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_09.!28 DEC 19, 2003 FR- ESTHER MYERS <br />ACORD CERTIFICATE OF LIABILITY INSURANCE <br />"'U"UER (714)569-Z700 FAX (714)569-3099 THIS CERTIFICATE IS ISSUE <br />PrideMark Insurance Agents/Brokers ONLY AND CONFERS NO RR <br />A Leavitt Group Company HOLDER. THIS CERTIFICATE <br />ALTER THE COVERAGE AFF <br />1820 F. First Street, Ste.#500 <br /># 9002 PAGE: 1.,2 <br />DATE (MWDDNYVY) <br />12/08/2003 <br />A MATTER OF INFORMATION <br />UPON THE CERTIFICATE ,. <br />Santa <br />Ana, <br />CA 92705 <br />INSURERS AFFORDING COVERAGE <br />wsuero <br />Orange <br />809 N. <br />County Crazies Znc. <br />Main St. <br />- --- <br />INsuRERA Nautilus_Insurance C <br />INSURER B. <br />Santa <br />Ana, CA 92701 <br />msURERC—_-------_-- <br />INSURER D. <br />.. <br />_ <br />INSURER F <br />rnvcoAncc <br />I HE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITl ISTANCnN <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CFRTIFICATE MAY BE ISSUED OR I,1AY PERTAIN THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AP:D CONDITIONS OF SUCH <br />10I.ICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INS R <br />DD' <br />- <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />12/02/2003 <br />POLICY EXPIRATION <br />12/02/2004 <br />LIMITS <br />A <br />cENERALUAearTY <br />X I COMMERCIAL GE.NERAI LAST T\' <br />L_' _ �_y � <br />CLAIMS h1ADE L—"J OCCURFSI <br />NC310828 <br />EACHo,CuPREN.E �s 1,000,00 <br />— <br />DARF� SF TO RENTEi b lOO Oo <br />I <br />MED ExP (Any ore person) <br />-- ---- -- -- <br />S <br />�00 <br />PERSONA; S ADV N.URY <br />_ <br />S _ 11000, 00 <br />—- <br />GENERAL AGGREGATE <br />S 2,000,00 <br />LMI'APPLIES PER ' <br />PROOJC-S-COMP1OPA-. <br />S INCLUDE <br />X POLIAGGREGATE <br />X POLICY PRO <br />JECT LOG <br />�— <br />— - _ <br />AUTOMOBILE <br />LIABILITY <br />_ <br />ANY AUTO <br />COMBINED SINGLE LIMIT <br />(Ea Ar.denC <br />S <br />ALL OWNED AUTOS-- <br />_ <br />bOUILY;NJURV(Per person) <br />S <br />SCHEDULED AUTOS <br />HIREOAUTOS <br />RDOIL" NJUR, <br />(Per accmenC <br />S <br />NON-OWNEDAUTOS <br />PROPERTY DAMAGE <br />(Per ac_rtlenq <br />S <br />GARAGE LIABILITY <br />_ <br />ANY AUTO <br />AUTO ONLY - EA ACCIDENT <br />S <br />OTHER THAN EA ACC <br />AUTO ONLY-. AGO <br />5 <br />S <br />EXCESSIUMBRELLA LIABILITY <br />OCCUR CLAIMS MADE <br />EACH OCCURRENCE <br />AGGREGATE <br />S <br />E <br />- <br />3 <br />DEDUCTIBLE <br />RETENTION S <br />—� �L������L�g <br />/ <br />2 <br />$ <br />WC STATU OTH. <br />S <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LUIB)UTY <br />ANY PROPRIETOWPARTNERIF.XECUTIVE <br />OrFICERIMEMBER EXCLUDED? <br />El EACH ACCIDENT <br />5 <br />E.L. DISEASE - EA EMPLOYE <br />5 <br />If yeS. describe under <br />SPECIAL PROVISIONS below <br />E.L. DISEASE -POLICY LIMIT <br />— <br />S <br />OTHER <br />I <br />DESCRIPTION OF OPERATIONS I LOCATIONS 'VEHICLES r EXCLUSIONS ADOEO BY ENDORSEMENT 1 SPECIAL PROVISIONS <br />o days notice of cancellation for non payment of premium <br />ity Of Santa Ana, its officers, agents, employers & volunteers are named as additional insureds per <br />ndorsement S114 forthcoming from the carrier. <br />E ICATE HOLDER -- <br />City of Santa Ana <br />Community Development Agency <br />P.O. Box 1986 <br />Santa Ana, CA 92702-1988 <br />ACORD 25 (2001/08) <br />cAnLaLLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL YrXAfXD Xft MAIL <br />30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. <br />Y��YWUtlG=xMdhNdDf;>IYXIXN�gtYYd(YifIXdF.`pN4X9iXi6Yl1(LY�(X X <br />%fMKIZEUREPRESENT TIVE Yi610fYXdt8NtY1SKYdHtrlfi6iW(p6MlEY7(XXXXXXXX <br />AUTHORIZED REPRESENTgTNE <br />lack WellsjESTHER <br />OACORD CORPORATION 1988 <br />