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<br />ACORDm <br /> <br />1IIIIIIIillllliilllllllllllilll::;~;~~~~~;;' <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 />COMPANIES AFFORDING COVERAGE <br />COMPANY Fireman's Fund Insurance Companie <br />A <br /> <br />92501 <br />... fax951-788-2994 <br /> <br />PRODUCER Nicholas Goldware <br />Talbot Ins & Fin Srvcs, Inc. <br />4371 Latham Street Suite 101 <br />PO Box 5345 <br />Riverside, CA <br />951-788-8500 <br /> <br />INSURED <br />Kinkle, Rodiger & Spriggs <br />3333 Fourteenth Street <br /> <br />COMPANY <br />B <br /> <br />Everest National <br /> <br />Insurance Compan <br /> <br /> <br />COMPANY <br />C <br /> <br />Riverside CA 92501 <br /> <br /> <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED, NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> <br />CO <br />LTR <br /> <br />TYPE OF INSURANCE <br /> <br />POLICY NUMBER <br /> <br />POLICY EFFECTIVE POLICY EXPIRATION <br />DATE {MMfDDlYYl DATE IMMfDDfYYI <br /> <br />LIMITS <br /> <br />A GENERAL LIABILITY AZC80724565 <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE [K] OCCUR <br />OWNER'S & CONTRACTOR'S PROT <br /> <br />04/01/2004 04/01/2005 <br /> <br />GENERAL AGGREGATE <br />PRODUCTS - COMP/OP AGG <br />PERSONAL & ADV INJURY <br />EACH OCCURRENCE <br /> <br />2,000,000 <br />2,000,000 <br />excluded <br />.1,000,000 <br />100,000 <br />5,000 <br /> <br />FIRE DAMAGE (Anyone firel <br /> <br />MED EXP (Anyone personl <br /> <br />A AUTOMOBilE UABIlITY AZC80724565 <br />ANY AUTO <br /> <br />04/01/2004 04/01/2005 <br /> <br />COMBINED SINGLE LIMIT <br /> <br />1,000,000 <br /> <br />ALL OWNED AUTOS <br /> <br />BODILY INJURY <br />(Per personl <br /> <br />SCHEDULED AUTOS <br />X HIRED AUTOS <br />X NON-OWNED AUTOS <br /> <br />,) <br /> <br /> <br />BODILY INJURY <br />(Per8ccident) <br /> <br />PROPERTY DAMAGE <br /> <br />GARAGE LIABILITY <br />ANY AUTO <br /> <br />IdHI Stilt Shee <br />,;;. am Cil)' Atto ney <br /> <br />AUTO ONLY - EA ACCIDENT <br /> <br />A EXCESS LIABILITY <br />UMBRELLA FORM <br />OTHER THAN UMBRELLA FORM <br />B WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br /> <br />UMB04012003 <br /> <br />OTHER THAN AUTO ONLY: <br />EACH ACCIDENT <br />AGGREGATE $ <br />04/01/2004 04/01/2005 EACH OCCURRENCE .5,000,000 <br />AGGREGATE $ 5,000,000 <br /> <br />CA20010190051 <br /> <br />01/13/2005 01/01/2006 <br /> <br /> <br />OTH- <br />ER <br /> <br />THE PROPRIETOR/ <br />PARTNERS/EXECUTIVE <br />OFFICERS ARE: <br />OTHER <br /> <br />INCL <br />EXCL <br /> <br />.1,000,000 <br />EL DISEASE POLICY LIMIT 1, 000 , 000 <br />EL DISEASE EA EMPLOYEE 1, 000 , 000 <br /> <br />DESCRIPTION OF OPERATIONS1LOCATIONSIVEHICLES/SPECIAl ITEMS <br />Re: Verification of Coverage for Workers Compensation <br /> <br /> <br />City of Santa Ana <br />Attn: City Attorney Joseph W. Fletcher <br />PO Box 1988 <br />Santa Ana, CA 92702-1988 <br /> <br />@dSlH673467 <br /> <br /> <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL <br />30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE lEFT, <br />ru-crays notice for non-payment <br />BUT FAilURE TO MAil SUCH NOTICE" SHALL IMPOSE NO OBLIGATION OR LIABILITY <br />OF ANY KIND UPON THE COMPANY, ITS <br />AUTHORIZED REPRESENTATIVE <br /> <br /> <br />81311 <br />