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<br />CERTIFICATE NO. <br /> <br />ISSUE DATE (MMIDDIYY) <br /> <br />----.- I <br />CPEIA-GL2-132 CERTIFICATE OF COVERAGE 07/19/05 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS <br />CSAC Excess UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR ALTER <br /> THE COVERAGE AFFORDED BELOW. <br />Insurance Authority <br />CIO DRIVER ALLIANT INSURANCE SERVICES, INC. <br />P.O. BOX 6450 COVERAGE <br />NEWPORT BEACH, CA 92658-6450 AFFORDED BY A - CSAC Excess Insurance Authority <br />LICENSE #OC36B61 <br />PHONE (949) 756-0271/ FAX (949) 756-2713 COVERAGE B <br /> AFFORDED BY - <br />CPEIA MEMBER: A- i'lSi -0'10 COVERAGE <br />BIG INDEPENDENT CITIES EXCESS POOL (BICEP) AFFORDED BY C - <br />AND ITS MEMBERS CITY OF SANTA ANA <br />ATTN: ROSA FLORES COVERAGE 0 <br /> AFFORDED BY - <br />20 CIVIC CENTER PLAZA, M-28, BOX 1988 <br />SANTA ANA, CA 92702-1988 COVERAGE E <br /> AFFORDED BY - <br />Coverages <br /> THIS IS TO CERT!FY THAT THE MEMORANDUMS OF COVERAGE LISTED BE~OW HAVE BEEN ISSUED TO THE MEMBER NAMED <br /> ABOVE FOR THE PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR <br /> OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN. THE COVERAGE AFFORDED <br /> BY THE MEMORANDUMS DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDITIONS OF SUCH <br /> MEMORANDUMS. <br />CO TYPE OF COVERAGE MEMORANDUM COVERAGE EFFECTIVE COVERAGE EXPIRATION LIABILITY LIMITS <br />LTR NUMBER DATE (MM/DDIYY) DATE (MMIDDIYY) <br /> ~ Excess General Liability Member: Each Occurrence <br />A Excess Auto Liability CPEIA-03-GL2-17 07/01/05 07/01/16 Self-Insured <br />129 Excess Errors & Omissions Master: Retention $2.000,000 <br /> EIA-03-GL2-00 <br /> OTHER <br /> Al <br />Description of Operations/LocationsNehicles/Speclalltems: <br />AS RESPECTS LICENSE AGREEMENT FOR USE OF PREMISES. <br />THE UNITED STATES OF AMERICA (DEPARTMENT OF THE NAVY) AND THE U. S. MARINE CORPS ARE ADDED AS ADDITIONAL <br />INSUREDS IN OPERATIONS OF THE POLICY HOLDER AT OR FORM THE PREMISES LICENSED FROM THE UNITED STATES. <br /> APPROVU) i {) ~ e, <br /> it/i.. '/ r //z_ - ... <br /> - <br /> , ..' ~,; ;~~Uation <br />Certificate Holder ~ 'tH'! \lll <br /> ,~c. ,. I SH91,J1.p ANY OF THE ABOVE DESCRIBED MEMORANDUMS BE CANCELLED BEFORE THE <br /> i'<..\)I"l,-if1!( ; ~ "EXPIRATlC)N DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITIEN <br />COMMANDING GENERAL NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO MAll SUCH NOTICE <br /> , SHAll IMPOSE NO OBUGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR <br />MARINE CORPS BASE REPRESENTATIVES <br /> AUTHORIZED REPRESENTATIVE <br />CAMP PENDLETON, CA 92099 ~~-~- <br /> C -=> <br /> CSAC . EXCESS INSURANCE AUTHORITY <br />