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<br />, ACBRD. <br /> <br />CERTIFIC" OF LIABILITY INSU \NC~~~b1 DA~E~~~~';o)3 <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 /> <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 /> <br />INSURERS AFFORDING COVERAGE <br /> <br />Kinkle Rodiger & Spriggs <br />3~33 14th Street <br />R1verside CA 92501 <br /> <br />INSURER A: <br />INSURER B: <br />INSURER c: <br />INSURER 0: <br />INSURER E: <br /> <br />Golden Ea Ie Insurance Co <br /> <br />INSURED <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 L1MlTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />1~i'G TYPE OF INSURANCE POLICY NUMBER ~~~lflr.M/DDNVi - I P~.k+i~:~rJ~J.}?N l.IMITS <br /> ~NERAL LIABILITY EACH OCCURRENCE $1,000,000 <br />A X COMMERCIAL GENERAL LIABILITY CBP9667121 02/28/03 02/28/04 FIRE DAMAGE (Anyone fire) $100,000 <br /> I CLAIMS MADE [!] OCCUR MED EXP (Anyone person) $ 5, 000 <br /> - PERSONAL & ADV INJURY $ EXCLUDED <br /> - GENERAL AGGREGATE $ 2,000,000 <br /> ~'L AGG~EnE LIMIT APnS PER: PRODUCTS - COMP/OP AGG $2,000,000 <br /> POLICY ,j~T LaC <br /> ~TOMOBIl.E LIABILITY COMBINED SINGLE UMIT $1,000,000 <br />A ANY AUTO CBP9667121 02/28/03 02/28/04 (Eaaccident) <br />f-- <br /> f-- All OWNED AUTOS BODilY INJURY <br /> SCHEDULED AUTOS (Per person) $ <br /> f--- <br /> ~ HIRED AUTOS BODILY INJURY <br /> ~ NON-OWNED AUTOS (Per accident) $ <br /> f--- PROPERTY DAMAGE $ <br /> (Per accident) <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ <br /> R ANY AUTO OTHER THAN EAACC $ <br /> AUTO ONLY: AGG $ <br /> EXCESS LIABILITY EACH OCCURRENCE $ 5, 000, 000 <br />A :!j-OCCUR D CLAIMS MADE CU9662824 02/28/03 02/28/04 AGGREGATE $5,000,000 <br /> '()R'~"l $ <br /> ~ ~EDUCTIBLE A, ; ;i,O , $ <br /> X RETENT\ON $10,000 $ <br /> WORKERS COMPENSATION AND J!31 "nl;___ I TORY'UMITSI IVER- <br /> EMPLOYERS' LIABILITY _..__.,._,^7_'.'____~,. <br /> E.L. EACH ACCIDENT $ <br /> L~'.'-:' " !\' <br /> E,L. DISEASE - EA EMPLOYE $ <br /> IL:.O!': '- ,\l', ,'lll:Y <br /> EL DISEASE - POLICY LIMIT $ <br /> OTHER <br />DESCRIPTION OF OPERATIONSlLOCATIONSNEHICLESlEXCLUSIONS ADDED BY ENDORSEMENTISPECIAl. 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 />CERTIFICATE HOLDER I y I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION <br /> SANTAN2 SHOUl.D ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO <br /> DATE THEREOF, THE ISSUING INSURER WILl. ENDEAVOR TO MAIL 30 DAYS WRITTEN <br /> - <br /> NOTICE TO THE CERTIFICATE HOl.DER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHAl.l. <br /> City of Santa Ana IMPOSE NO OBLIGATION OR L1ABIUTY OF ANY KIND UPON THE INSURER,ITS AGENTS OR <br /> P.O.Box 1988 REPRESENTATIVES. A _ - /"") <br /> Santa Ana CA 92702 ?7J,'. ~~ ./ r::l, <br /> , Linda Burns ~.-7'" <br />ACORD 25-S 7/97 -, <br /> <br />@ACORDCORPORATION1988 <br />