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<br />. <br /> <br />" <br /> <br />~ CERTIFICATE OF LIABILITY INSURANCE 1 DATE (II1WOfYYYY) <br /> 01/01/2004 <br />PRODUCER (310)393-9477 FAX (310) 393-7186 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />White , Company Insurance Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />POBox 70 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Santa Monica, CA 90406-0070 <br />Cecil Quinones INSURERS AFFORDING COVERAGE NAlC# <br />INSURED Pacific Coast Cabling Inc. INSURER A: Hartford Casualty Insurance Co 29424 <br /> 9340 Eton Ave INSURER 8: Majestic Insurance <br /> Chat.....orth, CA 91311 INSURER C: <br /> INSURER 0: <br /> . INSURER E: <br />"'...................... <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUREO NAMED ABOVE FOR THE POLICY PERIOO INDICATEO. NOTWITHSTANDINI <br />ANY REOUIREMENT, 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 L1MIT5SHOWN MAY HAVE BEEN REOUCED BY PAlO CLAIMS. <br />".. DO' TYPE OF INSURANCE POUCY NUMBER POUCY EFFECTIVE POUCY EXP1RA noN UMITS <br /> . .!.,.EHERAL UABIUTY " 72U1JNUQ7399 01/01/2004 01/01/2005 EACH OCCURRENCE . 1 000 000 <br /> .! COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED . 300 oor <br /> - j CLAIMS MADe 0 OCCUR MED EXP (Any one person) . 10 000 <br />A PERSONAL & ADV INJURY . 1,000 000 <br /> GENERAL AGGREGATE . 1 000 000 <br /> ~~AGG~rilE ~~: APriSIPER: PRODUCTS. COMPfOP AGO . 1 000 000 <br /> POLICY X JEer LOC <br /> ~OMOBII..E UABlUTY 72U1JNUQ7399 01/01/2004 01/01/2005 COMBINED SINGLE LIMIT . <br />/ ~ ANY AUTO (Eaacciclenl) 1 000 000 <br /> >- ALL. OWNED AUTOS BOOI\. Y INJURY <br /> (Per person) . <br /> SCHEDULED AUTOS <br />A >- <br /> ~ HIRED AUTOS BODILY INJURY <br /> . <br /> ~ NON-OWNED AUTOS (Peraccidenl) <br /> I- PROPERTY DAMAGE . <br /> (PI18Ccident) <br /> RRAGE UAB"ITY AUTO ONLY. EA ACCIDENT . <br /> ANY AUTO OTHER THAN EAACC . <br /> AUTO ONLY: AGG . <br /> ~ESSIUMBRELLA lIABILITY 72R11UUQ7263 01/01/2004 01/01/2005 EACH OCCURRENCE . 6 000 000 <br /> X OCCUR D CLAIMS MADE AGGREGATE . 6 000 000 <br />A . <br /> ~ DEDUCTIBLE . <br /> RETENTION . . <br /> WORKERS COMPENSATION AND C20030290701 01/01/2004 01/01/2005 X we STATU. IOJ~' <br /> EMPLOYERS' LIABIUTY E.L EACH ACCIDENT . 1 000 000 <br />B ANY PROPRIETOAIPAATNER/EXECUTlVE ~7~ :VE..j": AS T( > <br /> OFFICER/MEMBER EXCLUDED? "., " E.L. DtSEASE. EA EMPLOYE . 1 000 000 <br /> g~~,~~s~~J!S1o~s below " E.L DISEASE. POLICY LIMIT . 1 000 000 <br /> OTHER " /' ./.. , A, ,-Is. <br /> r~ ('u"'. _. ttj:-.-:l <br /> ,~,aura ';I;tt _<'~( y <br />DESCRIPnON OF OPERATIONS I LOCAnONS { VEHICLES I EX IE01f lNDOhSEMENT-j SPECIAL PROVISIONS <br />ertificate holder is an additional insured as per form HGOOOl1001, Section II, paragraph 6, attached <br />o the general liability policy and accompanying this certificate. <br />Except for 10 days written notice of cancellation for non-payment of premium. <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 />30* DAYS WRITTEN NOTICE TO THE CERTifiCATE HOLDER NAMED TOTHE LEFT, <br />BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABIUT'l' <br />OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. <br />AUTHORIZED REPRESENTATIVE <br />Kathleen Benner ACSR/KJB <br />ACORD 25 (2001/oB) @ACORDCORPORATION 19BB <br /> <br />City of Santa Ana, Its Officers, Agents , <br />Employees <br />Information Svcs Div M-12 <br />P.O. Box 1966 <br />Santa Ana, CA 92702 <br /> <br />