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<br />ACORD CERTIFICATE OF LIABILITY INSURANCE I DATE (MINDDIYYYY) <br />~ 08/25/2004 <br />PRODUCER (949)851-8800 FAX (949)851-8802 THIS CERTIFICATE IS ISSUED~:i! A MATTER OF INFORMATION <br />GSM Insurance Services ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />License No: OD15612 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />30 Corporate Park #307 INSURERS AFFORDING COVERAGE NAIC# <br />Irvine, CA 92606 <br />INSURED Curbside, Inc. ~_~-Dq1- INSURER A: Steadfast Insurance Company <br />1605 N. Spurgeon St. INSURER B: Zurich American Insurance Co <br />Santa Ana, CA 92701 Pr/~/l'lb INSURER c: State Compo Ins. Fund of CA 3>076 <br /> INSURER D: <br /> INSURER E: <br /> <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLtCY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER OOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES OESCRIBED 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 POUCYNUIIBER I ~ DA~ LIMITS <br /> GENERAL LlABtllTY GPL 543 5554-00 08/23/2004 08/23/2005 EACH OCCURRENCE s I,OOO.OO( <br /> X COMMERCIAL GENERAl lIABILITY I PRëMì5h œ\ S 100 001 <br /> I CLAIMS MADE [!] OCCUR MED EX? (Anyone person) S 25,001 <br />A PERSONAL & 1úJV INJURY S 1 000 001 <br /> GENERAl AGGREGATE S 1,000 001 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PROOUCTS-COMPIDPAGG S 1,000 001 <br /> POLICY n ~Gg: n lOG <br />, AUTOMOBILE UABIUTY BAP 543 5553-00 08/23/2004 08/23/2005 <br /> - COMBINED SINGLE LIMIT S <br /> -! ANYAUTO (Eaaccidenl) 1,000,0001 <br /> ALL OWNED AUTOS $1,000 DED CDMP <br /> - BODilY INJURY S <br /> SCHEDULED AUTOS $1,000 DED COLL (Perper$Of1) <br />B - HIRED AUTOS <br /> - BODILY INJURY S <br /> NON-OWNED AUTOS (PeracGident) <br /> - <br /> PROPERTY DAMAGE S <br /> (Per accident) <br /> GARAGE LIABILITY AUTO ONLY- EA ACCIDENT S <br /> =1 ANY AUTO OTHER THAN EAACC S <br /> AUTO ONLY: AGe S <br /> EXCESSIUMBRELlA UABlUTY EACH OCCURRENCE S <br /> :=J OCCUR 0 CLAIMS MADE AGGREGATE S <br /> S <br /> =1 DEDUCTIBLE S <br /> RETENTION S S <br /> WORKERS COMPENSATION AND 1750381-04 08/23/2004 08/23/2005 X I T'òj¡níWi. I I' ER <br /> EMPlOYERS' lIABILITY <br />C ANY PROPRIETORlPARTNERÆXECUTlVE E.L. EACH ACCIDENT S 1,000,001 <br /> OFFICERlMEMBER EXCLUDED? E.l. DISEASE. EA EMPlOYE S 1,000,001 <br /> g~~ht.~J\S1grNS below EL DISEASE. POLICY LIMIT S 1,000,001 <br /> OTHER GPL 543 5554-00 08/23/2004 08/23/2005 $1,000,000 Each incident <br /> ~õntractor I s Pollution <br />A Liabil ity $1,000,000 Policy aggregate <br />DESCRtPTlON OF OPERATIONS I LOCATIONS 'VEHICLES' EXCLUSIONS ADDED BY ENDORSEMENT' SPECIAL PROV1S1ONS <br />~he general liability policy includes the City of Santa Ana, its officers, employees, agents, <br />volunteers and representatives as additional insured with regard to work performed by or on behalf of <br />the Named Insured where required by written contract. <br />Except 10 days for nonpayment of premium. <br /> <br />COVERAGES <br /> <br />CERTIFICATE HOLDER <br /> <br />CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WtLL ~ MAIL <br />.....lO.!- DAYS WRlTIEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br /> <br />City of Santa Ana <br />Department of Public Works <br />20 Civic Center Plaza, ~r1) <br />Santa Ana, CA 92702 <br /> <br /> <br />1III06tIOOIIOO D~OOIIOOI!UIJI~X <br />I O~JlJlJIIU6roI (JI~J()(XXXXXXJ( <br />AUTHORtZ P7ATlVE <br /> <br />ACORD 25 (2001/08) <br /> <br /> <br />@ACORD CORPORATION 1988 <br /> <br /> <br />J, 'itv Al!orncy <br />