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<br />DATE (MMroD1YYYr- <br />.~~'C?fZD CERTIFICATE ~~ LIABILITY INSURANCE os/17/zoo4 <br />PRODUCER (7147905-1923 f (714)905-1910 THlS C TIFIGAT IS ISSUE AS A MA ER OF IN ORMATI N <br />ONLY AND CONFERS NO RIGHTS UPON THE CERT1FlGATE <br />Hayward Tilton & Rol app Ins . Assoc . , Inc , HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTENp OR <br />License #0614365 ALTER THE COVERAGE AFFORDCD aY THE POLICIES BELOW. <br />P.O. Box 25529 INSURERS AFFORDING COVERAGE NAIC # <br />Anaheim, CA 92825-5529 INSURER A; <br />INSURED Cycom Data Systems, Inc. Hartford Casualty Insurance Co 29424 <br />INSURER 0; Cpntlnental Casualty <br />6835 Roberta Rd. S.W. <br />Ocean Isle Beach , S[ 28469 INSURER C; <br />INSURSR D: <br />INSURER E: <br />COVERAGES <br />TWE POLICIES OF INSURANCE LISTED BELOW NAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE PC <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WWIC <br />POL C ESTAIGGREGATE LM TS SHOWN MED HAVE SEEN RIEDUCED BY PAID CLAIMS. SUBJECT TO ALL THE TERI <br />4TR N3 TYPE OF INSURANCE PODGY NUMBER GATE MM1RR DATE MM1bD <br />GENE.RALLIABILITY 725BAN71649DX 06/04/2004 06/04/2005 <br />X GOMMERCIALGENEIRA~L~LIABILITY, <br />CLAIMS MADE 171 I OCCUR <br />A <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />X POLICY jECT LOC <br />AUTOMOB[LE LIABILITY <br />ANY AUTO <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />'4 )( HIRED AUTOS <br />]( NON-OWNEb AUTOS <br />72SBANJ1649DX 06/04/2004 ~ 06/04/2005 <br />GARAGE I.IABILITT <br />ANV AUTO <br />EXCE95/UMBRELLA LIABILITY <br />OCCUR ~ CLAIMS MADE <br />DEDUCTIBLE <br />RETENTION § <br />k ~w~ ~~`xy- " <br />~ ~-_ <br />WORKERS COMPENSAnCtN AND <br />EMPLOYERS' LIA6ILITY <br />ANY PROPRIETORlPAR7NERrEXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />If y65~ desCrlb6 UntlAr <br />SPECIAL PROVISIONS belw+ <br />rofessional Liability <br />B <br />003 <br />LiCY PERIOD INDICATED. NOTWITHSTANDING <br />i THIS CERTIFICATE MAYBE ISSUED OR <br />rIS, EXCLUSIONS AND CONDITIQNS OF SUCH <br />uMITs <br />EACH OCCURRENCE $ Z, OOO OOO <br /> OO <br />$ 3 OO <br />PR MISES Ee OCWren , <br />MED EXP (Any one person) $ 1Q , QO <br />PERSONAL & AOV INJURY $ ~ r OOO r 00 <br />GENERAL AGGREGATE $ 2 ODa, OO <br />PRODUCTS - COMPIOP AGG $ 2 ' QOO , OO <br />COMBINED SINGLE LIMB E <br />(Ea acdaenU 1 000, 00 <br />GORILY INJURY S <br />(Per person) <br />BODILY INJURY § <br />(Per aCCld~~) <br />PROPERTY DAMAGE ~ <br />(P¢r a~cideni) <br />AUTO ON("Y , EA ACCIDENT $ <br />OTHER THAN EA ACC S <br />AUTO ONLY: AGG $ <br />EACH OCCURRENCE S <br />AGGREGATE § <br /> <br /> S <br /> § <br />TORY LIMITS ER <br />E.L. EACH ACCIDENT $ <br />E.L. DISEASE - EA EMPLOYE S <br />E.L. DISEASE -POLICY LIMIT b <br />51,000,000 Aggr. Incl Expenses <br />51,000,000 Each Wrongful Act <br />510,000 beductible <br />attached Additional <br />SCRIPTION OF DPERAITION$ J LOCATION51 VEHICLE91 EXL!-USIONS ADDED BY ENDORSEMENT! SPECIAL PROVISIONS <br />rtY~°icate Holder is Additional Insured as respects General Liability per <br />sured Endorsement 55 04 49 05 93. <br />en days notice of cancellation given for non-payment of premium. <br />CERTIFICATE <br />City of Santa Ana <br />Office of the City Attorney <br />Attn: Juanita Hernandez <br />20 C1vic Center Plaza <br />Santa Ana, CA 92701 <br />ACORD 25 (2001/06) <br />INCELLATION <br />SHOULD ANT OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />ExPIRATION GATE THEREOF, THE ISSUING INSURER WILL ENbEAVOR TO MAIL <br />,~~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED T4 THE LEFT, <br />BUT FAILURE TO MAIL SUCH NOTICE SMA44 IMPOSE NO OBLIGATION DR LIABILITY <br />OF ANY IOND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVE$_ <br />rlioielxED REPRESENTATIVE L <br />e hen Mori ama ML5 Ste I1e~ Ot r yam q <br />@AEORD-CORPORATIt~N 1988 <br />