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<br />-, -"-" .. . ....op IP,l~ <br />ACORD. CERTIFICA Tf ÎF LIABILITY INSURANC' DATE (MM/DDIYYYY) <br />CENTE01 03/12/04 <br />PRODUCER THIS CERTIFICATE IS ISSUEP AS A MATTER OF INFORMATION <br /> ONLY ANP CONFERS NO RIGHTS UPON THE CERTIFICATE <br />Barlocker Ins. - Laguna Hills HOLPER. THIS CERTIFICATE POES NOT AMEND, EXTENP OR <br />23332 Mill Creek Dr. Suite 105 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Laguna Hills CA 92653 <br />Phone: 949-461-3640 Fax: 949-461-3644 INSURERS AFFORPING COVERAGE NAIC# <br /> .. -, Hartford Casualty Ins. <br />INSURED INSURER A: CO. 29424 <br /> 1--'-'-. -. <br /> INSURER B: <br /> Centennial Heritage Museum INSURER c: <br /> 3101 West Harvard INSURER Q' <br /> Santa Ana CA 92705 - <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. NOTWITHSTANOING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <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 /> , . - .. <br />LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE iMMJDDrÑt DATE MMIDDNY LIMITS <br /> ~NERAL LIABILITY EACH OCCURRENCE .1,000,000 <br />A X X COMMERCIAL GENERAL LIABILITY 57SBAAV8856 03/15/04 03/15/05 I PREMISES (Ea occu~~nce) '100,000_- <br /> I ClAIMS MADE ~ OCCUR MED EXP (Anyone person) '10,000 <br /> PERSONAL & ADV INJURY .1,000,000 <br /> 1- .2,000,000 <br /> GENERAL AGGREGATE <br /> f-- '- r--' <br /> GEN'l AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG .2,000,000 <br /> h ,FiPRO. fl ~. <br /> POLICY JECr LOC Emp Ben. 1 000,000 <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> - .1,000,000 <br />A ANY AUTO 57SBAAV8856 03/15/04 03/15/05 (Eaaccìdenl) <br /> -- _. <br /> ALL OWNED AUTOS BODILY INJURY <br /> - . <br /> SCHEDULED AUTOS (Per person) <br /> - <br /> .!. HIRED AUTOS BQDll Y INJURY <br /> . <br /> .!. NON-OWHED AUTOS (Peraccidenl) <br /> - PROPERTY DAMAGE . <br /> (Per accident) <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT . <br /> ~ ANY AUTO OTHER THAN EA ACC . <br /> AUTO ONLY: AGG . <br /> ~ESSIUMBRELLA LIABILITY EACH OCCURRENCE .1,000,000 <br /> X X OCCUR D ClAIMS MADE - -S7SBAAV8856 03/15/04 03/15/05 c-- .1,000,000 <br />A ~.~ATE <br /> -, . <br /> ~ DEDUCTIBLE . <br /> "" h hi . <br /> X RETENTION .10,000 ~",,, . <br /> WORKERS COMPENSATION AND ¡it'.;¡ !-~ "-.. ~.~ "--" IToli/~œi's I IV.,,' <br /> EMPLOYERS' LIABILITY 'f/~!::.{~,~:{A <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.l. EACH ACCIDENT . <br /> OFFICER/MEMBER EXCLUDED? -.-~.... E.l. DISEASE. EA EMPLOYEE $ <br /> ~~è~l~tS~~~Ji~?~~s below '. E.L. DISEASE - POLICY LIMIT .$ <br /> OTHER P..S";l';~ll. ''''':il'¡ lL 'I' ;\;Y <br />DESCRIPTION OF OPERATIONS f LOCA nONS' VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br />City of Santa Ana is named as additional insured with respects to claims <br />arising out of the operation and uses preformed by or on behalf of the named <br />insure, such insurance as is afforded by this policy is primary and not <br />additional to or contributing with any other insurance carried by or for the ., <br />benefit of the additional insured. 10 day notice for non-payment of premium <br /> <br />CERTIFICATE HOlPER <br /> <br />CITYOFS <br /> <br />CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRAOON <br />DATE THEREOF, THE ISSUING INSURER WILL ¡¡s...........JR ~.. MAIL ~ DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,. ~If- <br />.ìi~~iiA~JM~_....œt4W~ <br />...ø <br />AUTHORIZED REPRESENTATIVE <br /> <br />City of Santa Ana <br />Community Development <br />M-25 <br />P.O. Box 1988 <br />Santa Ana CA 92702 <br /> <br />Agency, <br /> <br />ACORP 25 (2001/08) <br /> <br />Kell <br /> <br />Peterson <br /> <br /> <br />@ ACORD CORPORATION 1988 <br /> <br />~y <br />