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<br />ACORD~ CERTIFICATE OF LIABILITY INSURANCE I DATE (MMlDDIYV) <br /> 7-1-05 <br />PRODUCER THIS CERllFICATE IS ISSUED AS A MATTER OF INFORMAllON <br />PHILIP B. ROBINSON INSURANCE ONLY AND CONFERS NO RIGHTS UPON THE CERllFICA TE <br /> HOLDER. THIS CERllFICATE DOES NOT AMEND, EXTEND OR <br />2081 BUSINESS CENTER DR. # 200 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />IRVINE, CA 92612 9494749300 INSURERS AFFORDING COVERAGE <br />__u fJ - ;1005- c> i 0 ------- <br />INSURED INSURER A,AMERICAN STATES INSURANCE CO. <br /> ------ <br />MORELAND & ASSOCIATES Ii - ;;(tD(,-{YfD INSURER ",PHILADELPHIA INDEMNITY INS CO. <br /> ------- ---- <br />1201 DOVE ST # 680 92660~-;{ro5~'If) '-0/ INSURER C: - --- - <br />NEWPORT BEACH, CA INSURER O- n ------- <br />949 221 0025 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 THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERT,~.!N. THE !NSURANCE AFFORDED BY THE POLICIES DESCRI8ED 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 />t.m ' TYPE OF INSURANCE <br />-;- GENERAL lIABILITY <br />A Li~~MERCIAL GENER~~llITY <br /> <br />lti~AIMS MADE <_OCC~R <br /> <br />GEN'L AGGREGATE LIMIT APPLIES PER <br />-: POLICY ~- ~~,9T 7- LOC <br />~~fMOBILE LIABILITY <br />__~ ANY AUTO <br />__ ALL OWNED AUTOS <br />_---,- SCHEDULED AUTOS <br />A .J HIRED AUTOS <br />-J- NON-OWNED AUTOS <br /> <br />POUCY NUMBER <br /> <br />POLICY EFFECnvE ' <br />DATE fMUIDOIVV\ <br />3-26-05 <br /> <br />POIJCY EXPIRATION <br />DATE IMU100lVV\ <br />3-26-06 <br /> <br />LIMITS <br />EACH OCCURRENCE . ...~OQL.Q Q 0 <br />~RE D~~9~-'Any one lire) _ ~~, 00_9_1 000 <br />MED ~~_C~y.~ne person) _ _~lQLQ_OO <br />PERSC?~A!:._~ADVINJU~~______~J ,J2_QO, OOQ <br />GENERAL A9_~EGATE __ ...!~_! 000 , 000 <br />PRODUCTS_~. S:2..MP10P A~~ -.!1_1 0.9 9 , 0 0 0 <br /> <br />02B0769819 <br /> <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br /> <br />$ <br />1.L00~_00 <br /> <br />02B0769819 <br /> <br />3-26-05 <br /> <br />3-26-06 <br /> <br />! BODILY INJURY <br />I (Per person) <br />--- <br /> <br />$ <br />------ <br /> <br />r--- <br /> <br />I__C!~~AGE LIABILITY <br />ANY AUTO <br /> <br />BODILY INJURY <br />(Per accident) <br />.- <br />PROPERTY DAMAGE <br />(Per accident) <br /> <br />$ <br /> <br />$ <br /> <br />EXCESS LIABIUTY <br />A ITI OCCUR [ J CLAIMS MADE <br /> <br />i-- <br />I DEDUCTIBLE <br /> <br />01CT001899 <br /> <br />3-26-05 <br /> <br />3-26-06 <br /> <br />~'2_2~_LY - EA_~~~ <br />OTHER THAN ~~~ .!___ <br />AUTO ONLY AGG $ <br />I EACH OC~~~RENCE____ _!I.LQO Q_&~_ <br />: AGGRE,,^"-___.. $~QO , 000 <br />$ <br /> <br />, <br /> <br />RETENTION $ <br />! WORkERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br /> <br />AI <br /> <br />T OTHER <br />, <br /> <br />BlpROFESSIONAL <br /> <br />$ <br />$ <br /> <br />01WC027275 <br /> <br />4-1-05 <br /> <br />4-1-06 <br /> <br />I , WC STATU. I 10TH <br />I 'V_JIORY LIMITS _l.ER._ ______ ____ <br />i E.L. EACH ACCIDE_~T __ _~_.9 O.QL 000 _ <br />~EIS~_E - EA_~_~PLOYEE I $1 , q QgJ 000 <br />E.L. DISEASE - POLICY LIMIT $1 I 000 I 000 <br /> <br />PHSD094821 <br /> <br />:4-1-05 <br /> <br />4-1-06 <br /> <br />2 000 000 <br /> <br />DESCRIPTION OF OPERATIONSILOCATIONSlVEHICLESlEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br /> <br />CPA * IF CANCELED FOR NONPAYMENT 10 DAY NOTICE WILL BE GJi.~ovm) ;\S IU F'ORM <br /> <br />CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED <br /> <br />.Y-$:{\.;:_c,i.L ."- <br />"Laura Stitt Sb-",.tj" <br />CANCELLATION Assi~tanl City A11.,1rnc\ <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WIU I!IJf>b...un It MAIL ~ DAYS WRITrEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Btn I"ItII:tlRIi .- "^ C!n C!IJAU <br /> <br />ALL OPERATIONS <br />CERllFICATE HOLDER I .J I ADDmoNAL INSURED, INSURER LETTER, A <br />CITY OF SANTA ANA <br />PO BOX 1988, M-17 <br />SANTA ANA, CA 92702 <br />TTN - MIRELLA VARGAS <br /> <br />1....t'\1;:t... I\IU Ua...........:.,J un .....DILlII Vr" "1'1I1 ,Hili ""'<:'.. 'Alii 11I8Y'q~" <br /> <br />I'T'C! AI':!"NTC: OR <br /> <br />li........c.ox;nl..II."'~ <br /> <br />AUTHORIZED REPRESENTATIVE <br /> <br />!f~ /? <br /> <br />, <br />ACORD 25-S (7/97) <br /> <br />@ ACORD CORPORA llON 1988 <br />