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<br />. <br /> <br />ACORDN CERTIFICATE OF LIABILITY INSURANCE I DATE(MJAlDDIYYYY) <br />8/23/2005 <br />PRODUCER FAX (949) 851-8802 THIS CERTIFICATE IS ISSUED AS 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: 0015612 ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW. <br />30 Corporate Park #307 <br />Irvine CA 92606 INSURERS AFFORDING COVERAGE NAIC# <br />INSURED A - 2.004- l'OS INSURER A: Steadfast Insurance <br />Curbside, Inc. INSURER 8: Zurich American Insurance <br />1605 N. INSURER c: <br /> INSURER 0: <br />Santa Ana CA 92701 INSURER E <br /> <br />COVERAGES <br /> <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOlWlTHSTANDlNG ANY <br />REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER OOCUMENT WITH RESPECT TO WHICH THIS CER"I1F1CATE MAY BE ISSUED OR MAY PERTAIN, <br />THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE lERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. <br />AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, <br />INSA ADD'l. . POLI11"EFFECTIVE POUClt~P1RATlON UMITS <br />LTR NSR TYPE OF INSURANCE POuey NUMBER OA TE MMIODIYY) DATE MMlDOJYY) <br />A ~EAAl.I.IAe.ILITY GPL .543 .5.5.'54-01 08/23/2005 08/23/2006 EACH OCCURRENCE $ 1,000,000 <br /> X COMMERCIAL GENERAL UABlLITY ~~~~~'Te~~~ncol $ 100,000 <br /> I CLAIMS MADE ~ OCCUR MED EXP {/lnJ one peracn\ $ 25,000 <br /> PERSONAL & NJV INJURY $ 1,000,000 <br /> GENERAL AGGREGATE $ 1,000,000 <br /> ~~ AGG~n~M~ ^n~PER; PRODUCTS. COMPIOP AGO $ 1,000,000 <br /> POUCY JE'8r LOC <br />B ~TOMOBfLE UABILITY BAP 543 5553-01 08/23/2005 08/23/2006 COMBINED SINGLE LIMIT 1,000,000 <br /> (Eaaccldert) $ <br /> ..!. ANY AUTO <br /> - ALL OWNED AUTOS BODILY INJURY <br /> (par peBon) $ <br /> - SCHEDULED AUTOS - <br /> - HIRED AUTOS $1,000 DED CaMP SODll Y INJURY <br /> {Per Bccldenl) , <br /> I-- NQN..QWNED AUTOS <br /> I-- $1,000 DED COLL PROPERTY DAMAGE <br /> (peraccklenl) . <br /> RR'GEUABIUTY ....lITO ONLY. EA ....CClDENT . <br /> ANY AUTO OTHER THAN EA ACe $ <br /> AUTO ONLY: AGG $ <br /> EXCESSlUMBRElLA UABIUTY EACH OCCURRENCE . <br /> tJ OCCUR 0 CLAIMS MADE AGGREGATE $ <br /> $ <br /> r---l <br /> H ~EOUCTlBLE $ <br /> RETENTION S $ <br /> WORKERS COMPENSATION AND IT~lf .,1 10J,H- <br /> S ER <br /> eMPlOYERS' LIABILITY <br /> ANY PROPRIETORlPARTNERlEXECUTlVE E.L. EACH ACCIDENT $ <br /> OFFICERlMEMBER EXCLUDED? E.L DISEASE. EA EMPLOYEE S <br /> Ifyu,wlcrlbB LO:l... E.L. DISEASE. POUCY LIMIT S <br /> SPECIAL PROVISIONS below" <br />A OTHER Contra.ctor I B GPL 543 ~~~4-01 08/23/2005 08/23/2006 $1,000,000 Each incident <br /> Pollution Liab.i.li.ty $1,000,000 Poli.cy aggreqate <br />DESCRIPTION OF OPERATIONS/LOCA.TIONSfV&lICL.ESJEXCLUSlONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br />'!'he general liability policy inel.udes the City of Santa Ana., its officers, employee.8, agents,volunteers and <br />representatives as additional insured with regard to work performed by or on behalf of the N~d Insured where requirad <br />by wr1tten contract.*Bxcept 10 day. for nonpayment of prem <br /> <br />CERTIFICATE HOLDER <br /> <br />City of Santa Ana <br />Department of Public Works <br />20 Civic Center Plaza, <br />Santa Ana, CA 92702 <br /> <br /> <br />CANCELLA nON <br />SHOULD ANY OF THE ABOVE DESCRIBED POlICIES BE CANCELLED BEfORE THE <br />expiRATION DAn: THEREOF, THE ISSUING INSURER WUJ.. ~ MAIL <br />AYS WRITTEN NOTICe: TO THE CERTIFlCATl! HOLDER NAMED TO THE lEFT, B <br /> <br />o R9RI!!S!NT A. TIVE <br /> <br />ACORD 2S (2001108) <br />INS025 (0108)06 AMS <br /> <br />Deputy City Attorney <br />VMP Mc.1gege Sohiiore, Inc. (BOQ}327-o545 <br /> <br />ACORDCORPORATtON 1998 <br />Page 1 r:J2 <br />