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<br />AUG-17-200d 11:d6 <br /> <br />SPECTRUM RISK MGMT <br /> <br />P.01/0d <br /> <br />k;( <br /> <br />.ACDBD.. 'CERTIFICATE OF LIABILITY INSURANCE I ""'1r.'IIIII_.....'...., , <br /> 01/1712004 <br />ReDUC!R (949)756-5730 FAX (949)756-5740 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />;pectrum Risk Mgmt. & Insurance Services ONLY AND CONFERS NO RIGHTS UPON THE CERnFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />CA Lie. #OC77415 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />18010 Skypark Circle, #140 <br />Irvine, CA 92614 INSURERS AFFORDING COVERAGE NAIC' <br />"UIUlI TSCM Corp. A-~OO3-~ INSURER., Evanston Insurance Co. 35n. <br /> 1&281 Gothard St..Ste.109 INSUReRD, Ameri c:an States Insuranc:e <br /> Huntington Beach, CA 9264& A -~oot- 02.3 INSUReA c: AlCl Grollll <br /> INSUAERe: State CClqIensation Ins. Fund 3507& <br /> INSUReR e: <br />. <br /> TH~ POLICI~S OF INSURANCE LISTED IIELOW HAVE BEEN ISSU6> TO THE INSUl\6> NAhlED ABOVE FOR THI' POLICY PERIOD INDICATED. NOTWITHSTANDINI <br /> ANY REOUlREMENT. TERM OR CONDITION OF ANY CONTRACT OR OlliER DOCUMENT WITH RESPeCT TO WHICH THIS CERTIFICATE idA Y BE ISSUED OR <br /> MA V PERTAIN. niE INSURANCE AFFORDED BY THE POlICIES DESCRUlED HEflElN IS SUBJECT TO AU. TIE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH <br /> POLICIES. AGGReGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID Cv.tMS. <br />'"" T'ItIIE OF INlURANCI! POUCy NUIIBER ""UCf IiFFEC11V! ~~JEZJIRATlc:. UIl111l <br /> G,"I!IW....L..lABlLfl'V 04ClLPI00SZ36 01/01/2004 01/01/Z005 EACH occuAAS.NCE J 1.000 00( <br /> 1-= <br /> X COI.HiRCIAl GENERAL UA9!UTY OAMA.Ge TO RENTED . 50 OO~ <br /> I CL<1M9 MAOE [!] occu~ MED E)(p (Any ClIlI penon) . 5,OO~ <br />A PERIONAL._ INJURY S 1.000 OOC <br /> r- GENERALAGCAEG,l.TE S 2.000,001 <br /> I- <br /> GiN'LAGGRiCA,Te UMIT APPliES PER: PROIlUCTS - COl.tPIOP AGO S 1 000.001 <br /> n I'OLlcvlXllr8r n LOe <br /> AUTOII08IU!! IJ48ILJ'N 01-CE-703426-60 01/01/2004 01/01/2005 CO"'INED SINGLE L.'...rr <br /> --oc- S <br /> X "'NY AUTO (Ee Ig:;;jdanl) 1.000 000 <br /> =: AUOWNEe AUTOS BODII.YINJURY . <br />B SCHEDULED AUTOS (PBfpetlQll) <br /> X HIRED AUms ;eJ BODilY INJURY <br /> X l6 . <br /> NON-OWNeD AUTOS (L~ / (PetDCCfdenl) <br /> I--'- <br /> I- PROPERTY DAMAGE <br /> (PIII"I~dln:l J <br /> RAIIAGI! UUlUTY !I AU'P'O ONly. EA ACCCJENT J <br /> AN'( AUTO OTHER lMAN EAACC J <br /> AUTO ONLY; AOO J <br /> DCII!!:IIIU_RElLAI..IA8II.In 8E2349062 01/01/2004 01/01/2005 EACH OCCU~RCNCE J 2 000 OO~ <br /> :Kl OCCUR 0 ClAIMS "'0. AGGREGI\1E S <br />C ~OOO.OOO J 2 OOO.OOC <br /> R ,OEOUCTlB.... S <br /> RETENTION . I <br /> WOIlKER8C011PEN8A1'1ON AJIO 1750075-04 07/01/2004 07/01/2005 X we STAT\J.. lel,)t <br /> EMPLOYERS' LIAIIIUJY TO BE ISSUED BY SCIF. <br />D ANY PRClPRIETOAlPARTNewcxeCUTIVE E.l., EACH ACWEI'lT J 1.000 OOC <br /> OFFICERlWa.eeA excLUOa>? ..L 015EM. -... ......0\15E J 1.000,OO~ <br /> ~ aflKtlbt und.,. <br /> CWO ~ISION~ lIA10w 1;.1.. DISEASE - Fi'OlICY lIMrr I 1.000 OO~ <br /> OTIIER <br />)EIC'AIP]1OM OF OPERAnoNeI LOCAT1ON', ~ff f D:CLUIION. ADDIO 8Y BNDGR$U9If, IPICIAL PROVISION. <br />he Clty of Santa Ana, its 0 cers. employees. agents, and representatives are included as additional <br />nsure~s. Insurance is primary an~ non-contribu~ory <br />e notice below: 10 Days for NonPayment/NonReport1ng Payroll <br />. 'ft~D <br /> <br />Ci~y of Santa Ana <br />20 Civic: Center Place <br />P.O. box 1911 <br />Santa Ana, CA 92702 <br /> <br />SHouLD AN1' 0,: THE A80Vl Dl8CRl8eO PQuelee 8f! CANCS.1..m ftFORE THE <br />EXPIIiIAllOll DAn: ntbEOF. 11'IE ISIUJPtG INlURI.. W1LLI6VIt~ IIWL <br />J.O.-. DAYS WlUTTEN NOTles 11'J THE Q!.RllFlCA1E HOUJeli ftAWED TO ntE LEFT. <br />16_"w~~'~"'Tnl'" l6'IIMJJNJ'*."'l6Ill6llWIJI_1(1l <br />lUOIIll.......... . If!r-W-~-'-""^,,,,<XlOOlJOOO( <br />AU'"......,_~.~A11VE rI.. -.:11 ~-_ <br />J;m W.~e~hou~e CINNIE ~ . <br />~COROCORPORAnON188~~~ <br /> <br /> <br />'C:ORD 25 /20D1/081 <br /> <br />