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ACORI).' CERTIFICATE OF LIABILITY INSURANCE CSR DR I DATE (MMJDDNYYY) -, LIDGA-1 03/24/05 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Wood-Gutmann Insurance Brokers ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE License #0679263 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 14192 Franklin Ave., Suite 200 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Tustin CA 92780-7044 Phone: 714-505-7000 Fax:714-573-1770 INSURERS AFFORDING COVERAGE NAIC# INSURED A-J-()(Y/- //0 INSURER A: CNA Insurance Companies INSURER B: Lid~ard & Associates, Inc. INSURER C Sco t Lidgard 2808 E. Kate11a Ave. #107 INSURER 0 Orange CA 92867 INSURER E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WlTH RESPECT TO VlJHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I'N5F [ADD1 TYPE OF INSURANCE POLICY NUMBER 'D'1..';!~~MM/DDIYY DATE-'MMJDDIYY L.IMITS LT. N5. ~NERAL LIABILITY EACH OCCURRENCE $ 1000000 A X X COMMERCIAL. GENERAL LIABILITY 2077135975 03/04/05 03/04/06 ~~~~~~s (Ea occurence) $ 100000 I CLAIMS MADE D OCCUR MED EXP (Anyone person) $ 10000 PERSONAL & ADV INJURY $ 1000000 GENERAL AGGREGATE $ 2000000 ~'~ AGGREnEILlMIT AP~tIPER: PRODUCTS - COMP/OP AGG $ 1000000 PRO- POLICY JECT LOC ~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1000000 A 0- ANY AUTO 2077135989 03/04/05 03/04/06 (Ea accident) I--- ALL OVv'NED AUTOS BODILY INJURY (Per person) $ f- SCHEDULED AUTOS I--- HIRED AUTOS BODILY INJURY $ NON-OVv'NED AUTOS (Per accident) I--- I--- '\ :~ '0 '~. (j j,-l-""~ PROPERTY DAMAGE $ nQj')\' -. ) (Peraccidenl) , RRAGE LIABIUTY , , AUTO ONLY - EA ACCIDENT $ 'i)1 , (;.,/ 'i " ANY AUTO --"' ~_...--~ OTHER THAN EA ACC $ .~It -' . "--..-:--:-:~~- 'jn~~ 1)' AUTO ONLY AGG $ .- '"' " i\t\\,n~"': OESSfUMBRELLA LIABILITY !\.s;,tSlJ,lll L,t) EACH OCCURRENCE $ OCCUR D CLAIMS MAOE AGGREGATE $ $ R DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND I TOr\'/UMITS I IO~.- A EMPLOYERS' LIABILITY 2077136009 03/04/05 03/04/06 $ 1000000 ANY PROPRIETOR/PARTNER/EXECUTIVE E,L EACH ACCIDENT OFFICERlMEMBER EXCLUDED? E.L. DiSEASE - C::A EMPLOYEE:. $ 1000000 ~~Etl~tS~~~v~s1oNS below E.L DISEASE - POLICY LIMIT $ 1000000 OTHER A Business Property 2077135975 03/04/05 03/04/06 PROPERTY 36300 DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS *10 day notice of cancellation for non-payment of premium. Certificate Holder is named as additional insured per attached G134844A. CERTIFICATE HOLDER CANCELLATION CITYSAA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Santa Ana DATE THEREOF, THE ISSUING INSURER WILL. ENDEAVOR TO MAIL ~ DAYS WRITTEN Public Works Agency NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHAL.L Attn: Taig Higgins IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR P.O. Box 1988 Santa Ana CA 92702 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE c~ ?,'vx > ACORD 25 (2001/08) @ ACORD CORPORATION 1988