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<br />ACORD CERTIFICATE OF LIABILITY INSURANCE I DATE {MMI'DO{Yyyy¡ <br />N 08/25/2004 <br />PRODUCER (949)851-8800 FAX (949)851-8802 THIS CERTlFICA!~IS ISSI!.~P. ~~ A MÞ:! !.ER OF INFORMATION <br />GSM Insurance Services ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />license No: 0015612 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />30 Corporate Park #307 INSURERS AFFORDING COVERAGE HAIC. <br />Irvine, CA 92606 <br />INSURED Curbsiae, Inc. tJ-~-Dq1- INSURER A: Steadfast Insurance Company <br />1605 N. Spurgeon St. INSURER B: Zurich American Insurance Co <br />Santa Ana, CA 92701 Pr"~-'"l~ INSURER c: State Compo Ins. Fund of CA 35076 <br /> INSURER Ð: <br /> INSURER E; <br /> <br />COVERAGES <br /> <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POliCY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTlFICA TE MAY BE ISSUED DR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO AlL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POliCIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID ClAIMS. <br />~ ~ TYPE OF INSURANCE POUCYNUUBER DAT~ DA~ UM/TS <br />~ GENERAl LIABILITY GPl 543 5554-00 08/23/2004 08/23/2005 EACH OCCURRENCE . 1.000 OO~ <br /> X COMMERCIAL GENERAL LIABILITY ~Ea œ $ 100 OO~ <br /> I CLAIMS MADE 00 OCCUR MED EXP (Anyone person) $ 25.00~ <br />A PERSONAL & ADV INJLRY . 1 000.000 <br /> r- GENERAl AGGREGATE . 1,000 OO~ <br /> t"GEN'l AGGREGATE LIMIT APPliES PER: PRODUCTS-COMPJOPAGG . 1,000 OO~ <br /> h POLICY n f~g n lOC <br />, AUTOMOBILE UABJllTY BAP 543 5553-00 08/23/2004 08/23/2005 <br /> COMBINED SINGLE LIMIT <br /> X ANY AUTO (Ea accident) . I,OOO,O~ <br /> - All OWNED AUTOS $1, 000 DED COMP <br /> BOOIl Y INJURY . <br /> - SCHEDULED AUTOS $1.000 DED COll (Per person) <br />B r- <br /> HIRED AUTOS BOOIlYINJURY <br /> ¡---- (Per accident) . <br /> NON-OWNED AUTOS <br /> ¡---- <br /> ¡---- PROPERTY DAMAGE . <br /> (Per accident) <br /> GARAGE UABIUTY AUTO ONLY. EA ACCIDENT . <br /> ~ ANY AUTO OTHER THAN EAACC $ <br /> AUTO ONLY: AW . <br /> EXCESSfUMBREllA LIASIUTY EACH OCCURRENCE . <br /> P OCCUR 0 CLAIMS MADE AGGREGATE . <br /> . <br /> R ~DUCTIBlE . <br /> RETENTION . . <br /> WORKERS COMPENSATION AND 1750381-04 08/23/2004 08/23/2005 X I iÓRi,i"ITS I IV",,' <br /> EMPlOYERS' LIABILITY I,OOO,OO! <br />C ANY PROPRIETORIPARTNERlEXECUTIVE E.L EACH ACCIDENT . <br />OFFICER/MEMBER EXCLUDED? E.l. DISEASE. EA EMPLOYEE $ 1,000,0001 <br /> g~~i~S18"NS below EL DISEASE - POLICY LIMIT $ I,OOO,OO! <br /> OTHER GPl 543 5554-00 08/23/2004 08/23/2005 $1,000,000 Each incident <br /> ~õntractor I s Pollution <br />A liabil ity $1,000.000 Policy aggregate <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES' EXCLUSK>NS ADDED BY ENDORsEMENT I SPECIAL. PROVISIONS <br />The general liability policy includes the City of Santa Ana, its officers, employees, agents, <br />olunteers and representatives as additional insured with regard to work performed by or on behalf of <br />he Named Insured where required by written contract. <br />"Except 10 days for nonpayment of premium. <br /> <br />CERTIFICATE HOLDER <br /> <br />City of Santa Ana <br />Department of Public Works <br />20 Civic Center Plaza. ~r1P <br />Santa Ana, CA 92702 <br /> <br /> <br />CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCEllED BEFORE THE <br />EXPIRATJON DATE THEREOF, THE ISSUING INSURER WIlL ~ MAIL <br />3.0!- DAYS WRITTEN NOTICE TO THE CERßACATE HOLDER NAMED TO THE LEFT, <br />~~~eBSOOlIOOll(~x <br />IO~~JI~XXXXxxx <br />AUTHORIZ P.z:ATlVE <br /> <br />ACORD 25 (2001/08) <br /> <br />@ACORD CORPORATION 1988 <br /> <br />