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Client: 2791 <br />COMPl1LMGM <br />ACORD <br />CERTIFICATE OF LIABI DnrrYl <br />° <br />LITY INSURANCE <br />,M 0 <br />2,09/~ <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />John Burnham Insurance Svcs 21 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />2415 Cam us Drive, Suite 200 <br />P HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Irvine, CA 92612 <br />949833-2462 INSURERS AFFORDING COVERAGE NAIC# <br />INSURED INSURER A: SL PBUI Flre and Marine Ins. (.0. 24707 <br />Compulink Management Center INSURER B: <br />Attn: Jack Adams 3545 Long Beach INSURER c: <br />Blvd.#110 <br />INSURER D: <br />Long Beach, CA 90807 <br />INSURER E: <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT W ITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAV HAVE BEEN REDUCED BY PAID CLAIMS. <br /> POLICY EFFEC POLICY E%PIRATION <br />LTR N8 TYPE OF INSURANCE POLICY NUMBER T LIMITB <br />A GENERAL LIABILITY TE06100575 01/06/04 OIIOO/OS EACH OCCURRENCE $1 OOO OOO <br /> X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $2SO OOO <br /> CLAIMS MADE OCCUR MED EXP(Any one parson) $10000 <br /> PERSONAL & ADV INJURY $1 OOO OOO <br /> GENERAL AGGREGATE $2 OOO OOO <br /> GEN'LAGGREGATE LIMITAPPLIES PER: PRODUCTS-COMPIOP AGG $2000000 <br /> POLICY PRG LOL <br /> AUT OMOBILE LIABILRY <br />COMBINED SINGLE LIMIT <br />$ <br /> ANY AUTO (Ea eMtlenn <br /> ALL OWNED AUTOS <br />BODILY INJURY <br /> <br />SCHEDULED AUTOS <br />(Per parwn) $ <br /> HIRED AUTOS BODILY INJURY <br />$ <br /> NON-OWNED AUTOS (Per accitlenl) <br /> PROPERTY DAMAGE <br /> <br />itl $ <br /> enQ <br />(Par ecc <br /> GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ <br /> ANYAUTO OTHER THAN EA ACC $ <br /> ~ AUTO ONLY: AGG $ <br /> EXCESSNMBRELLA LIABILITY ~~ <br />~ ° EACH OCCURRENCE $ <br /> . <br /> OCCUR CLAIMS MADE ~ , AGGREGATE $ <br /> <br /> $ <br /> DEDUCTIBLE $ <br /> RETENTION $ $ <br /> WORKERS COMPENSATgN AND WC STAN- OTH- <br /> EMPLOYERS' LIABILITY <br /> Y PROPRIETOR <br />ERIEXECUTIVE E. L. EACH ACCIDENT $ <br /> AN <br />rPARTN <br />OFFICER/MEMBER EXCLUDED? E. L. DISEABE-EA EMPLOYEE $ <br /> Ily9A tlescribe antler <br /> SPECIAL PROVISIONS bebw E.L. DISEABE-POLICY LIMIT $ <br /> OTHER <br />DESCRIPTION OF OPERATKINS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROW SgNB <br />Cert holder is additional insured as per attached wording from policy form <br />City of Santa Ana <br />Attn: Pat Healy, M/SM-30 <br />20 Civic Center Plaza <br />Sanfa Ana, CA 92701 <br />IY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />EOF, THE 188UIN0INSURER WILL ENDEAVOR TO MAIL ~_ DAYS WRITTEN <br />THE CERTIFICATE HOLDER NAMED M THE LEFT, BUT FAILURE TO 00 SO SHALL <br />OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AOENTS OR <br />eCnan 05 l7n01/Ml • _ea ASaa4COA r o a Annon T•n RDn CnT'InN SOAR <br />~- <br />