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<br />~ ~ -MAY-25-2005 WED 05:05 PM
<br />
<br />FAX NO,
<br />
<br />p, 02/04
<br />
<br />,
<br />
<br />SANJOAQ.()2 AYDA
<br />
<br />_CEO (559) 432'()222
<br />DiBuduo & DeFendis Insurence Brokers, LLC
<br />License #OE02096
<br />P.O. Box 5479
<br />Fresno, CA 93755.5479
<br />
<br />ACORD", CERTIFICATE OF LIABILITY INSURANCE DA~~;;;r'
<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 AMENO, EXTENll OR
<br />ALTER THE COVERAGE AFFORDED BY THe POLICIES BI;LOW.
<br />
<br />IN!.up!r;;f1
<br />
<br />Sa" Joaquin Chemicals Inc.
<br />
<br />~:n~~~::~~;;':;;o IV- vl0C>:J,-OJ '/
<br />A,I - ,3L'03 -OS'1 -UI
<br />
<br />INSURERS AFFORDING COVERAGE
<br />"';SUR'R" Hudson insurance Company
<br />l~sURER B: State corn.penS8tion Insu~~c. Fund
<br />INSUR~A; S.:
<br />INSURf;RD:
<br />INSURER Ii:
<br />
<br />NAle#
<br />
<br />COVERAGES
<br />
<br /> THE POLICIES OF INSURANCE LISTED BEL.OW HAVE aEEN ISSUED TO THE INSURED NAMED AaOVE FOR THE POl-ICY PERIOD INDICATED. NOTWIUSTANDING
<br /> ANY REaUIREM~NT, TERM OR CONDITION OF ANY CONTRACT OR OTHER POCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUEJ OR
<br /> MAY PERTAIN, THE INSURANC. AFFORDED BY THE POLICI~S DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS 'IF SUCH
<br />~~:;f:;S' AGG~~~GATE LIMITS SJ:iOWN MAY H4,Ve,.~EEN REDUCED ,BY PAID ClAIMS:.,," PRkI.fJ ExPIRATION ~,.,. -....-
<br /> POLICY NUMBER POl-...'SY EFFECTIVE LlMIT$
<br /> i~~r;RAL LIABIUTY EACH OCCU~CE . I,OOO,OOC
<br />A X ..!. 3MMERelAL GENERAL LIASILrT'f CHEPLOOOSS 413012005 4/30/2006 ~gE"IUI'U:.NIt:lJ...\ . "rotooc
<br /> PREMISES lEa oeaJrcnce
<br /> _._ CLAIMS MADE [!] OCCUR . . ;iJ~;;
<br /> ~~(AnyOI'lCj;lCl"&OI'1)" .
<br /> f- -'.,. .._~ PERSONAL. & AOY INJURY I 'l~OOO,
<br /> .... GENERAl AGGREGATe . . - 2.000,00
<br /> "0.- "- I_Z'OO~,~
<br /> ~'~ AGG~EnEtIMIT APnS PI'iR PROOUCTs-eOMP~PAGG
<br /> PO~ICY ! f~8T LOC
<br />A ~TObllOBJLE LlABIUTY COMBINEO 5INGL..E LIMIT . 1,000,001
<br /> ..! ANY AUTO CHEf'AOO0100 4/30/2005 4/30/2006 lEaaccldent)
<br /> -'- -'--"-
<br /> - AI-I- OWNED AUTOS 800ll Y INJURY
<br /> SCHEDULED ""UTOS (PerpMO"') .
<br /> - APPROVED -- -- "-
<br /> - HIRliD AUTOS A~ TO POR ~
<br /> BODilY INJURY ,
<br /> NON-OWNED AUTOS (PfIraccldenll
<br /> /~ 1-- -------~
<br /> I-- - .;7', J, j _ __ \ 1/ /? PROpeFl'rY DAMAGE ,
<br /> - ,.c. (Per~tleoll
<br /> ROE UABlLITY , Laura ~tl!t pheedy
<br /> Assistant City ~.C?Nl v. 5A ACCIOENT , '-----,-
<br /> ANY AUTO Attornev EAA~_ ,
<br /> OTHER THAN
<br /> AUTO ONL v: AGG S
<br /> ~~$JlJMIiIRiLl...A UA8lLITY EACH OCCURRENCE . 1,000,000
<br />A OCCUR 0 CLArMS MACE CHEPUOO0101 4/30/2005 4/3012006 I_~~
<br /> ~~REGATE
<br /> ~ IDI:DUC"r18lli - S ___
<br /> X RETENTION , 10,000 -- '.---
<br /> ,
<br /> WORKIiRS COMPENSATION AND _J we StATU; I 10....
<br />B EMPl.OYEfUj:' UAIllI.ITY 168187504 .TORY LIMtr~ ';-j-,OOO.OOI
<br /> ANY F'ROPRIETOR/F'ARTNE'RIliiXECUTlVE: 6129/2004 6129/2005 ~t:!.~CCIDENT .,._
<br /> OF~ICERlMi;MBE!R EXCI-I.lOEO'i' ;---, ,0Qo-;Daj
<br /> ~~~~V~g~NS below e.l. DISE.-'se . e~ EMPI.OYEf
<br /> OTHER 1i.1-, DISEASE. POLICY LIMIT . 1,000.001
<br />~CRl"TJON OF OPERATIONs. I LOCATIONS I VEHICt.ES f ~I:LUSION$ AgDED BY ENOORSEMEN'r I SIi'ECJAl,.. PROVISIONS
<br />City of Santa Ana, its officers, employees, agenls, volunteers and r8$presentatlvGS are named as addltonal insureds as per wlinen
<br />contract for general liability.
<br />
<br />CERTIFICATE HOlDER
<br />
<br />City of Santa Ana
<br />Building Maintenanclfit Division
<br />20 Civic Center Plaza #M-ll
<br />Santa Ana, CA 92702-
<br />
<br />CANCELLATION
<br />
<br />SHOULD AlIIV' OF THE ABOvE OESCRlB~ POLICIES BE OANCIi~ BEFORE THE IiJPIRAT10N
<br />DATE THEFlIiOF. THE I$SUlNO INSUR!ft WILL l6lAlVM.VJOlMAlL 3L- DAYS WRlTIIlN
<br />NOTICETOTHEC~ATlfICATEHO~NAMI5D TO T)tf:UfT. ~~
<br />)("''''''~'''''''''''''fllll''''-lllQlrV.Y'''~lIllO''~
<br />~~
<br />AUTHORIUD REPRESENTATIVE
<br />
<br />;::;?
<br />
<br />ACORo 25 (2001/08)
<br />
<br />@ACORDCORPORATIC'N1988
<br />
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