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<br />10/04/2004 MON 10:24 <br /> <br />FAX 714+565 4020 CITY OF SANTA ANA <br /> <br />I4J 002/005 <br /> <br />~ <br /> <br />""'1'.1..1'1..1'. .;. ~ I.'" r:;, ~^\Jr:.. I:CA DC\.L.LU ""I:"iI)'1.Ç\U\.-1t: .ft.Y1I:!.u......J' <br /> <br />JU; ~ .L I~~ ~O~ ~~~V <br /> <br />I!'I->""¡"; UU.I. UJ! UU.1 <br /> <br />-. - --'., <br />ACORD CERTIFICATE OF LIABILITY INSURANCE DATE (MPo1JDDIYY) <br />09/27/04 <br />PRODUCER TH~ C:;EiRTlFICATJ: IS ISSUED AS A MATTER OF INFORMATION <br />8aird Insurance Agency - 0877688 ONLY AND CONFERS ND RIGIiT UPON THE CERTIFICAïE HOLDER- <br />THIS CERTIFICATE DOES NOT AMEND, EXTEND, OR At TI::R THE <br />5150 E. Pacific Coast Hwy.. Suite 200 COVERAGE AFFORDED BY THE POUCIES BELOW. <br />long Beach. CA 901304 (562) 346-3207 INSURERS AFFORDING COVERAGE <br />INSURED: N -J/X>1-057 INSURER A:. Scottsdale Instrlince Company <br />Richard Paö.erson INSURER- Er-- <br />9442 Ficker Ave INSURER C: '. <br />Fountain Valley, CA 92708 INSURER D: <br /> INSURER E: <br /> <br />, '. <br /> <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BUN ISSUIiO TO THE INSURED NAME ABOVE FOR THE POLICY PERIOD INDICA"reO. <br />NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTMCT OR OTHER DOCUMENT WITt>! ResPECT TO \'\IHICH <br />THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE fNSUAANCE AFFORDED BY THE POUCIU OesCRI8iiD HEREIN IS SUBJECT TO <br />ALL 'THE TERIß. EXCLUSIONS, AND CONOI'tlONS OF SUCH POLICIES, AGGREGATE LIMITS S ' QWN MAY HAVE BEEN REDUCED 8Y PAID <br />ClAIMS. <br /> ~ ~vllnNn:e Paley I>IInÞor ':~N LJnOI. <br /> Dab! r~ <br /> GErERAL LIABUTY 114247 5/24/04 5/24/05 URRENCE 5'.DOU.OOO.UO <br /> IBlcow.teRCIAt, GIiii~RN. ~IAëII{.ITY FIRE DAMAGE r- on. 6... <br /> CIIClAtoIS W'DE C OCCUR ~ EXP ¡any !nil gOfWll <br />A C ÆHSON.o.l.. oJ ÞDV 1N..URY <br />C GlËNEAAL AGGREGATE $'.000.000.00 <br /> DEN'L AGGREGATE LIMIT APPLIES PR OOUCTS - COhtP/OP PlGG <br /> PER; <br /> I!II POLICT DPROJECT r1 LCC <br /> AUTOMOBILE UA8UTY COMBINED SINCLE UMIT <br /> [J ANY AlITO (EAACCI[)~) <br /> 0 ALL OWEO AUTOS BoDILY I'lJURY <br /> 0 SCHEDULED AUTOS (pER ACCIDENT) <br /> 0 HIRED AUTOS BODILY INJURY <br /> [J NON-OWNED AUTOS (pERACCID9JT) <br /> 0 PROPERTY DÞ.P,IAGE <br /> 0 (PER ACCIOIiNT) <br /> CARA.:E UASLITY AlITO ONL'1' - EA I'CCIŒNT <br /> 0 AHY AUTO OTHER THAN EA ACC <br /> 0 AlITa ONLY AGG <br /> EXCESS UABØ...lTy EAcH OCCURRENCE <br /> 0 OCCUR [J CLAIMS MADE AOGREGATE <br /> [J DEDUCTIBLE . <br /> 0 RETENTION .--..-- <br /> WGl1œ~ Cðlllpens-lorl [J we STATUTORY LIMITS <br /> 0 OTJolIiR <br /> ErT'f'I~' lillbilily E.L. ~HACCIDENT <br /> E.t" DISEASE - E'A EMPLOYEE <br /> E.L DISE'ASE - POliCY LIMIT <br /> 0d1e r <br />Dt:SCRlPTDN OF OPERAmNB I Loc.o.TION8I-.& ElCCLUBIONS ADDED II\" E~JIT I ~ PRQ\IItIOJlS <br />The city of Santa Ana, its officers, agents and employees are to be named as additional <br />insureds per the attached CG201 0 with respects to all job operations performed by the <br />named insureds. A 10 day notice will be sent for non-payment of premium. <br /> . ,-. I, <br /> ''¡ .,--' .:) <br /> . ~Jà---~ <br /> ~' . <br /> -_.""',-,r~\", '.! "'.~:./.".;,y <br /> t'\.~,>...S'~i:L~Ll.j . <br />csmI=lCATE HOLœA II AOOITrO~ INSURED: ~Ut'Ct:t{ LE Ell II CANCELLA11CN <br />City of Santa Ana SHOI.\D JW'( Of YHe ""gVt: DtSCRDEC POUCES BE CANœI.I.EO SEFOQE 11£ <br />Downtown Development Division ~mN[) I,TE 11IEREOF, THE rasulNC JNS~WIù. eNOeAlIO!'I TO IIIAII. 3D DO.'1'I! <br /> 'ft1IITTEN NOTICe TO T>II; ~tll'~TIi HOUJER NAMED TO TIE I.S'T, BUT FÞoI..II<!1! TO <br /> De :!O SlIN.l.IMPCSE NO œUI1I\TION OR LlASlLI"'" O!" I'IIYKlND úl'CN TtiI! ¡æURSI, <br />305 E Fourth street, Suite 201 ITS _NTB DR RS>RESI;NTATrveS. <br />Santa Ana, CA 92701 /""11 Ifr"'TIVE <br /> Chris Baird <br /> <br />