,GE LlA, 8I,L. ITY
<br />-1' NY AU'I ,-
<br />
<br />AUTOONLYMACOIDENT ,
<br />
<br />eTHBR THAN
<br />AUTO ON(X.
<br />
<br />"'AGC ,
<br />
<br />AGO'
<br />
<br />~E"'LlA8ILlTY
<br />~ 'Coo""" 0 GLAIMSMAD'
<br />
<br />ÎL'W,""'BLB
<br />I R,,"NncoN ,
<br />B WORKERS COMPENSATION AND
<br />B EMPLOYERS' LIABILITY
<br />
<br />MGH OXURRENCB
<br />AGO""ATE
<br />
<br />WVA7734752
<br />
<br />11/13/03
<br />
<br />11/13/04
<br />
<br />X ~G"An'-
<br />EL "A"H ACGlDeNT
<br />
<br />ç~~
<br />
<br />11 000 000
<br />
<br />C OTHER Professional
<br />lability
<br />
<br />SAE0232768
<br />
<br />09/13/03
<br />
<br />09/13/04
<br />
<br />',L,DISEASE ,EAEMPLOYeE ,1 000000
<br />ELOISEASEPCOLICYLlMIT $1000000
<br />$1,000,000 per claim
<br />$1,000,000 ann I aggr.
<br />
<br />"ESCRlmON C< OPERATIONS/LOCATION~YEHICLES¡EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
<br />City of Sanla Ana, Ra officers, agenls, volunteers and representatIves
<br />are named ss an addRlonallnsured ss respects general liability for claims ,-,(521,-, / ,{ 0 ~, '
<br />arising from the operations olthe named Insured. ~c;:::l~" (
<br />
<br />¡/f2-
<br />
<br />CERTIFICATE HOLDER
<br />
<br />1 ADOITIONAL~SURED'INSURERLETIE"
<br />
<br />CANCELLATION
<br />
<br />City of Santa Ana
<br />Marlo Ghlzzl;Bulldlng Malnlenance Division
<br />20 Civic Center Plaza, M-11
<br />Santa Ana, CA 92702
<br />
<br />SHOUWANYQPTHEABOYEDESCRlBE" POLICIES BECANCELLED BEPORETHEEXPIRATION
<br />DATETHEREC<, THE ""UING ""RER WILL"-MAI<.'!O.-DAYSWRJl'rEN
<br />
<br />NanCETOTHE CERI"'I'~rE HOLDERNAMEOTOTHELB>1', R
<br />
<br />ACORD 25-S (7/97) 1
<br />
<br />of 1
<br />
<br />#S98124;11/198123
<br />
<br />A,,"~Z~"REPI<ESENTAT(v'
<br />T flAM1\'- a.. -)f~
<br />MAF
<br />
<br />@ ACORD CORPORATION 1988
<br />
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