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<br />A CORDmllllllilllllllillllillillllll.I::;~~~~~~;;' <br /> <br />PRODUCER Nicholas Goldware THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />Talbot Ins & Fin Srvcs, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />4371 Latham Street Suite 101 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />PO Box 5345 COMPANIES AFFORDING COVERAGE <br />Riverside, CA 92501 COMPANY Fireman's Fund Insurance Companie <br />951-788-8500 ... fax951-788-2994 A <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 /> <br />Riverside CA 92501 <br /> <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE PDLlCY 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 1$ 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 />POLlCY NUMBER <br /> <br />POLlCY EFFECTIVE POLlCY EXPIRATION <br />DATE IMMfDD!VYI DATE IMMfDDfYYl <br /> <br />LIMITS <br /> <br />A AUTOMOBILE LIABILITY AZCB0724565 <br />ANY AUTO <br />ALL OWNED AUTOS <br />SCHEDULEO AUTOS <br />X HIRED AUTOS <br />X NON-OWNED AUTOS <br /> <br />04/01/2004 04/01/2005 <br /> <br />COMBINED SINGLE LIMIT <br /> <br />2,000,000 <br />$ 2,000,000 <br />. excluded <br />1,000,000 <br />100,000 <br />5,000 <br /> <br />.1,000,000 <br /> <br />A GENERALUABILlTY AZCB0724565 <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 />FIRE DAMAGE (Anyone firel <br />MED EXP (Anyone person) <br /> <br />BODILY INJURY <br />(Per person) <br /> <br />.J L.J AS <br /> <br /> <br />BODILY INJURY <br />(Per accident) <br /> <br />PROPERTY DAMAGE <br /> <br />A EXCESS LIABILITY <br /> <br />UMB04012003 <br /> <br />AUTO ONLY - EA ACCIDENT <br />OTHER THAN AUTO ONLY: <br />EACH ACCIDENT <br />AGGAEGATE $ <br />04/01/2004 04/01/2005 EACH OCCURRENCE .5,000,000 <br />AGGAEGATE $ 5,000,000 <br /> <br />ney <br /> <br />GARAGE LIABILITY <br />ANY AUTO <br /> <br />UMBRELLA FORM <br /> <br />OTHER THAN UMBRELLA FORM <br />B WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br /> <br />CA20010190051 <br /> <br />01/13/2005 01/01/2006 <br /> <br /> <br />OTH- <br />ER <br />EL EACH ACCIDENT $ 1,000,000 <br />ELDISEASE - POLICY LIMIT $ 1,000,000 <br />EL DISEASE - EA EMPLOYEE $ 1, 000 , 00 0 <br /> <br />THE PROPRIETOR/ <br />PARTNERS/EXECUTIVE <br />OFFICERS ARE: <br />OTHER <br /> <br />INCL <br />EXCL <br /> <br />DESCRIPTION OF OPERATlONSflOCATIONSNEHICLES/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 />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 />~ays notice for non-payment <br />BUT FAILURE TO MAIL SUCH NOIICE" SHALL IMPOSE NO OBLIGATION OR LIABILITY <br />OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. <br />AUTHORIZED REPRESENTATIVE <br /> <br /> <br />@ds#1673467 <br /> <br />81311 <br />