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<br />ACORD. CERTIFICATE OF LIABILITY INSURANCE CSR ND I DATE (MMIDDIYYYY) <br />CUMCA03 03/01/05 <br />PRODU~R . THIS CERTIFICATE is ISSUED AS A MATTER DF INFORMATION <br />, ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />Woods & Grooms, Inc. HOLDER. THIS CERTiFICATE DOES NOT AMEND. EXTEND OR <br />529 Washington Street AL TEll THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Columbus IN 47201 <br />Phone:812-373-4435 Fax: 812-373-4445 INSURERS AFFORDING COVERAGE NAIC# <br />INSURED N - ;}-.V{) 1- /53 INSURER A- Zurich API.riOa In.~r",nOQ Co. 0212 <br /> INSURER B Z1.II:ioh ~ria. Insur¡¡nC8 C3?'P 0212 <br /> cumm~ns Cal Pacific LLC INSURER C <br /> 1939 Deere Avenue IN5URf;¡'¡ D. <br /> Irvinø CA 92606 <br /> 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- NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THLS C¡;;RTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POL.ICIES DESCRIBED HEREIN \5 SUBJECT TO All THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUC.FD BY PAID ClAIMS <br /> <br />LTR ftSR <br /> <br />TYPE OF INSURANCE <br />GENERAL LIABILITY <br />X~MERC\Al GENfRAL UABIllTV <br />I -.J CLAIMS MADE ~ OCcuR <br />X Broad Form Liab <br />X Contractual Liab <br />GEN'L AGGREGATE LIMIT APPLIES PER. <br />X ~f8r LaC <br />AUTOMOBILE LIABILITY <br />X ANY AUTO <br /> <br />B <br /> <br />x <br /> <br />B <br />B <br /> <br />B <br /> <br />x <br /> <br />B <br />B <br />B <br /> <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />X HIRED AUTOS <br />X NON-OWNED AUTOS <br />X Auto Phys Damage <br /> <br />B <br /> <br />x <br /> <br />GARAGE lIABlUTY <br />X ANY AUTO <br /> <br />A <br /> <br />EXCESs/UMBRELLA LIABIUTY <br />X X OCCUR 0 CLAIMS MADE <br /> <br />x <br /> <br />D!:DUCTIBLE <br />RETENTION <br /> <br />110 000 <br /> <br />B <br /> <br />WORKERS COMPENSATION AND <br />EMPLOYERS'LIABILlTY <br />ANY PROP:tlETùRiPARïNŒIE;<EGUïï.,iE <br />OfFICERtMEMBER EXCLUDED? <br />~~~~I~~~W¡;'V~~~~~s below <br />I OTHER <br />Property Insurance <br /> <br />A <br /> <br />POLICY NUMBER <br /> <br />- P <br />DATE MMroDIYY DATE MM/DDIYY <br /> <br />EACH OCCURRENCE <br /> <br />GL0373102201 <br /> <br />03/01/05 <br /> <br />03/01/06 <br /> <br />PREMISES (Ea occ;ureoœ <br />MED EXP (Any one per50n) <br />PERSONAL & ADV INJURY <br /> <br />GENERAL AGGREGATE <br />PRODUCTS - COMPIOP AGG <br /> <br />COMBINED SINGH LIMIT <br />(Eaa~dent) <br /> <br />BOO',L Y INJURY <br />(Perp8fMn) <br /> <br />BAP373102101 <br /> <br />03/01/05 <br /> <br />03/01/06 <br /> <br />BODilY INJURY <br />(Peraccldenl) <br /> <br />PROPERTY DAMAGE <br />(Peracddonl) <br /> <br />AUTO ONLY. EA ACCIDENT <br /> <br />BAP373102101 <br /> <br />03/01/05 <br /> <br />03/01/06 <br /> <br />OTHER THAN <br />AUTO ONLY. <br /> <br />UMB373880401 <br /> <br />03/01/05 <br /> <br />03/01/06 <br /> <br />EACH OCCURRENCE <br />AGGREGATE <br /> <br /> <br />UMIT5 <br /> <br />$ 1,000, _°00 <br />$ Included <br />.5,~ <br />.1 000,000 <br />'.2,000,000 <br />.2,000,000 <br /> <br />s 1,000,000 <br /> <br />. <br /> <br />. <br /> <br />. <br /> <br />.1,000 000 <br /> <br />EA ACC S <br />AGG $ <br />.5,000,000 <br />.5 000,000 <br />. <br /> <br />. <br />. <br /> <br />WC373102301 <br /> <br />03/01/05 <br /> <br />03/01/06 <br /> <br />X TORY LIMITS <br />E,L~ ~ACH_~9~~~~~-- ~~QQ9~ -..---- <br />H.OISEASE-EAEMPlOYEE $1000000 <br />E.L DISEASE-POLlCYL\MIT $1000000 <br /> <br />CP0373880301 <br /> <br />03/01/05 <br /> <br />03/01/06 <br /> <br />Spec Form <br />RC <br /> <br />DESCRIPTION OF OPERA nONS I LOCATIONS I VEHICLES I eXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br />DieBel engine sales and sérvice. The City of Santa Ana, its offìcers, <br />emmployees, agents, volunteers, and representatives are added as additional <br />insur9ds for work pérformed, but only as respects to Cummins Cal Paci~ic, <br />LLC's so~e negligence. fax 714-647-6944 fax 949-253-6080 <br /> <br />CERTIFICATE HOLDER <br /> <br />CANCELLATION <br /> <br />ER <br /> <br />A <br /> <br />DEPOTSA <br /> <br />SHOULD ANY OF THE AÐOVE DESCRIBED POLlCIE:5 81: CANCI!LLED BEFORE THE EXPIRATION <br />DATE 'THEREOF, THE ISSUING INSURER WILL EIJBEA.ðK TO MAIL ~ DAYS WRmEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BtJT ñl.,ll:.t:I[1[ 18 88 !- un...t:.-l. <br /> <br />The Depot as Santa Ana <br />Carolyn Fullerton <br />1000 East Santa Ana Blvd. #108 <br />Santa Ana CA 92701 <br /> <br />APPROVED AS 'TO <br /> <br />ACORD 25 (2001/08) <br /> <br />2'd <br /> <br />RErREa[WM.,.~a, <br /> <br />IMP ee.E liB BBI:-I& d16U fll. t.l !Itl'f'. tjr n ~'v Kll\ln IIPnl\l TI-I,. 1N.<¡Lllu.a IT" . ^P"tll1J' QA <br /> <br /> <br />@ ACORD CORPORATION 1988 <br /> <br />.~ I <br />... - VId'J / è.. <br />;/ ura Stitt S~edY <br />Assistant City Attorl1c~ <br /> <br />1:;1" 11.1 <br /> <br />"85:80 <br /> <br />50 EO "'''101 <br />