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<br />ACORD CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDIYYYY) <br />. m 10/05/2005 <br />PRODUCER (610)356-0400 FAX (610)356-1794 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Summit Insurance Group, Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />2098 West Chester Pike, 2nd Fl ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />P.O. Box 457 <br />Broomall, PA 19008 INSURERS AFFORDING COVERAGE NAIC# <br />'NSUREO OPEX Corporatlon INSURER A: St Paul Travelers 25674 <br />305 Commerce Drive INSURER B: <br />Moorestown, NJ 08057-4234 INSURER c: <br /> INSURER D: <br />A-1M2- r,'J,1-1l1 1\.-1002-031- O~ 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 W'TH 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 />~ ~ TYPE OF INSURANCE POLICY NUMBER DATE MMlDD DATE MMIOONVf LIMITS <br />p:.:..:.:. GENERAL LIABILITY Y-630-5070A300-TIL-05 10/01/2005 10/01/2006 EACH OCCURRENCE $ l,OOO,OOl <br /> f-c <br /> X COMMERCIAL GENERAL LIABILITY PREMISES )E~:C~~nce\ $ 100 , 00< <br /> I CLAIMS MADE [!] OCCUR MED EXP (Anyone person) $ 5,OOl <br />A PERSONAL & ADV INJURY $ l,OOO,OOl <br /> GENERAL AGGREGATE $ 2.0oo,OOl <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS. COMP/O? AGG $ 2,000,00< <br /> h POLICY n ~:8i n LOC <br /> AUTOMOBILE LIABILITY Y-810-5070A300-TIL-05 10/01/2005 10/01/2006 COMBINED SINGLE LIMIT <br /> X Id'N AUTO (Eaaccidenl) $ 1,000,000 <br /> - <br /> ALL OWNED AUTOS BODILY INJURY <br /> - $ <br /> SCHEDULED AUTOS (Per persOn) <br />A X <br /> HIRED AUTOS BOOlL Y INJURY <br /> X (Peraccidenl) $ <br /> NON-OWNED AUTOS <br /> -'-'- . <br /> PROPERTY DAMAGE $ <br /> (Per accident) <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ <br /> . ~ A"'AUTO OTHER THAN EAACC $ <br /> AUTO ONLY: AGG $ <br /> EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ <br /> :=J OCCUR D CLAIMS MADE AGGREGATE $ <br /> $ <br /> ~ DEDUCTIBLE $ <br /> RETENTION $ $ <br /> WORKERS COMPENSATION AND TRJ-UB-2922B09105 10/01/2005 10/01/2006 X I T'6~ lfJlis I l"l,f <br /> EMPLOYERS' UABILlTY l,Ooo,OOC <br />A ANY PROPRIETORIPARTNERlEXECl1TIVE E.L. EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYE $ l,OOO,OO( <br /> 1f~,describEtunder 1,000,000 <br /> S EC!AL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ <br /> OTHER <br />~ESCRlPTlON OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONA <br />...ity of Santa Ana is named as Additional Insured. PI";')',! rI-'." 1'0 <br />.' ~ '.' ...-l/.. ~i\j <br /> ~}//;/;Cy/ Ie <br /> A~':'bt2,1l eilll i\./'.\" '.. <br /> <br />CERTIFICATE HOLDER <br /> <br />CANCELLATION <br /> <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL <br /> .3.0..- DAYS WRITTEN NOTICE TO THE CERTIACATE HOLDER NAMED TO THE LEFT, <br />City of Santa Ana BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABIUTY <br />20 Civic Center Plaza OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. <br />Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE ~ .&'fF -P" , <br /> , "' "" "'~ <br /> <br />ACORD 25 (2001/08) <br /> <br />@ACORD CORPORATION 1988 <br /> <br />(\'Illy <br />