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<br />' ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) <br /> CSR DS I 04/08/04 <br /> EMPIR-D <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIO <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />CROSBY INS., INC. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />P.O. BOX 31150 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW <br />ANAHEIM CA 92809 <br /> Phone: 714-221-5200 Fax:714-221-5210 INSURERS AFFORDING COVERAGE NAIC# <br />INSURED A -;).004- 013 INSURER A starnet Insurance Company <br /> INSURER B State Compensation Ins Fund <br /> ~;re Pipe Cleaning & INSURER c' <br /> E~J.P!!'E'nté Inc. <br /> P.O. Box 035 INSURER D. <br /> Anahei.m CA 92812 -- <br /> INSURER E <br /> <br />COVERAGES <br /> <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE 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 BY 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 /> <br /> POLICY NUMBER C IVE POLlC 0 LIMITS <br />L TR NSR TYPE OF INSURANCE DATE MM/DDIYY DATE MMIDDIYY <br /> GENERAL LIABILITY EACH OCCURRENCE $1,000,000 <br />A X COMMERCIAL GENERAL LIABILITY 2SMCC4CGL006304 04/07/04 04/07/05 PREMISES (Ea occurence) $ 300,000 <br /> CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $10,000 <br /> X XCU PERSONAL & ADV INJURY $ 1,000,000 <br /> GENERAL AGGREGATE $ 2,000,000 <br /> PRODUCTS - COMPIOP AGG $2,000,000 <br /> LOC <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br />A X ANY AUTO 2SMCC4BAU009404 04/07/04 04/07/05 (Eaaccident) $1,000,000 <br /> ALL OWNED AUTOS BODilY INJURY <br /> SCHEDULED AUTOS (Per person) <br /> X HIRED AUTOS BODILY INJURY <br /> $ <br /> X NON-OWNED AUTOS (Per accident) <br /> X Comp/Co11 PROPERTY DAMAGE <br /> Ded $1,000 (Per accident) <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT <br /> ANY AUTO OTHER THAN EA ACC $ <br /> AUTO ONLY. AGG $ <br /> EXCESS/UMBRELLA LIABILITY 113 EACH OCCURRENCE $ <br /> OCCUR D CLAIMS MADE pdS AGGREGATE $ <br /> $ <br /> DEDUCTIBLE $ <br /> RETENTION $ <br /> WORKERS COMPENSATION AND ER <br />B EMPLOYERS' LIABILITY 1578253-04 04/01/04 04/01/05 $ 1,000,000 <br />ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT <br /> OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYE $1,000,000 <br /> If yes, descJibeunder <br /> SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 <br /> OTHER <br /> <br /> <br />DESCRIPTION OF OPERATIONS / LOCATIONS 'VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS <br />City of Santa Ana, its officers, employees, agents, representatives and <br />volunteers and Environmental Engineering Contracting are named as Additional <br />Insureds. *10 Days Notice of Cancellation for Non-Payment of Premium. (xx) <br /> <br />CERTIFICATE HOLDER <br /> <br />CANCELLATION <br /> <br /> SANTA12 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />Ci.ty of Santa Ana DATE THEREOF, THE ISSUING INSURER WIL.L. 1AIL *30 DAYS WRITTEN <br />Attn: Clerk of the Ci.ty NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, L <br />Council <br />P,O. Box 1988 '-.,. ./ ") <br />Santa Ana CA 92702-1988 <br /> AUTHORIZED REPRESENTATIV.5.- <br /> <br />ACORD 25 (2001/08) <br /> <br />@ACORD CORPORATION <br /> <br />(W~ <br />