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j ACORDTM CERTIFICATE OF LIABILITY INSURANCE o3-26ATZOOB
<br />PRODUCER ~~ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br />HAYWARD, TILTON&ROLAPP INS/PHS ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEN'J OR
<br />' 18 5 019 P : (8 6 6) 4 6 7 - 8 7 3 0 F : (8 7 7) 9 O 5 - 04 5 7 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />PO BOX 3 3 015 1N-2003-078 I
<br />SAN ANTONIO TX 78265 INSURERS AFFORDING COVERAGE
<br />~iNSURED ~'
<br />N-20033-07 ,;NS H~Rg.Hartford Casuall~Ins Co ___ l
<br />i ~
<br />--
<br />CYCOM L)ATA SYSTEMS INC N-2003-078-03 ~INSURERC
<br />--
<br />PO BOX 9 2 4 3 7 N-2003-078-04 INSLwER °:
<br />' ?,nNG BEACH CA 9 0 8 0 9 Ir.;suRER E: ___,
<br />---
<br />COVERAGES
<br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHLCH THIS CERTIFICATE MAY BE ISSUED OR
<br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL TFiE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
<br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INTR
<br />TYPE OF INSURANCE
<br />POLICY NUMBER
<br />___
<br />LIMITS
<br />i DATE IMMFDDTYYE DATEYIMMIDD YION
<br />-
<br />GENERAL LIABILITY
<br />~
<br />'~ ~~ ~' EACH OCCURRENCE S Z , O O O , O O O
<br />,
<br />.
<br />A ~~ ~ COMMERCIAL GENERAL LIABILITY ,
<br />7 2 SBA NJl 64 9 ~
<br />it
<br />0 6 / 04 / 0 8 ' 0 6 / 04 / 0 9 ~ FIRE DAMAGE IAny one fire) ~, S 3 0 0 , 0 0 0 ~'~
<br />~' 'CLAIMS MADE ~~. X I, OCCUR ~! ~ MED EXP IAny one person) ~ S 1 0 , 0, 0
<br />Il h l7e?le rcl l iL 1 ap I ~ '~ PERSONAL & ADV INJURY S l, 0 0 0, 0 O 0 T
<br />'. I ''. GENERAL AGGREGATE S 2, 0 0 0, O O O
<br />GEN'L AGGREGATE LIMIT APPLIES PER: '~ '~~ '~ PRODUCTS - COMPIOP AGG ~'I S2 , O O O , O O O ',
<br />i
<br />--
<br />~-',, POLICY ~'. II PRCT Iii X ~ LOC I
<br />-r --
<br />' .AUTOMOBILE LIABILITY
<br />_
<br />~
<br />I
<br />
<br />~
<br />'. i, '
<br />I COMBINED SINGLE LIMIT ~, Sl , 0 0 0 , 0 0 0 '~
<br />accidentl
<br />'IE
<br />ANYAlTiO
<br />~A
<br />~- ~72 SBA NJ1649 a
<br />06/04/08(06/04/09
<br />-
<br />Al L OWNED AUTOS
<br />
<br />'r-i
<br />
<br />i
<br />i
<br />I
<br />~ I ~ BODILY INJURY S
<br />!SCHEDULED AUTOS
<br />i 'i I, (Per person) ~~. ~,
<br />,
<br />~' ~X '. HIRED AUl OS
<br />~ ~~ I ' --?
<br />~,, ~;, '~, BODILY INJURY '~ S
<br />,.
<br />I ~y
<br />X 'NON-OWNED AUTOS I iPer accident)
<br />I
<br />_ ___
<br />i I~ !i
<br />PROPERTY DAMAGE S
<br />I
<br /> I ~ (Per accident)
<br />_____~
<br />~~ GARAGE LIABILITY ~'~ AUTO ONLY - EA ACCIDENT ~~.,, S
<br />'~ 'r-~'~ ANY AUTO ~I ',. ', '~. OTHER THAN EA ACC~S
<br />'. I~ ', AUTO ONLY: AGG S ~
<br />' EXCESS LIABILITY ' I' ''~. EACH OCCURRENCE '. S ~~
<br />i
<br />', J' OCCUR I~~~I CLAIMS MADE ~ I ~ AGGREGATE 5
<br />I
<br />' , '„ S
<br />
<br />~; DEDUCTIBLE !,I ~,..,
<br />S
<br />~ i !RETENTION 5
<br />
<br />+ I I
<br />~ S
<br />~
<br />i
<br />i
<br />WORKERS COMPENSATION AND WC STATU I OTH-I
<br />I ,
<br />TORY LIMITS ~ ER i
<br />i I EMPLOYERS' LIABILITY I ~
<br />'~ i
<br />'
<br />I
<br />E
<br />L. EACH ACCIDENT 5
<br /> -
<br />I
<br />.
<br />'.
<br />i I ~.~. E.L.. DDISEASE - EQ EMPLOYEE ! S
<br />---
<br />' -_ 1_ ~~ '~ E.L. DISEASE -POLICY LIMIT i S
<br />OTHER
<br />i I I
<br />DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLESIEXCLUSN)NS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
<br />(Those usual to the insured's opertations.
<br />~~~
<br />~~ -
<br />- - - -
<br />CERTIF_I_CAT_E__HO_L_DER_ ~-AODITroIUAL INSURED; INS_uRER LETTEn: ,___ _CANCELLA_TIO_N ___
<br />I i i SHC)ULD ANV OF THE ABOVE DESCRIBED POLICIES BE CANCELl.FO BEFORE THE '
<br />~ City Of Santa Ana its Officers EXPIRATION DATE. THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL '
<br />~ Employees , Agents & Volunteer 30 DAYS WRITiE.N NOTICE (lU DAYS FOR NON-PAYMENT) TO THE CERTIFICATE i~
<br />I Off 1Ce of the Clt Attorne HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO
<br />y y (OBLIGATION OR LIABILITY OF ANY KIND UPON 1 tIE INSURER, I fS AGENTS OR
<br />I20 C1V1C Center Plaza (REPRESENTATIVES.
<br />(Santa Ana, CA 92701 - ,'
<br />A ORI D RE ESEN AT1
<br />I ,
<br />ACORD 25-S (7/97) '~ ACORD CORPORATION 1988
<br />
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