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<br />" <br /> <br />A.ÇJ2.ß/),. <br /> <br />CERTIFICATE OF <br /> <br />LIABILITY <br /> <br />DATE /MMIODIYYI <br />]/04/04 <br />THIS CERTIFICATE IS ISSUED AS A MATTER DF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />COMPANIES AFFORDING COVERAGE <br /> <br />INSURANCE <br /> <br />PRODUCER <br /> <br />AI.ndsls Insursncs-6lsnd. <br />750 Fsi rmont hsnus <br />P.0.80.831 <br />Glsnd.lo CA 91209-0831 <br />18181 244-1144 <br />INsURED <br /> <br />COMPANY <br />A <br /> <br />Hortford Fin Insunnco Co. <br /> <br />Ph..nl. Group Infor.otlon 5ys. <br />369 Yon Noss W.y. .730 <br />Tornnco, CA 10501 <br /> <br />A. - ;?IJo4 - 011 <br /> <br />COMPANY <br />B <br /> <br />HArtford Cosu.lt Ins. Co. <br /> <br />CO""ANY <br />C <br /> <br />COMPANY <br />D <br />¡;øvm:t¡¡!I!!i,.,.....'...'..'...'........?~;i;?+";§?;?ww.;\fiWF"tifMiW:¡i\;'..rnnWiU@¡rm¡¡¡¡r:L'iiMIl...iP'¡w,.""""'.....,.. ."'" .... ......'" '.. <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED, NO TWITHST ANDING ANY REQUIREMENT, TERMOR CONDITIONOF ANY CONTRACT OR OTHER DOCUMENTWITH RESPECT TO WHICHTHIS <br />CERTIFICATE MAYBE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />~ TYPE OF INaURANCE POUCYNUMaER P:~':~~=~ P~¡~=~~ <br /> <br />LIMlTa <br /> <br />A OENERAL UAaLlTY <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE GJ OCCUR <br />OWNER'S . CONTRACTOR'S PROT <br /> <br />7258U82635 <br /> <br />10/01103 <br /> <br />10/01104 <br /> <br />GENERAL AGOREGATE S <br />PRODUCTS.CO..../OP AGG S <br />PERSONAL' ADV INJURY S <br />EACH OCCURRENCE S <br />FIRE DAMAGE (Anyon, II,,) S <br />'-ED EXP (Anyone p",on) S <br /> <br />2,000,000 <br />2,000,000 <br />1.000.000 <br />1,000.000 <br />300,000 <br />5 000 <br /> <br />AUTOMDBU LIABLITY <br />ANY AUTO <br />ALC OWNED AUTOS <br />SCHEDULED AUTOS <br /> <br />7258U82835 <br /> <br />10/01103 <br /> <br />10/01104 <br /> <br />COMBINED SINGLE LIMIT <br /> <br />2,000,000 <br /> <br />BODILY INJURY <br />(Po, p",on) <br /> <br />X HIRED AUTOS <br />X NON.OWNED AUTOS <br /> <br />BCDIL Y INJURY <br />(P" ."Ident) <br /> <br />PROPERTY DAMAGE <br /> <br /> <br /> <br />II- <br /> <br />UMeRELCA FORM <br /> <br />OTHER THAN UMBRELLA FORM <br /> <br />8 WORKERa ODMPEN'ATION AND <br />EMPLDYERa' LlAaLJTY <br /> <br />721£CKG3983 <br /> <br />10/01103 <br /> <br />10/01104 <br /> <br />AUTO ONi. Y . EA ACCIDENT S <br />OTHER THAN AUTO ONi. Y, <br />EACH ACCIDENT S <br />AGGREGATE S <br />EACH OCCURRENCE S <br />AG""EGATE S <br />S <br />OTH- <br /> <br />C STATl!- <br />Y <br />R EACH ACCIDENT S <br />R DIS"AS".POLICY CIMIT I <br />R DIS"ASE.EA EMPCOYEE S <br /> <br />I,OOO,ODO <br />1,000,000 <br />1.000.000 <br /> <br />THE PROPRIETOR/ <br />PARTNERS/EXECUTIVE <br />OFFICERS AR", <br />DTHER <br /> <br />INCC <br />EXCC <br /> <br />Commsrcl.1 Crlm. Policy <br /> <br />6497223 <br /> <br />11/18/03 <br /> <br />11/16/04 <br /> <br />$975,000 Limit par Occurnnc. <br />$25,000 Ooductlbl. <br /> <br />..BOIIiPTION DFDPER TlDN"'DOATIONa H IlIPEOIAL Ma It la 'Irood th.t tho City of Santa Au Is n..d Additional <br />Insurod w/rOIArd to &8nonl Liability co.srsgos .nd par tho ottachsd Addltlon.1 Insund Sndor....snt. <br /> <br />tlmœØiìIiHØIiØíiWI;mrr;iHWWq;;¡P¡; <br /> <br />¡r;¡¡TiH¡¡tm«fí¡¡¡¡¡Dtw, '... ....'" .." <br /> <br />""""w' <br /> <br />....... <br /> <br />... <br /> <br />City of Sonta An. <br />Attantlon: L.un Sh.ddy <br />20 CI.lc C.ntar PI... <br />Sonta An., CA 12701 <br /> <br />aHO"" ANY DF THE ABOVE D!SOII18ED POLIO,"B BE OANCELLED BEFORE THE <br />EXPIRATION DATE THEIIEOF, THE ..aUINO CDMPANY wu. ENDEAYDR TD MAL <br />30 DAYB WIIITTIN NOTICETD THE OEIITIFIOATEHDCDER NAMED TD THE LDT, <br />BUT FALUIIE TO MAL 'UCH NOTICI! aHAU. "PoaE NO OBLIOATION DR LIABLITY <br />DF ANY k"O UPDN T. !TO AOENTB DR REPAElENTATIVES. <br />AUTHDR P B..TATI <br /> <br /> <br />Ht~~eðfiíii¡iæit¡bN¡i.i : <br />/"UJ.., <br />