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<br />Da~e, 1/2V2004 Time, 9,02 AM To,
<br />
<br />@ 17146475421
<br />
<br />1-510-452'2193
<br />
<br />Paoe, 002-003
<br />
<br /> -.. -"'.ftft.A ,An.A
<br />ArnRD CERTIFICATE OF LIABILITY INSURANCE '1 DATE (MM/DD/n¡
<br />01/21/04
<br />PRODUCER TIllS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br />Dealey, Renton & Aaaoelates ONLY AND CONFERS NO RIGHTS UPON TIlE CERTIFICATE
<br />P. O. Box 10550 HOLDER. TIllS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br /> AL:rER THE COYERAGE An'ORDED BY THE POUCIES BEWW.
<br />Santa Ana, CA 92711-0550
<br />714427-6810 INSURERS AFFORDING COYERAGE
<br />INSURED A/'Áooj-13/P INSUNSR A. Unned States Fidelity & Guaranty
<br /> Basilio Associates, Inc. ,v-J.JJD';'- /43 INSURERS. SI. Paul Fire & Marine Ins. Co.
<br /> 71 Stoney Polnte I"VRER c, Security Ins. Co. of Hartford
<br /> Laguna Niguel, CA 92677 tV - .){!Ol - I g,;.. INSURBR D,
<br /> 'NSIINSR E
<br />
<br />COVERAGEs
<br />
<br />TIIE POUGES Of INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR TIIEPOLlcY PERIOD INDICATED NOT\VITIISTANDIN
<br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTIIER DOCUMENT WITII RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED 0
<br />MAY PERTAIN, TIIE INSURANCE AFFORDED BY THE POUGES DESCRIBED HEREIN IS SUBJECT TO ALL TIIE TERMS, EXCLUSIONS AND CONDmONS OF SU
<br />roums. AGGREGATE LIMITS SHO,,", MAY HAVE BEEN REDUCED BY PAID CLAIMS
<br />
<br />&~ TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLlii' EXPIRATION
<br />
<br />A OE"R'L LIABILITY
<br />
<br />BK01473871
<br />
<br />09113/03
<br />
<br />09113/04
<br />
<br />EACH OCCURRENCE
<br />
<br />$1 000000
<br />'300 000
<br />,fOOOO
<br />'1 000 000
<br />$2000000
<br />,2000000
<br />
<br />
<br />"NS DAMAGE (My 'uP '<oj
<br />
<br />MEDEX'(M "'",,"u)
<br />
<br />PER"ON^, & ADV INJVRY
<br />
<br />GENERAL AGGREGATe
<br />
<br />PRODU('fS .COMPiOPAGG
<br />
<br />A Aè~OMOBILE LIABILITY
<br />
<br />BK01473871
<br />
<br />09113(03
<br />
<br />09113/04
<br />
<br />OCMEINED SINGLE LlM'T
<br />(11""ldom)
<br />
<br />'1,000,000
<br />
<br />ALL ",WNED AUTe<;
<br />
<br />BODILY "]')RY
<br />~"W,ocj
<br />
<br />s,:!mDULED AUTOS
<br />X H'ERr'A"T,-,S
<br />X N,C'NC'WNEDAUF'S
<br />
<br />K,D"_Y INJURY
<br />~,,=i...rn)
<br />
<br />PROPERTY DAMAGB
<br />~'mi"'ct,
<br />
<br />
<br />AVTOONLYEAACCIDßNT ,
<br />
<br />('fHER THAN
<br />AUTO ,ONLY
<br />
<br />EA Ace $
<br />
<br />ADD'
<br />
<br />eACH oJXURRßNCE
<br />
<br />B WORKERS COMPENEATION AND
<br />B EMPLOYERS'LlABILITY
<br />
<br />WVA7734752
<br />
<br />11113(03
<br />
<br />11113/04
<br />
<br />
<br />11 000 000
<br />
<br />EL EACH AC':IDENT
<br />
<br />C arHER Professional
<br />lability
<br />
<br />SAE0232768
<br />
<br />09113(03
<br />
<br />09113/04
<br />
<br />E.LDISEA"'EAEMPLOYEE.1000ooo
<br />B.L.OISEA'" -PULlCYLIMIT ,1000000
<br />$1,000,000 per claim
<br />$1,000,000 annl aggr.
<br />
<br />DESCRWrlON OF OPERATIONS/LOCATIONE/VEHlCLE~EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
<br />City of Santa Ana, Ka officers, agents, volunteers and representatives
<br />are named as an addnlonallnaured as respects general liability for claims ,~' ^ "J, ,,' , -' ,,'
<br />arising from the operations of the named Insured. / c:;:://' ~
<br />
<br />;/62-
<br />
<br />CERTIFICATE HOWER
<br />
<br />ADDITOONALINSURED"'SURERLETIERo
<br />
<br />CANCELlATION
<br />
<br />City of Santa Ana
<br />Marlo Ghlzzl;Bulldlng Maintenance Olvlalon
<br />20 Civic Center Plaza, M-11
<br />Santa Ana, CA 92702
<br />
<br />SHOl'LD ANYOFTHEABOVE DESCRIBED POLICŒS BE CANCELLED BEFORETIiE EXPIRATION
<br />DATE THEREOP, THE ISSUING INSURER WILL""""""",MAlI.'IIL-DAYSWRmEN
<br />
<br />NOTICE TOTHE CERTI"CAI'R HOLDERNAMW'1DTHE LE"'-, B
<br />
<br />ACORD 25.S (7/91) 1
<br />
<br />of1
<br />
<br />#S98124(M98123
<br />
<br />
<br />MAF
<br />
<br />@ ACORD CORPORAll0N 1988
<br />
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