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ACORD", CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDOIYYYY) 7/20/2004 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Venbrook Insurance Services ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 22801 Ventura Blvd, Third Floor HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Woodland Hili., CA 91364 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Phone 818-225-8200 Fax 818-225-8210 INSURERS AFFORDING COVERAGE NAICII INSURED Overland, Pacific & Cutler, Inc. INSURER A, Great American E & 5 Company 100 West Broadway INSURER B, The Hartford Insurance Company Suite 500 'OSURER c, Everest National Insurance Long Beach, CA 90802 INSURER [>. illinois Union Insurance Company , INSURER E, RSUI Indemnitv Company COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. rNSR DO POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION 6/24/2004 6/1/2005 LIMITS $ 1,000,000 $ 50,000 $ Excluded PERSONAL&ADVINJURY $ 1,000,000 $ 2,000,000 PRODUCTS. COMP/OP AGG $ Excluded PREMISES Ea occu nee MED EXP An one person) ...ENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY PL 5574310-01 A CLAIMS MADE ŒJ OCCUR GEN'LAGGREGATE LIMIT APPLIES PER: PRO- LOG AUTOMOBILE UAØIUTY ANY ALITO 72 UECUM6536 ALL OWNED AUTOS B SCHEDULED AUTOS X HIRED AUTOS X NON-QWNED AUTOS GARAGE UABIUTY ANY AUTO EXCESSlUMBRELlA UABIUTY X OCCUR 0 CLAIMS MADE NHA212256 E EACH OCCURRENCE GENERAL AGGREGATE 6/24/2004 6/24/2005 COMBINED SINGLE LIMIT (Eaaccid&fll) $ 1,000,000 BODilY INJURY (Per person) $ BODilY INJURY (Peraccidenl) $ PROPERTY DAMAGE (Peraccidenl) $ ì/9/200 4 6/1/2005 AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG $ EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 $ $ $ i)~iJl.J(;i.n:sLt; RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' UABIUTY C ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? YES g~:~:¡'~(~~~S1ÓNS below D ~;;','~royment Practice. Llab & Errors & Omissions Prof Llab 3900048305-041 6/1/2004 6/1/2005 x we STATU- om- BMI20010437 6/24/2004 6/1/2005 E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 EPL: $1,000,000 - $15,000 Retention E & 0: $2,000,000 - $50,000 Retention DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PR "10 Days Notice of Cancellation for Non-Payment of Premium" AS TO FORM CERTIFICATE HOLDER City of Santa Ana Public Works Department Attn: Talg Higgins 20 Civic Center Plaza Santa Ana, CA 92701- A itionallnsure CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO so SHALL IMPOSE NO OBUGATION OR UABIUTY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25 (2001/08) ~ J-..1. e 0 e @ACORD CORPORATION 1988