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DATE (MMMM) <br />ACtORD,. CERTIFICATE OF LIABILITY INSURANCE 01/27/2005 <br />PRODUCER 310 568-5900 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Hub International of California, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />6101 West Centinela Avenue ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Suite 210 <br />Culver City, CA 90230 INSURERS AFFORDING COVERAGE <br />INSURED LaBelle - Marvin, Inc. INSURER A: Golden Eagle Ins_u_rance Corporation _ <br />2700 S. Grand Avenue INSURER R: Houston Casualty Company <br />Santa Ana, CA 92705 wsuatR c: Granite State Insurance Co./AIG <br />_�` ` _ ^ INSURER D: <br />I /�/�(�/\ `-y1-- 'INSURER E: <br />COVERAGES <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 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 />MSN TYPE Of INSURANCE ! POLICY NUMBER POLICYEFFECTIVE POUCYEXPIMTiOMDATE IMA -LIMITS <br />!06/16/2005 <br />A <br />cENERAL UABIUTY <br />I CBP949124B <br />6/16/2004 <br />EACH OCCUMENCE_ <br />F 1, 000, 00.0 <br />X' <br />COMMERCIAL GENERAL UABILITY <br />—]CLAIMS <br />FIRE DAMAGE (ARY one Bre) <br />E 100,000 <br />_ MADE f XIOCCUR <br />MED EXP 1".. M.1 <br />0 5,000 _ <br />PERSONAL&ADV INJURY <br />01,000,000, <br />GENERAL AGGREGATE <br />e2,000,000 <br />PRODUCTS COMPIOPAGG <br />GEI L AGGREGATE LIMIT APPLIES PER: <br />__ <br />02, OOO, OOO <br />POLICY PRO. <br />LOC <br />_. <br />—.... <br />A <br />AUTOMOBILE LIABILITY <br />CBP9491248 <br />6/16/2004 <br />6/16/2005 <br />X <br />COMBINED SINGLE LI MIT $1,000,000 <br />ANY AGTD <br />(Ee AF61.ID <br />ALL OWNED AUTOS <br />I <br />rF� <br />D AS <br />�jL�( <br />FORM <br />BODILY INJURY P <br />SCHEDULED AUTOS <br />APPP O <br />.1 <br />IP.r wr.Rnl <br />HIRED AUTOS <br />.—. . <br />BODILY INJURY <br />NON -OWNED AUTOS <br />IPer eCGCmtI 0 <br />t <br />uTa S tt She <br />dy <br />PROPERTY DAMAGE <br />IPer oeU0enl) 0 <br />GARAGE LIABILITY <br />AUTO <br />AUTO ONLY - EA ACCIDENT0 <br />OTHER THAN EA ACC L <br />IHANY <br />AUTO ONLY: AGO I 0 <br />EXCESS LIANUTY <br />ICU9492251 <br />06/16/2004 <br />6/16/2005 1 <br />EACH OCCURRENCE e5, 000, 000__ <br />A XI OCCUR F—ICWMS MADE <br />_ <br />AGGREGATE r$5, 000, 000 <br />DEDUCTIBLE <br />RETENTION 6 <br />° <br />C' MAXUS COMPENSATION AND <br />WC5402953 106/16/2004 <br />6/16/2005 XIER <br />EMPLOYERS' UAB&UTY <br />pRYLIMIT51 I <br />EL EACH ACCIDENT61,000,000 <br />_ <br />E. L. DISEASE EA EMPLOYEE 51,000,_000 <br />F.L. DISEASE -POLICY LIMIT Q,DDO, DQD <br />Bl Professional <br />HC051008401 '01/04/2005 <br />1/04/2006 imit $1,000,000 <br />Liability <br />eductible $25,000 <br />DESCRIPTION OF OPERATIONSAOCATIONSNEHOLES/EXCLUSIONS ADDED BY EMDORSEMENTS EGAL MOV19ONS <br />Certificate Holder is Listed as Additional Insured per Attached <br />City of Santa Ana <br />20 Civic Center Plaza- Mr, <br />Santa Ana, CA 92701 <br />ACORD 25-S <br />SHOUtD ANY OF THE ABOVE OESCMBED POLICIES BE CANOnLED BEFORE THF EXRIRATN)N <br />DATE THEREOF. THE MUM INSURER WILL}ayZyAV LXKMAR 3 D DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT yxx3SSiVu+_�y <br />v.XYY��var7ura�Yx�zilFs�aE7c�5�Yi�fy�v�CT`.�Rsx�l'akSin�e: <br />o<a1Y/ GLa1ne Croxton <br />F <br />.J <br />1QRN <br />