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<br />08/30/2004 16:0g
<br />
<br />714571420g
<br />
<br />PARKS AND RECREATION
<br />
<br />PAGE 01. --
<br />
<br />-ËV~STON INSURANCE COMÞ~
<br />CERTm""" n NO . - . ff:i I',
<br />~ ~ "}::,,
<br />. ." ~ ..~~ "'J~""r."
<br />/ 'j' tiQTmCATI: OF INSURANCE
<br />EXcr.Ulll:s (;()VEllA.G& FO~$>PoìINE&'tvBNrs. SEE SI:P-'\RATI Al'PLICAno¡,¡¡ FoR NOMIND; IVkNn.
<br />¡,~, SPECIAL EVENT LlADIIJTY PR.OGRAM
<br />I) ! '"r:;'; , ,
<br />. ." /", ".
<br />
<br />~ ~'>~.~ . PUBUC mmTY (ADDmONAL .INSURED)
<br />
<br />Driver Alliaat ~ ,r'i'''''''~f}.
<br />P 0 D- 283~' .'. ",'. "".; .' . ~*~'. ".!;¡.
<br />r aliift.l.A. . ~~ -V( . ~tl..-... .~~
<br />Sama~. CÄ:799.S321 .~ . ,I. ," " .~, - ,
<br />(949) 66()..816j. :\. ,,~<t;
<br />LiœUc No: oC 36861 ".,' .,
<br />N~ INSUR.ED (IDfBNf R:OWER):. ",,..,..'
<br />.son.i.4 t.tiA r.u.túL
<br />2~O E,.. FoUlf.t:h Sbteu, Su.«e ~O2
<br />'S£lJILt.It Ana., C A 92702
<br />
<br />PAODUCER:
<br />
<br />City of Santa Ana
<br />20 Civiç Center Pla2a, M-28
<br />P.O. H/;IX 1988
<br />San~a Ana, CA 92702
<br />
<br />"
<br />
<br />EVENT D'*ORMATION:
<br />mE: B~e.tIVa.nee
<br />DATE(S)~ 1¡'luII - J'L/~II04
<br />I,.()CATION~ ~a.do Cl.~vr.
<br />
<br />This is ro cërtity that the policies of ~ Ü5tecJ.beJow have bet.q issued to the insured mt.DlGd above for the f)Qlícy period
<br />&wiè:atcd. Notwith8~ IJ1y R:q11Û'8mlnll, fCI:b or conditions of qy CoDttact or other cIocu!bem With respecl to wlUch this
<br />~1e may be issued or DIlly pcrtaiq. the ÏDI1Ir8I1ee úJèmIt:d by the poli~ie8 ~ibc:d herein is subjecr 10 all the ~JmS.
<br />exclnsions 8Dd <:oøditiOlØ of such ~. Liuúts shown may have been reduced by paid claims.
<br />JNSVRANC'I; CAR1UER: BvatlStan JU8t\Qzac. Company
<br />
<br />MASTER ÞoUCV NUMIŒIt: 04SEPlOOOOOJ
<br />
<br />IlAS'l'ERPOUCYDATES; EFFECTIVE: JA,Nt¡ARY 1,2004 i;.XP1RA110N:JANl1ARY 1,2005
<br />
<br />COMI.ŒRCIAL OENSR.AL I,..Wuun
<br />Gia..J J\arqpœ Limit
<br />Prudu.;t, II: ~1cWd Opcratioøs
<br />Prftœll.t: ~"'I hajury
<br />lab Occ~ Limit'
<br />Iiift DImtp (Any One rITe)
<br />Mlllical P"ymanlli (Any One Pen/;In)
<br />
<br />OCCURJœNœ FORM
<br />
<br />DEDUC.TJBLB: NONE;
<br />
<br />S 2.000.000
<br />1.000.000
<br />1.000.000
<br />1..000.000
<br />~.,OOj
<br />5,000
<br />
<br />Thalinútc ofihlluAncc XI,IUUeI)' ID ead, Penl insUred by 1h~5 policy ill ír ~ ICp8ntll POIiq of inSUl'lIlU .... ~ --. fOT IN.t evl!l'Jt.
<br />'"WbcI.. În11umf" ill ~"" ID ìncl~.... illllUal. v. lllllOII.or "'PIIiwion.!} own in.thi. sdl.edül...lioll& ""I)' wit!ll1:8þect 10 liability ~IiÎlla OUI of the
<br />CMIInI:r¡I¡ p, It1iIinfl:l1lnl:l! or ... of ~ JIRIDÏ8aaI used 1)" the II8med ì~ (cvont holder). This jftStll1lKc docs Do.! ilpply ro: Any "oççllrR:nœ" which I8tes plaee
<br />Ißz- die a-COt hol4er ~ to be. tanItIIC in !bIt
<br />
<br />OTIŒRAD»mÖNALINS\JREDs
<br />
<br />CANe¡ ¡ I'm", ........ - - - to ---....... .......,..~........ '" ",.,. -, "'~ ....1 30"'""", _. ~..
<br />~16 ~'dc:r 8l1li addiôonlll inlUNc:l. ,;,.
<br />
<br />AtmlOIUZED~ATIVE'~
<br />DAT2ISSUED: 7/5/04
<br />
<br />. /'?Y~7
<br />
<br />M..l4-
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