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<br />NCSPID LY <br />\ ~NKR01 03/11/03 <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 />. ACeRD. <br /> <br />CERTIFIC~ OF LIABILITY INSU <br /> <br />PRODUCER <br />North American Ins Agency <br />A Div of Hilb,Rogal & Hamilton <br />P.O. Box 6700 <br />Rancho Cucamonga CA 91729 <br />Phone: 909-476-3300 Fax:909-484-5176 <br />INSURED <br /> <br />INSURERS AFFORDING COVERAGE <br /> <br />INSURER A: <br />INSURER B: <br />INSURER c: <br />INSURER 0: <br />INSURER E: <br /> <br />Golden Ea Ie Insurance Cor <br /> <br />Kinkle Rodiger & Spriggs <br />3333 14th S~reet <br />Riverside CA 92501 <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 />1~1: TYPE OF INSURANCE POLICY NUMBER <br />~NERAL LIABILITY <br />A X COMMERCIAL GENERAL LIABILITY CBP9667121 <br />I CLAIMS MADE ~ OCCUR <br /> <br />DATE (MM/D~ I P~..k{i~~rJ~?N <br /> <br />EACH OCCURRENCE <br /> <br />02/28/03 <br /> <br />02/28/04 <br /> <br />FIRE DAMAGE (Anyone fire) <br /> <br />MED EXP (Anyone person) <br /> <br />~'l AGGRE~E LIMIT AP~S PER: <br />I POLICY I I j:8,: I I lOC <br />.!..'!TOMOBILE LIABILITY <br />A _ ANY AUTO CBP9667121 <br />_ All OWNED AUTOS <br />_ SCHEDULED AUTOS <br />~ HIRED AUTOS <br />~ NON-OWNED AUTOS <br /> <br />I-- <br /> <br />PERSONAL & ADV INJURY <br />GENERAL AGGREGATE <br />PRODUCTS-COM~OPAGG <br /> <br />02/28/03 <br /> <br />COMBINED SINGLE LIMIT <br />02/28/04 (Eaaccidenl) <br />BODilY INJURY <br />(Per person) <br /> <br />BODilY INJURY <br />(Peraccidenl) <br /> <br />PROPERTY DAMAGE <br />(Peraccidenl) <br /> <br />hRAGE LIABILITY <br />H ANY AUTO <br /> <br />AUTO ONLY - EA ACCIDENT <br />EA ACC <br /> <br />OTHER THAN <br />AUTO ONLY: <br /> <br />EXCESS LIABILITY <br />A t:!:5'OCCUR D CLAIMS MADE <br /> <br />h DEDUCTIBLE <br />iii RETENTION $ 10,000 <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br /> <br />02/28/03 <br /> <br />02/28/04 <br /> <br />EACH OCCURRENCE <br />AGGREGATE <br /> <br />CU9662824 <br /> <br />t.,. : ',,0 <br /> <br />", <br /> <br />;"()Rf'-,/J <br /> <br />,P3// / <br />r YA"//cL~7-_u <br />'['7", 'I 'y I <br /> <br />._-,~.--_._-~~" <br /> <br />I TORY LIMITS IlvER- <br />E.L EACH ACCIDENT $ <br />E.L. DISEASE - EA EMPLOYEE $ <br />E.L. DISEASE - POLICY LIMIT $ <br /> <br />I): -"., <br /> <br />':. i \- 1\[ '_l1]"lle:Y <br /> <br />OTHER <br /> <br />DESCRIPTION OF OPERATlONSfLOCATIONSNEHICLESlEXCLUSIONS ADDED BY ENOORSEMENTfSPECIAL PROVISIONS <br />With regards to the Santa Ana Office of the named insured, The City of Santa <br />Ana,its officers,&employees are named as additional insured. *Except 10 Days <br />Notice of Cancellation for Non-Payment of Premium. <br /> <br />CERTIFICATE HOLDER <br /> <br />I Y , ADDITIONAL INSURED; INSURER LETIER: <br /> <br />CANCELLATION <br /> <br />DATE (MM/DDfYY) <br /> <br />LIMITS <br /> <br />$1,000,000 <br />$100,000 <br />$ 5,000 <br />$ EXCLUDED <br />$ 2,000,000 <br />$ 2.000,000 <br /> <br />$1,000.000 <br /> <br />$ <br /> <br />$ <br /> <br />$ <br /> <br />AGG <br /> <br />$ <br />$ <br />$ <br />$5,000,000 <br />$ 5,000,000 <br />$ <br />$ <br />$ <br /> <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATlO <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1.L. DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO so SHALL <br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR <br />REPRESENTATIVES. A-/"') <br />/"7'v . d... J / ..A' ~ J. <br />Linda Burns {/". - ~/ <br /> <br />SANTAN2 <br /> <br />City of Santa Ana <br />P.O. Box 1988 <br />Santa Ana CA 92702 <br />, <br />ACORD 25-5 (7/97) <br /> <br />r <br /> <br />@ACORDCORPORATION1988 <br />