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<br />TM <br /> <br />CERTIFICATE OF LIABILITY INSURANCE <br /> <br />I DATE (MMIDDiYYYY) <br />DEC 20 04 <br /> <br />\4 CORD <br /> <br />INSURED <br /> <br />~__ ~ AgencyLiC#: 03150~_ <br /> <br />tJ -ao04 -1-'t3 <br /> <br />PARADIGM IMAGING GROUP INC <br />1590 METRO DR #116 <br />COSTA MESA CA 92626- <br /> <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> <br /> <br />. INSURERS AFFORDING COVERAGE 1- NAIC # <br /> <br /> <br />-I~:_~::: ~_n ~~:~:~~~~~~~:~~NES~::~~I~~. ~- I ~ ~ .- <br /> <br />I",,~URE~__ ' _ <br />INSURER 0: <br />INSURER E: <br /> <br />- <br /> <br />PRODUCER <br />ALLIED BROKERS\ YEARGIN INSURANCE AGENCY <br />15375 BARRANCA PARKWAY, #C-102 <br />IRVINE CA 92618 <br /> <br />COVERAGES <br /> <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING <br />ANY 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 MAY HAVE BEEN REDUCED BY PAID CLAIMS <br /> <br />1-~~-;rAOO~l TYPE OF INSURANCE <br />lTR'IINSR <br /> <br />72SBAAB2623 <br /> <br />POLICY EFFECTIVE <br />DATE MMIDDIYY <br />NOV 20 04 <br /> <br />POLICY EXPIRATION <br />DATE MMJDDIYY <br /> <br />LIMITS <br /> <br />POLICY NUMBER <br /> <br />A <br /> <br />GENERAL LIABILITY <br />1- X _COMMERCIAL GEN,=-RAL L1ABILI <br />~'MS MADE X OCCUR I' <br /> <br /> <br />-- - <br />GEN'L AGGREGATE LIMIT APPLIES PER! <br /> <br />NOV 20 05 EA~H OCCURRENC~ ___~_ _~OO~.OOO <br />~~~~~":~~~~""e' ' ~OO~ <br />MED EXP(Anyoneperson} 1$ 10000 <br />PERSONAL & ADV INJURY k -1.000:00~ <br />GENERAL AGGREGATE ~__ 2,OOO!.!>.OO <br />PRODUCTS-COMP/OP AGG. $ _2,000,000_ <br /> <br />POLlCY <br /> <br />PROJECT <br /> <br />LaC <br /> <br />AUTOMOBILE LIABILITY <br />; ANY AUTO <br />!---l ALL OWNED AUTOS <br />SCHEDULED AUTOS <br /> <br />72SBAAB2623 <br /> <br />NOV 20 04 <br /> <br />NOV 20 05 <br /> <br />COMBINED SINGLE LIMIT <br /> <br />I' ~::I::~S~RY -----r,' <br />{Per person) I: <br /> <br />1,000,000 <br /> <br />A <br /> <br />I-~ <br /> <br />HIRED AUTOS <br />NON-OWNED AUTOS <br /> <br />BODILY INJURY <br />(Per accident) <br /> <br />i$ <br /> <br />PROPERTY DAMAGE <br />(Peraccidenl) <br /> <br />$ <br /> <br />GARAGE LIABILITY <br />ANY AUTO <br /> <br /> <br />I' AUT9 ONLY - EAA~C;:IDENL--,!-_ <br /> <br />OTHER THAN EA AGe $ <br />AUTO ONLY: - $ <br /> <br />EACH OCCURRENCE $ <br />--- -~ <br />, <br /> <br />I AGGREGATE <br /> <br />~I:~ <br /> <br />'$ <br /> <br />I I: E.XCESS/UMBREL.~__L1ABILITY I <br />__I OCCUR [J CLAIMS MADE <br />. , ' <br />-1 DEDUCTIBLE I <br />RETENTION $ <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br />B ~~~16~:"~~1~~~~~~~~~:ECUTIVE <br /> <br />r: <br />v <br /> <br />v <br /> <br />3900001790031 <br /> <br />OCT 1 04 <br /> <br />OCT 1 05 <br /> <br />I ,WCSTATU. L' OTHER <br />~-------IORYllMrrS_ I <br />I E.L. EACH ACCIDENT 1$ <br />, ~~~SEAS-E~EA EMPLOYEEl $ <br />E.L. DISEASE-POLICY LIMIT $ <br /> <br />_~,ooo,ooo <br />100,000 <br />1,000,000 <br /> <br />;Ifyes, describe under <br />SPECIAL PROVISIONS below <br /> <br />OTHER: VALUABLE PAPERS <br /> <br />72SBAAB2623 <br /> <br />NOV 20 04 <br /> <br />NOV 20 05 <br /> <br />$25,000. <br /> <br />A <br /> <br />DESCRIPTION OF OPERA TIONS/LOCA TIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS <br />CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED AS PER THE ATTACHED ENDORSEMENT <br /> <br />THE CITY OF SANTA ANA <br />PUBLIC WORKS AGENCY Mas <br />220 SOUTH DAISY AVE. <br />SANTA ANA, CA. 92703 <br /> <br />CANCELLATION <br /> <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL MAil 30 DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT <br /> <br />CERTIFICATE HOLDER <br /> <br />AUTHORIZED REPRESENTATIVE <br /> <br /> <br /><:.. <br /> <br />ACORD 25 (2001108) <br /> <br />Certificate # <br /> <br />3584 <br /> <br />lchael Yeargin <br />0315093 @ACORDCORPORATION1988 <br /> <br />Attention: <br /> <br />DAVE PATTON <br />