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<br />C(TMPIII MCM <br />1A1B11M'F. LI iI ~~ -- -- <br />AC~ n ,CEFYTIFICATE OF LIABILITY INSURANCE o; o~, $""Y"'' <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />UnionBanc Insurance Svcs, Inc. A "~D OS - / ~ Z <br />~ - X04 - ~~~ ~ ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />2415 Campus Drive, Suite 200 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Irvine, CA 92612-8530 13 ' ~~O 1 - ~l5 <br />949 833-2462 P - a~ 3 -,x,.23 INSURERS AFFORDING COVERAGE NAIC # <br />INSUam INSURER A: OneBeacon Insurance Company 21970 <br />Compulink Management Center INSURER B: <br />Accu-Flex, Inc. & Laserfiche INSURER C: <br />3545 Long Beach Blvd #110 INSURER D: <br />Long Beach, CA 90807 INSURERS <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW NAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED 8V THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> TI EY E <br />F <br />F <br />ECTIVE <br />P <br />O E ~IRATION <br />Pp <br />~ LW~ <br />LTR NSR <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />MM <br />I <br />O <br />D <br />A <br />A <br />M <br />/{ GENERAL LIABILITY 711010331 D1lDS/BB D1lD$/B9 EACH OCCURRENCE E7 OOB BBD <br /> DAMAGE TO RENTED B <br /> X COMMERCVLLGENERALLIABILITY E7 BBB.DD <br /> CLAIMS MADE ~ OCCUR MED E%P (Anyone person) $1D DDB <br /> PERSONAL BADV INJURY E1 DDB DDD <br /> GENERAL AGGREGATE s2 000 000 <br /> GEN'L AGGREGATE LIMB APPLIES PER: PRODUCTS-COMP/OP AGG E2 DDD BBB <br /> POLICY JET LOC <br />A AUT OMOBILE LUIBILITY 711010331 B1/Otll08 B7lDBlD9 COMBINED SINGLE LIMIT <br />$1 <br />DDD <br />DDD <br /> X ANV AUTO (Ee ecdtlanl) , <br />, <br /> <br /> ALL OWNED AUTDS BODILY INJURY <br />$ <br /> (Per perean) <br /> SCHEDULED AUTOS <br /> <br /> X HIRED AUTOS BODILY INJURY S <br /> X NON-0WNED AUTOS (Par ar~tlenl) <br /> <br /> PROPERTY DAMAGE E <br /> (Per acdtlenl) <br /> GARAGE LIABILffY AUTO ONLY-EAACCIDENT S <br /> <br /> ANY AUTO OTHER THAN EA ACC S <br /> AUTO ONLY: AGG E <br />A EXCESSNMBRELLA LIABILITY 711010331 B1lD8/BB D7lD8lB9 EACH OCCURRENCE $S BBD DBD <br /> X OCCUR ~ CLAIMS MADE AGGREGATE $S BDD DBB <br /> <br /> <br /> DmUCTIBLE _ S <br /> <br /> X RETENTION E1BD <br />D <br />D S <br />A _ <br />_ <br />_ <br />WORKERS COMPENSATION AHD _ <br />4DtID2DB72 12!27!0] 12/27!88 ~( WC 3TATU- OTIF <br /> ENPLOYERS'DABILITY EL EACH ACCIDENT $1,888,888 <br /> ANY PROPRIETORrPARTNER/E%ECUTIVE <br />OFFICERIMEMBER EXCLUDEDT <br />EL.DISEASE-EA EMPLOYEE <br />E1,BDD,DDB <br /> If yas, tlesaibe un0er DISEASE-POLICY LIMIT <br />E <br />L DDD <br />DBB <br />E1 <br /> SPECIAL PROVISIONS below . <br />. , <br />, <br /> <br /> OTHER <br />DESCRIPTION OF OPERAIN)NS I LOCATONS! VEHICLES f EXCLUSIONS ADDED BY ENDORSEMENT / SPECAL PROVISIONS : ~ = ,~ xi <br /> <br />. <br />Certificate Holder is additional insured as respects to general liability, - ~ '.... <br />i <br />~J ' <br />y~„ . , : f%:.~,r <br />as required by written contract per attached wording from policy form <br />"_~~``^ <br />VCG205 0205 attached. ;.%-~p~Q <br /> <br />City of Santa Ana <br />Attn: Pat Healy, MlSM30 <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 <br />LD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE EXPIRATION <br />THEREOF,THE ISSUING INSURER PALL ENDEAVOR TO NAIL ~D_ DAYS wRffTEN <br />E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 SO SHALL <br />iE NO OBLIGATKXY OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />ACORD 25 (2001/081q Gf2 #M4252$5 MASUA W AVVRV VVRfVIV1rIVR IC'ea <br />