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<br />Mar~h ,
<br />
<br />Inc,
<br />
<br />11/8/2004 7:08 PM
<br />
<br />PAGE
<br />
<br />3/004
<br />
<br />Fax Server
<br />
<br />
<br />PRODUCER
<br />Marsh Risk & Insurance Servicea
<br />4695 MacArthur Court. Suite 700
<br />(949) 399-5800
<br />Ucem~e #0437153
<br />Newport Beach, CA 92660
<br />40960-00-00-
<br />
<br />-c. ..:,~.,;,." ",'.'-:.~:. ':.' ,
<br />j~Êr;j:;¡' ~';~~:;;;o~
<br />
<br />THIS CERTIFICATE IS ISSUED AS A MATTER Of INFORMATION ONLY AND COrtFERS
<br />NO RIGHTS UPON THE CERl1fICA1ë HOWER OTHeR THAN TrIOSE PROVIOED IN THE
<br />POucv. THIS CERTlf'CATe 00£8 NOT AlIENO, EXTEND OR ALTER ntE COVERAOE
<br />AFFORDED BY THE POUÇ ES DESCRIBED HEREIN.
<br />
<br />COMPANIES AFFORDING COVERAGE
<br />
<br />ltens, Inc. & Meyer Mohaddes
<br />Associates
<br />1515 S. Manchester Avenue
<br />Anaheim, CA 92802
<br />
<br />/11- :<001-003
<br />
<br />COMPANY
<br />A Hartford Fire Insurance Company
<br />COMPANY
<br />B Hartford CastJatty Insurance Company
<br />
<br />IKSURED
<br />
<br />COMPANY
<br />C Twin Cjty Fire Insurance Company
<br />
<br />COMPANY
<br />D ACE American Insufance Company
<br />(;'()~,. ..' "..:;;'Î1i~'~:$!i~¡¡¡¡'¡~@'¡¡)P¡â¡;.'äiíýi,,~b~~¡¡¡¡¡¡;~Ïj~î¡;(Qr.¡WP¡¡!ÍÖyP¡¡@\i¡'¡¡tédt!~1oW;'1 .
<br />THIS1S TO CERTIFY- THAT POtlCIES--OF INSURANCE -oeSCRlBED HEREIN HAVE BEEN ISSUED TO -THE- INSURED NAMED HEREIN FOR TKE POUCY PERIOD INDICATED.
<br />NOTWITHSTAND!NG MY REQUIREMENT, TERM OR CONDmoN OF ANY CONTRACT OR OTHER DOCUMENT y.¡rrH RESPECT TO 'M-fICH THE CERTIFICATE MAY BE ISSUED OR MAY
<br />PERTAIN, THE INSURANce AFFORDED BY THE POLICIES DESCRIBED HEREIN 18 5UWECT TO ALL THE TERMS. CONDlTlcms AND EXCLUSIONS OF SUCH POLICIES. AGGREGATe
<br />lIMIT~ SH(MTI MAY HAVE l;léEN REDUCED BY PAID CLAIMS.
<br />
<br />CO
<br />LTR
<br />
<br />TYPE OF INSURANCE
<br />
<br />P-OUCY NUMBER
<br />
<br /> POUCY EFFECTIVE POUCV EXPIRAT10N
<br />, DATE IMMlDDIYY) ! OATE (MMfDDNY) i
<br />
<br />UMITS
<br />
<br />A
<br />
<br />GeNERAl. UABlU1Y
<br />X ! COMMFRCIM GF.NERAt llARllITY 72CES0A1989
<br />~ ClAIMS MADE ~ OCCUR
<br />r O\r"mER'S & CONTRACTOR'S PROT I
<br />,
<br />I
<br />
<br />04101/04
<br />
<br />04/01105
<br />
<br />GeNERAL AGGREGATE $
<br />PRODUCTS. COMPlOP AGO $
<br />PERSONAL.s. ADV INJURY $
<br />EACH OCCURREI'ICE $
<br />FIRE DAMAGE QmI f!nÞ $
<br />!MEDEXP 0I"IIiI rson $
<br />
<br />COMBINED SINGLE LIMIT $
<br />
<br />2,000,000
<br />2,000,000
<br />1,000,000
<br />1,000,000
<br />300,000
<br />
<br />I
<br />AUTOMOElLE UAEIIUTY
<br />~
<br />B ¡~~ ANY AUTO
<br />, i All OWNED AUTOS
<br />0 SCHEDULED AUTOS
<br />'x HIR~D AUTOS
<br />X NON.oV'otllED AUTOS
<br />X 1,000 Comp/CoU Ded
<br />
<br />72UUNUM2574
<br />
<br />1,000,000
<br />
<br />04/01/04
<br />
<br />04101105
<br />
<br />BOOll Y INJURY $
<br />¡Per"pøriQl11
<br />aOOIlY INJURY $
<br />(Pørlilccidøol) I
<br />PROPERTY DAMAGE $
<br />
<br />GARAGE UAelUTY
<br />I ~y AUTO
<br />
<br />Exœss UAElUTY
<br />
<br />
<br />IlL
<br />I
<br />I
<br />i
<br />
<br />AUro ONLY. EA ACCIDENT
<br />OTHER THAN AUTO ONLY.
<br />
<br />$
<br />
<br />EACH A ~DENT $
<br />AGGREGATE $
<br />EACH OCCURRENCE $
<br />
<br />UMBRELlA FORM
<br />OTHER THAN UMBRELLA FORM
<br />KERS COMPENSATION AND
<br />EMPI.OVERS' UASlUTY
<br />
<br />"-GGREGATE
<br />
<br />i$
<br />$
<br />
<br />x
<br />
<br />InWEKT 4991
<br />INCL I
<br />! EXCL
<br />
<br />! 04101 104
<br />
<br />04/01105
<br />
<br />
<br />X
<br />
<br />ER
<br />
<br />C
<br />
<br />THE PROPRIETORl
<br />PARTNERSlEXECUTIVE
<br />OFFICERS ARE:
<br />
<br />$
<br />fL DISEASe-POLICYLNIT $
<br />iEL DISEASE-EACH EMPLOYEE $
<br />
<br />1,000,000
<br />1.000,000
<br />
<br />D
<br />
<br />Professional Liability
<br />I Clalms.Made Form
<br />
<br />EONG21656045011
<br />
<br />104/01104
<br />I
<br />
<br />04/01105
<br />
<br />Limit per Occurence 1,000,000
<br />Aggregate 2,000,000
<br />Ded~c:t~bl. ------------- 50,000
<br />
<br />OESCR! PT10N OF OPI.RAnONIILOCAtJONSlVEHlCLaiI8ÆCW..llEYS
<br />City of Santa Ana, its officers, employees, agents, volunteers and representatiVes are included as. additional insured per attached endorsement Exhibit B.
<br />
<br />Re: On-CaUITIS Agreement
<br />
<br />Project#: J04.1703
<br />
<br />
<br />
<br />Santa Ana, City of
<br />Aftn: Zed Kakula
<br />20 Civic Center Plaza, M-30
<br />Santa Ana, CA 92702-1988
<br />
<br />SHOULD ANY Of" THE POLICIES œSCRJBfD I1I::REIN fiE CNOCEU.ED WORE 1)jE EXPIRATION OATE THEREOf,
<br />THe INS\J~EIII AI'I"OR.DINO COVUtAaE WIt.!. EM:lEAVOFl TO MAL --3JJ CAVil WfIITTDf NOTtœ TO THe
<br />
<br />CiRT11'lCAT( HOLœR NAM£;O J.jriREIN. aUT FAILURE TO MAJL SUCI-i NOTICE sw,u. IMPO¡¡¡;¡ 00 OBUGATlCN OR
<br />
<br />UAB-IUTY OF ÞH'( KANO tJÞON THE INS~ AFFOfI:DINO COVEAAOE, ITS AGENT,s OF! ~PREaENTATM:S. OR T~E
<br />ISSUER a: THJ$ CERTIFICATe.
<br />MARSH USA INC.
<br />B'(; Stephen Flynn
<br />
<br />J;tl-+
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