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<br />~ CERTIFICATE OF LIABILITY INSURANCE I DATE (IMMJDOlYYYYl <br /> 10/09/2003 <br />'RODUCER (949)263-0606 FAX (949)263-0906 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Complete Insurance, Inc. ONLY AND CONFERS NO RIGHTS UPON n-tE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />California DOl #0437762 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />19000 MacArthur Blvd., PH Flr <br />Irvine, CA 92612-1447 INSURERS AFFORDING COVERAGE NAIC# <br />NSUREC I ransportat,on Stua1es. J.nc. INSURER A: United States Fidelity & Guar. <br /> 1350 Reynolds Avenue, INSURER B: Fidelty & Guaranty Ins Co <br /> Ste. 115 INSURER c: St. Paul Fire & Marine Ins Go <br /> Irvine, CA 92614 A- ;20n3-14D INSURER 0: (c/o St. Paul - KS) <br /> INSURER E: <br />. <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDIN <br />~Y 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 JdAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /><.R DO' TYPEQF I~SURANCE POLICY NUMgER PO..L.!.~Y EFFECTIVE P~~s.r EXPIRATION LIMITS <br /> CENERAL UABILITY BK01514910 10/01/2003 10/01/2004 EACH OCCURRENCE $ 1,000 000 <br /> !-,-,.- <br /> X COMMERCIAL GENERAL LIABILITY MAGE T RENTED . 300,000 <br /> I CLAIMS ~ADE m OCCUR MED EXP (An;, 000 person) I 10,oor <br />A PE~SONAL & ArN It-.lJUlty $ 1,000.001 <br /> - GENERAL~GGREGATE . 2.000.000 <br /> = <br /> ~.~ AGG~Em,lIMIT APr!~tl PER: PRODUCTS - COMPJOP AGG I 2,000.000 <br /> POLICY X ~ID loe <br /> ~OM08lLE UAElIUTY BA0161&060 10/01/200! 10/01/2004 COMBINED SINGLE liMIT <br /> (Eaaco.d$l'otl I I,OOO,OO( <br /> ANY AUTO <br /> X All OWNED AUTOS BODILY INJURY <br /> .;.;.. (Per perron) . <br />B X SCHEDULED AUTOS <br /> HIRED AUTOS BODIL V INJURV <br /> Y . <br /> NON.OWNED AUTOS (Peracclclenl) <br /> - <br /> pROPERTY DAMAGE . <br /> "'"I" :nr,u (PlIraccldenl) <br /> ... <br /> ~~G. L1.BILllY i\ ,-",u .. <br /> AUTO QNL Y - EA ACCIDENT I <br /> ANY AUTO :/&... ,.I~ , 1'/ ) OTHER THAN EA ACe I <br /> \'." " " AUTO ONL V: AGG $ <br /> :=J~SSlUMBRELLA UABILITY L;\~' .! ::\1\:;,,(,: 'l::/ "'.'" EACH OCCUR:RENCE $ <br /> OCCUR D CLAIMS MADE Dl..'j'::!Y C\{: AGGREGATE I <br /> I <br /> ~ OEOUCTIBLE I <br /> RETENTION $ $ <br /> WORKERS COMPENaATlON AND WVA7735793 10/01/200! 10/01/2004 X 1~'19.STATU..1 ~ <br /> EMPLOYERS' LIABILITY 1.000, OO~ <br />C ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT . <br /> OFFICER/MEMBER EXCLUDED? E.L. DISEASE. EA EMPLOYE I I,OOO,OOC <br /> ~~~I~~~:JJ:~1gN5 below E.L. DISEASE. POLICY LIMIT I 1,000 OOC <br /> OTHER 10 day notice applies to <br /> non-payment and/or <br /> non-reporting <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICL~ I EXCLUSIONS ADDED BY ENDORSfMENT I SPECltL PROVISION-1 <br />~rtificate holder is additiona insured as respects genera liabillty and auto liability but only if <br />'equired by written contract with the named insured prior to an Dccurence and as per coverage form <br />:L/BF26090903 and endt, form CL/CA99090&95, Coverage subject to all policy terms and conditions. <br />:E: On-ca 11 traffic counting service. <br /> <br />City of Santa Ana <br />20 Civic Center Plaza, M-43 <br />Santa Ana, CA 92702 <br /> <br />SHOULD ANY OF THE ABOVE DE!CRlBED POLICies I!I;E CANCELLED BEFORE THE <br />EXPIRATION DATI! THI:RI:OF, T'HElSSUING IN5URERWlLLHJtX~ MAIL <br />~ DAYS WRITTEN NOTICE TO THE CERTIFICA.TE HOLDER NAMED TO THE LEFT. <br />~_UU__lIJlIIlOOIlQIl__AVJOO(X <br />__IKlOOilClJ(P1)(jl(IllI_I.I~IIlWCI16ltJO(XX)()(X)()(X <br />AUi1-IORlZED REPRESENTATIVE P.R- ~ 4fI~ ) <br />Alic1a I ram ICHMA ~.7~-- <br /> <br />ACORD 25 (2001/08) <br /> <br />@ACOROCORPORATION 1988 <br />