CENTENNIAL HERITAGE MUSEUM 1-2003

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. CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) ACORD. OP IDl~ 03/12/04 CENTE01 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Barlocker Ins. - Laguna Hills HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 23332 Mill Creek Dr. Suite 105 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Laguna Hills CA 92653 Phone: 949-461-3640 Fax: 949-461-3644 INSURERS AFFORDING COVERAGE NAIC# INSURED A- d-.OO3 ~ tJ7f-1Z- f 5(P INSURER A' Hartford Casualtv Ins. Co. 29424 -- INSURER B, Centennial Heritage Museum INSURER C, 3101 West Harvard INSURER 0, Santa Ana CA 92705 INSURER E, COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUIREMENT. TERM OR CONDITION OF IWY CONTRACT OR OTHER OOCUMENTWITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. '~~~ ~s':ó! TYPE OF INSURANCE POLICY NUMBER DATEMMIDDiYY DATE M UMITS ~NERAL LIABIUTY EACH OCCURRENCE S 1 000,000 A X ~ OMERCIAL GENERAL LIABILITY 57SBAAV8856 03/15/04 03/15/05 PREMISES E. """"""') s100,000 I--- CLAIMS MADE ŒJ OCCUR MEDEXP¡"""",," ""on) s 10,000 I--- PERSONAL' ADV INJURY S 1,000 000 I--- GENERAL AGGREGATE s2 000,000 ñ.~ AGG~EñE ~~ APñS PER. PRODUCTS. COMP/OP AGG S 2,000,000 POLICY JECT LOC IEmn- Ben. 1 000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT I--- S 1,000,000 A ANY AUTO 57SBAAV8856 03/15/04 03/15/05 (E. "d'M') I--- I--- ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS ¡Per....on) $ I--- e-!- HIRED AUTOS BODILY INJURY ~ NON-OWNED AUTOS (P"""'M') $ PROPERTY DAMAGE S (Per 'Od'M') GARAGE LIABIUTY AUTO ONLY. EA ACCIDENT $ ==1 ANY AUTO OTHER THAN EAACC $ AUTO ONLY, AGG $ 5~SSlUMBRELLA LIABILITY EACH OCCURRENCE S 1 00O-r000 A X X OCCUR 0 CLAIMS MADE 57SBAAV8856 03/15/04 03/15/05 AGGREGATE sl,OOO,OOO $ ~ ~EDUCTIBLE S X RETENTION $10 000 ~, ;./r","'.l' S WORKERS COMPENSATION AND ~u '~:- '/h ITö',\'v"t',:":i'š I ¡UJ.. EMPLOYERS' L,.BIUTY IWY PROPRIETDRIPARTNERÆXECUTIVE E.L. EACH ACC'DENT S OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ g~Mr~v'r"s,tNS b~"" !(¡'-~' L~aSÚr.[ S',C' 1':;---- E.L.DlSEASE-POLICYLIMIT $ OTHER ASJ¡,\6lll CilY .'-ll H"CY - DESCRIPTION OF OPERATIONS' LOCATIONS 'VEHICLES' EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS City of Santa Ana is named as additional insured with respects to claims arising out of the operation and uses preformed by or on behalf of the named insure, such insurance as is afforded by this policy is primary and not additional to or contributing with any other insurance carried by or for the benefit of the additional insured. 10 day notice for non-payment of premium . CITYOFS CANCELLATION SHOULD IWY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL _MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. /iIIi ~ ~ Ø1#IPN fj ~*-tJU"~ ~ AUTHORIZED REPRESENTATIVE CERTIFICATE HOLDER City of Santa Ana Community Development Agency, M-25 P.O. Box 1988 Santa Ana CA 92702 Kell Peterson @ ACORD CORPORATION 1988 }tty ACORD 25 (2001/08)