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<br />~7/07/?004 10:3" FAX 714 53S 405"
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<br />Bannister 8 Assoc. Ins.
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<br />III 002/003
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<br /> ~ CERTIFICATE OF LIABILITY INSURANCE I C.&.TBIIIIMlDDIV'tYY) i
<br /> 07/01/2004
<br />I ".OoIlOER (714) 536-6086 FAX (714)536-4054 THIS CERTIFICATE IS ISSUED AS A MATTER DF INFORMATION i
<br /> Bannister & ASsociates Insurance Agency. Inc_ ONLY AND CONFERS NO RlGHTI UPON THE CERTIFICATE
<br /> LiCQhse ~0691071 HOLDER, THIS CERTIFICATE DOES NOr~EJ!e',~.ls~D OR
<br /> ALTER TH!! COVERAGE I!D BT I BELOW.
<br /> 305 17th St~eet I
<br /> Huntington Heath, CA 9Z64f-4Z09 'NSURERS AFFORDING coveRAGE NAlCI# I
<br /> '"'U~EO Roger !"Bubel PubHc Affau's J:nc. a CA \;orp INSU~A. Ma"yland Casualty CoqJany i III
<br /> . I dba: Waters & FRubel 4-~-1J6 INSURER a: Philadelahia J:nsurance'Oompanies I
<br /> , 25 orchard II'lAUi<ER C: ,
<br /> , i
<br /> lake Forest, CA 92630 INSURSR 0; , I
<br /> ,
<br /> INSl!R6I< EI
<br /> THE POUCIES OF INSUAA~C! ~ISTED BELOW HAVE BeEN IssuED TO niE INSUI'IED NAMED ABO\/E FOR THE PO~lcY Ft!FUOD J~DICATED. NO""IlliSTANDII+
<br /> ANY REQUIRliMEN"I', TERM r;lFl CONDITION OF ANY CONTRACT 01\ OTHeR DOCUMEN"I' WITH ResPECT TO WHICH THIS CERTIFICATE MAY e. ISSUED DR
<br /> ~RTAIN' THE INSURANCE AFFORDED BY THE FOUCIES DESCRIBED HEREIN IS aUIlJECT TO AU. THE TERMS. El<Cl.USIONS AND CONDITIONS OF SUCH
<br /> PPUCIES, AGGREaATE ,!M1T3 SHOWN MAY ~VE BEEN REDuceD 8" FAlD:&: ~
<br /> 11.5" TYJIE Of: rNlUAANCE l=IcLI~ NU!IlBeR. CY. EF EXJiIIM: ON UMIT$
<br /> ..;!~_~IAIILm' PPS 33413221 07/0 2004 0710112005 ~N'ENCE · 1.000.0
<br /> K Cle"'MEl:.c~ G1CNEJIl:AI.I.IAIIIUTY TO ~ oS 1 000 01111I
<br /> I Cl.AI"'" MAO. 00 ocou. "EO ro '"'" ." ."'''1 . 10,0 ,
<br /> A - PERSoNAL" AQV INJVRY . bcl ud
<br /> llINli"",AGGIlEGATE s 2,000.0
<br /> ---,
<br /> GEN'l AGtJnE, L1ii1I'1'APn PER: FROCUCTS. CClAl>/tlP.<GO S 2.000.0
<br /> Xl "'oLlCY ~~ Loe
<br /> ~aMOBU UUlLfTY PPS H41U21 07/01/2004 01/01/2005 COMBINED al~ LIMI'r
<br /> ISo .."".." ,
<br /> ANY AUTO 1 000 0
<br /> -
<br /> AI, ov>'";O AUTOS BODILY INJURY
<br /> - (PQrpersCl"l I
<br /> A X eQlotaDULEDAUTOS
<br /> ttFl.ED ~UTO~ ElbDll.V INJURY
<br /> X (Pw .-h:lllf1l;) , I'll
<br /> NON.OWNED Ai.J'T'QS X$utJ 'yIP ,
<br /> "-'- I
<br /> , PRQPEh:'1Y oAMAGE . :
<br /> ('''_l.; ,
<br /> =r'~ UAlIJLm' /I AIJTC ON\. y. SA ACGIDINT . "
<br /> /JIfrAijTO C1THOIl THAll EAACe . ! :~l
<br /> AUiO CN...': AGG . I
<br /> EKCE.S~UMMIZt.LA UAlIlJ'T'T PPS 33413221 07/0l/2004 07/01/200S l!ACH accUMENCI , 2.000 0
<br /> Xl OCCUA 0 cLAJMS w,oE AOGReGATE . 2.000,0
<br /> iAI I
<br /> 1 R ~E~ueTIBlE
<br /> i I
<br /> ~ON . I
<br /> WOFu<ERs CClt1I'Il~DATION AND CSTAT\lo,1 m
<br /> ElAPI.OW\S' ~
<br /> ANY P~QPRJI!TOFWART/II~UTI\IE E.,. iAi.:fi ACQID2NT .
<br /> oFPIC.I!~!M81i~ MtLUOED? &L.O'll....e.EA-.OTUi .
<br /> If rn' dMCribe Wldllr e,!... OIBI$ASE -PCLICYL1MlT Ie
<br /> " EClAl PROVISIONS hellow
<br /> ~'j!!ess;ona' Liability PHSD060366 07/21/2003 07/21/2004 $1,000,000 each claim
<br /> B 51,000,000 annual aggr.gate
<br /> ;ncludins cla;ms "Dense
<br /> ~ aF OP'lunONS/L0C4~CNS IV~' ElCL.UltoMe APPEC 5' INffrlClENT 19P5CI~;t~
<br /> O~ ay noti~e of cance lat;on or non-payment/t S notice w 1 be sent in thB event of company elBct10n
<br /> he C;ty of Santa Ana, its officers. agants, representatives. volunteers and emploYHHs are named as !
<br /> ddit;ona' insured as rHspHcts genHrll liability. ,
<br /> rimary ~rding included per general liability ~overage form 952001 049 "
<br /> aiver of subrogation andorement applies to be issued by the carrier. i "
<br /> I ~.~
<br /> I ,
<br /> , "~B .. 1 II
<br /> GHOULD ANY ar THe ABOVE tlElClllBBD PIX,)GIUi .. GANCELUD.1IIOIIr. TtIE II I I
<br /> I ,
<br /> ..-TION OATE T~elWlf, TIlE "UlNO ...y....WlLL ~ MM- , ."1
<br /> I i ~l
<br /> C;ty of Santa Ana -.!!!....1l.O,. WItlTreH NOTICe TO TIlE Cl!Rl1I'ICATE ~OUoEll NAIlED Tll TIlE LE1'T. '
<br /> Public Works AsHney M-36 __"~r1m~"JIII{V'IlUlXlK.~IIU~MWtGlU
<br /> PO BOll: 1988 , lft'..........v."~nxxxxx
<br /> I Santa Ana, CA 92702 AU1'HORl~~RE91 "TNI! .6:,/ , ;
<br /> ! , _ ,;("":':"'" "...:L. ._. I
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<br /> m-, i'OO/BOOd 9ll-! _WOJ, WE 10: II i'OOHI-^"N I.
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