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<br />07/15/2004
<br />
<br />08:26
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<br />4
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<br />PAGE
<br />
<br />01
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<br />
<br />
<br />PETTY BURTON ASSOCIATES,
<br />
<br />INC.
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<br />ij'i"'~-:;-" O¡ i1':¡õi'i . . . ':.~
<br />.. .~~ DAR (IIIIWDiYYI t
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<br />T"IS CERTIfICATE IS ISSUED AS A IIATT£R OF INFORMATION
<br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />HOLDER. THIS CEAT1F1CATE DOES NOT AMEND, EXTEND OR
<br />ALTER THE COVERAGE AFFORDED BY THE PDUCIES BELOW.
<br />COMPANIES AFFORPING COVERAGE
<br />
<br />PAOIIIJØ¡II
<br />
<br />.~,
<br />
<br />350 WEST PASSAIC STREET
<br />ROCHELLE PARK, NJ 07662
<br />
<br />CQMPNoiY
<br />A
<br />
<br />US FIDELITY AND GTJARANTY:CO
<br />
<br />IN9IfflW
<br />
<br />LZA TECHNOLOGY
<br />
<br />N.-dOö4-o01
<br />
<br />COMI"ANV
<br />8
<br />
<br />FIDELITY AND GUARANTY INS CO
<br />
<br />15892 SOUTH PASADENA AVE #200
<br />TUSTIN, CA 92780
<br />
<br />COMI"ANY
<br />C
<br />
<br />ST PAUL FIRE & MARINE
<br />
<br />COUPANV
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<br />
<br />THIS IS TO CERTIFY THAT THE POUcaE.s OF INSURANCE LISTED BELOW HAVe BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLJGY, p~ i IOD
<br />INDICATED, NOTWfTH6T^NbINQ AtoN REQUIREMENT, TEAM OA CONDmON OF AHf CONTRACT OR OTHEA DOCUMENT wm! RESPECT TO WHICH THIS
<br />CERTIFICATE MAY DE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POUOIES DESCRIØEP "'fiRIFIN IS SUBJECT TO ALL THE' TERMS,
<br />EXCLUSIONS AND CONDITIONS OF sum.. POLICIES. LIMITS SIoIOWN MAY HAVE BEEN REDUCED BV PAID CLAIMS.
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<br />GENERAL LIAJIUTY
<br />X <;(;IMMliinO!N. ø~N~M¡' U,""U"ITV
<br />OVJIoÆS MADS [K] OCCUR
<br />OWJ\lIffi'! & CONTRACTOR'S PAOT
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<br />BK01440174
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<br />9 01/03
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<br />9 01 04
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<br />eeNEfW. AßGREßATE .2 , 0 Q,O 000
<br />PftODL1CT$ - ÇQMPfOP ^'IQ .2 , 0 OiO 0 0 Q
<br />ÆRSONAL. I NN INJURY' 1, 0010 0 0 0
<br />EACH OCCURRENCE Ü , 000 000
<br />FlRIi DAMAG¡¡ [My - arw) ,1, 00 0 0 0 0
<br />MI!Ð EXP IAnJ' ..... p8I1IOII) I 1 0 , 0 0 0
<br />1,000,000
<br />COM6INED 6INOLE UI'IIT I
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<br />AUTOIlðIl8.E UAIIIUTY
<br />X ANY AUTO
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<br />BA0131B9~2
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<br />AU. OWNED AUT05
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<br />SCHEDULED AUTOS
<br />X HIRED AI.1TM
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<br />X NON-owNI!D AUTOS
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<br />BODILY INJUA't
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<br />QAllACE LWILII'Y
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<br />~MI"M'rY DAUAI;I!:
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<br />AU'I'O ON!. V ' IUt. ACClDgff .
<br />OTHER 'THAN Al1t'O ONlV:
<br />~ ACCIDENT I
<br />^lili~'m $
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<br />EXCESS LWILIJY
<br />UUBR!l.1-' fORM
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<br />OntER THAN UMBREl1.1\ fORM
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<br />WOIIIœRI COftlll!NlATION AND
<br />1!MJIl.( Y£RØ' UA8JTV
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<br />WVA77SSl00
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<br />II Ol O~
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<br />EACH OCCURRENCE
<br />AGGREGATJ;
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<br />'1\111 rAO"!'IIrTOIII
<br />PARnlERSlEXECUTlVEi
<br />OFFICEI\& AR:E'
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<br />X INCI.
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<br />EL Du:~e-poucy UMIT
<br />a DlSEASE.EA, 8JlPlDYEE
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<br />,1,000,000
<br />,1, ODD, 000
<br />11 QaO, 000
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<br />0E8C~ OIl QN!RAl1OQ"-OCA'I1ONSIRIftCa.af.W~"" ITEMS
<br />AS RESPECTS GEN LIABILITY ONLY CITY OF SANTA ANA. ITS OFFICERS, EMPLOYE~S,
<br />AGENTS AND REPRESENTATIVES ARE ADDED AS ADD'L INSUREDS PER THE ATTACHED'
<br />FORM CL BF 21 81.
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<br />8HOULD ANY 01' 'ftC A8OYI! DQCUII!D I"OUCll!S III! CANeEI.LED IIEFpfIE 1N;
<br />CITY OF SANTA ANA ' IDIPlRAnoN DAft. TllERlEOF. 1H& I&5U181O COMPANY WLL ~vo,,,o 11M.
<br />PARKS, RECREATION & COMM. ,SRVC JQ..... DAYliWRlTTUN01IœTO TI1ECl!RTlPlCATI: HO~I"IMþT(ÞTMU.Ð"
<br />8 8 8 W SANTANA ANA BLVD S ~2 0 Ú BUT ..AlLURE TO MAL MIeN NOl1eE SHALL. "POSE NO 08UCA.'IIOJI CIII,'UAIIILIJY
<br />SANTA ANA, CA 927 (ll 01' ANY om UPON 'M! OOMPANY m: AGUI1'S QII REPIlEJjil!II1'A1M:S.
<br />. , AuntOlIIIIID lI......mrlA11V1. ~I} ~ ,..
<br />. "" Linda Burton'- ltt, "JC Ã:..... '
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