<br />.,
<br />(Jun
<br />
<br />."""
<br />1,8
<br />
<br />04
<br />
<br />02:07p
<br />
<br />Public
<br />
<br />Works
<br />
<br />Yard
<br />
<br />714-647-3342
<br />
<br />Jun-lB-04
<br />
<br />lO:OOA
<br />
<br />p.2
<br />
<br />P.02
<br />
<br />ACORD... CERTIFICATE OF LIABILITY INSURANCE
<br />310.37<4-6011
<br />
<br />CMTE(~,""I
<br />06/18/2004
<br />THIS CERTIFICATE 18 ISSUED A8 A MATT~R OF INFORMATION
<br />ONLY AND CONFERS NO RIGHTS UPON THE c;ERTlflCA TI
<br />HOLDER. THIS CERTIFICATE DOES NOT AMEND. UTEND OR
<br />ALTER THE COVERA E AFF R D BY THE¡ P I lIS I&L.OW.
<br />
<br />\ PkOnuCf.1I.
<br />F'OOEûRACZ INSURANCE AGENCY
<br />,,, 7 'HI'! ST .204
<br />MANHAT rAN
<br />lIC II OEn25<44, CA !I02IJ6
<br />I"SUAEÞ
<br />
<br />INSUR@.IUI A'fORDING COVERAGE
<br />i lHijl,I~~"A ZURICH GROUP
<br />IN:iURFA R fARMERS INSURANCE
<br />INS.JRERC GREAT AMERICANE&S
<br />INSURER D
<br />'''I:!\lF\fR[,
<br />
<br />fJ -doð4.. ()(pt
<br />
<br />HEAVENS SYSTt:MS
<br />2200 PACIFIC COAST HWY #:)07
<br />HERMOSA BGAC:1i CA fl0254
<br />
<br />I HAIC.
<br />
<br />1
<br />I
<br />
<br />COV~RAGES . C NOTWITlfST-NOING
<br />, n~E. POLICIES or IN5URANCf. IltòTfO RfI OW tlAVI' ßf[N ISSUED TO THE INSURED NAMED ASOvE FOR THE POLICY Pt:~IOU 'NCI AT~V UEO OR
<br />"'NY REQUIRrMrIIIT T¡;R~ nil CONDITION or ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHIC~ IHIS C~."III'ICATf. MA~TIJOeNI:~F SUCIo\
<br />MAY PERTAIN. niE INSUWANCl' AHOIWI:U tiy 1 HE POLICIES OESCRIBEO Hf.REIN IS SUIU¡::CT TO ALL THE TERMS. EXCLUSIONS AND COND 1
<br />, POLICIES. AGGREGATE. LIMITS SHDWN MAY HAilE BEEN REDUCED BV PAID CLAIMS
<br />:~:;:::J. ..... "....AuRAHca.. ..__.--~~~!"~.~.~~-- f'~~.!~~~'1 . P~WE(PIRATION --_...!:!!,~n'S
<br />
<br />Ii A. X "'GXE;-RAllIAB'.IT'Y . .- -...-.- PAS O"90""",ro10-22-2003 10-'2""2-::" ~~~~~g"~~~~~ . $
<br />COIAMf«CIAlG(~(R'.CCI"'DllITY ~ IN"'" : PA£~Isc.S\("<A:UI8"CII) ;'
<br />(;1 AI\I~ WiAI »- X ut.cU~
<br />
<br />"([, I)
<br />~dl~,\J ,'-
<br />j f , () (,_\ 1 ..
<br />./' rv ,¡JV ...\.1 v) ':ANCELLATlCN
<br />... \ ^.~ ';,.. {y/f? ,../'1 r ly ,"OUI.OANY 01' 'OIl! AIOIIa DI.&C"18EDI'OUCIE$ I" ç,...ç¡LUO IE'OII. ! TIt! !IIPlltA'I1ON
<br />t ý\ L'.. ,~(\ h \'Ie TMlIII!OI'. ."" 18'\1."0 "IIUIIIEIIIII"LI,I~AVOll TO "'Aft. ..~.~.- OA.' VI"'",,"
<br />CITY OF SANT A AN~ ..', )J-¡ ','- TIU TO TMI! CIIIITIFICATE HOLM! ..""'EO TO lt4f; LEFT, lilT 'AlLURe TO DO &0 "'ALl
<br />PUBLIC WORKS AGEl .'v~t - -I ¡J../,¡1J' ~1iE 101() OIR.K1ArlOOI 011 :ry OJ AN\' Knoo ""°11 'Þ4IIH1UMII, nl AGSNTB DII
<br />220 S DAISY AVf: () (f' IIIE.,'UEIITATIVU,
<br />SANTA ANA CA 9210~ AUTI4ORIØOR..""
<br />
<br />. ACORD CORPORA TION 1988
<br />
<br />G[i'I'l,,\3GI'ICQA1( UO¡OIT "I'F C'(~ FI:~
<br />PRO.
<br />11'"'::1
<br />
<br />l
<br />
<br />I
<br />09125/2003 I
<br />
<br />. t.A~t)~.~ (A"~ ~':.'8~r.~nl
<br />.P~R~O"Al'" f,Oy INJUR' ,
<br />. .Gt..t:llI.l MÃ,R[GAI~ ,
<br />,PROùuCIS'I',t)IIP¡()PAOU . t
<br />
<br />þot,¡(.'(
<br />
<br />u,n;
<br />
<br />, ~(I"'M1Nf(}SINO¡E ll""'T
<br />([.ilc;¡;idDr".
<br />
<br />B
<br />
<br />x
<br />
<br />AU"rQMOBLE UAalUTY
<br />X ANV AUTfJ
<br />
<br />OODllYINJUWY
<br />(lIe,p...",,1
<br />
<br />0941107666
<br />
<br />09/2.5(2004
<br />
<br />N.l OWN!:D ^UTO~
<br />
<br />~!.:HH~UI H)AI)H)~
<br />X ...,,£t1 "UTOt
<br />X "ON,OWN~O,\ÚTt)"
<br />
<br />OOOll'f INJ'tJR f
<br />(J.'8t ..r~I(I.J\')
<br />
<br />
<br />~kO""d.u. UA..-ACjF.
<br />cP..,a~nc
<br />
<br />""TOONI.~'IAACCI!>EII.T !.'
<br />
<br />[AACe s
<br />
<br />Ace.
<br />
<br />G&IU,Gt LlAIILIT'i
<br />
<br />lHH~R HiAN
<br />^\I~OO"cY;
<br />
<br />AN'" ..~ H)
<br />
<br />IkCi' I,U"."'''-lA L'AIoIL r~
<br />
<br />. ""CM OCCU""ENCE
<br />
<br />: .AGGR[GAlt
<br />I
<br />
<br />().(".t,.ltW
<br />
<br />n J..tt..-~ IotAf"¡F
<br />
<br />Dt-\UJeIIHI t:
<br />nET[NlIC1N
<br />
<br />---....
<br />
<br />WC SlATU, .
<br />. TORY L'~ITS "
<br />
<br />OHI,
<br />...
<br />
<br />~
<br />
<br />. 1'IO""IMC;-~""~T1O"ANO
<br />I B EIilPLO.ER5' LIII8II.'TY
<br />
<br />"'" ~kOlliltL' ')RI~"l<lNL"'l~l.t V'iVL
<br />OFF¡CFR,~F.UI'IF.R fxr.1 ~JnFr)?
<br />
<br />~;;;~r~~r:;~~;IÕN~. ~Ic"¡~
<br />
<br />09/25(2003 '
<br />
<br />09125/200.4
<br />
<br />. H F ~C''''.C('l!?E~T
<br />I f. l DISEASE. .EA ~NlPlOY~~ I
<br />: F' ("$E"':)f' rOltC~ LllAlT ,
<br />
<br />N09203249
<br />
<br />OTIlER
<br />; C PROFESSIONAL LIABiliTY
<br />
<br />09/25/2004 . LIMIT
<br />
<br />EDN585532901
<br />
<br />09125(2003
<br />
<br />DEIICRIPTlON OF OPEIIAnOHI' LOCA r,ONII' \I[HIC."~I...C."SIl~". ADOioey ENDOIIIUNENT ¡IHetA. .1lIOII1...,11&
<br />
<br />CERTIFICAT!. HOLDER
<br />,
<br />
<br />
<br />I
<br />ACORD 25(2001/08}
<br />
<br />
<br />, .000.000
<br />50,000
<br />5.000
<br />1,000.000
<br />2.000,~~_.
<br />1.Q..QÇ..QQO
<br />
<br />1,000,000
<br />
<br />\ '
<br />
<br />i,
<br />I
<br />
<br />a
<br />I'
<br />,
<br />
<br />,
<br />I
<br />
<br />1.000,000
<br />1,000,000
<br />1 000 000
<br />
<br />1,000.000
<br />
<br />-
<br />
|