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ACORP_ CERTIFICATE OF LIABILITY INSURANCE CSR AB I DATE (MflNDOIYVYY) LYN-01A 03/02/05 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION May's Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 500 N. Pine Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 455 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Burlington WI 53105 Phone: 262-763-2408 Fax:262-763-5080 INSURERS AFFOROING COVERAGE NAIC# INSURED LYNCH CHEVROLET~PONTIAC INC; INSURER A: CINCINNATI INSURANCE CO. JOHN LYNCH JEEP/EAGLE, LDV, INC, LYNCH CHICAGO, INC, INSURER B: ETAL. INSURER C 941 MILWAUKEE AVENUE POBOX 739 INSURER 0: BURLINGTON WI 53105-0739 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TEAM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I~~~ ~~~ TYPE OF INSURANCE POLICY NUMBER ~NERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CPP074 9 3 2 5 I CLAIMS MADE [!] OCCUR :JIVE POLICY EX~"RpION DATE MMlDDIYY\ DATE IMMlDDIYYl A EACH OCCURRENCE PREMISES (E~~~~~nce) MED EXP {Anyone person} 04/11/03 04/11/06 f-- f-- ~'L AGGRE~E LIMIT AP~S PER' I I POLICY Ix I j~gT I I LOC f~TOMOBIlE LIABILITY ~ ANY AUTO ~_ ALL OWNED AUTOS ~ SCHEDULED AUTOS ~ HIRED AUTOS f----- NON-OWNED AUTOS f--~... PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG ~~~""\/C i' "'TY'\ "'riD \1f COMBINED SINGLE LIMIT (Eaaccident) J " ;I / r"l{J ~1[ll~):.\ '-2. IJ/~ l -) ;/ ~dj~: _,.1 i ~i~dy Assistant Cl y Attorney BODILY INJURY (Per person) BODILY INJURY (Peraccidenl) PROPERTY DAMAGE (Per accident} ~G~AR.AGE LIABILITY A X ANY AUTO X OTHER THAN AUTO ~~~ESSlUMBRELLA LIABILITY ~ OCCUR D CLAIMS MADE AUTO ONLY. EA ACCIDENT CPP0749325 04/11/03 04/11/06 OTHER THAN AUTO ONLY: 04/11/06 EACH OCCURRENCE AGGREGATE A CPP0749325 04/11/03 h DEDUCTIBLE tx1 RETENTION $NIL I WORKERS COMPENSATION AND EMPLOYERS' LIABILITY A ANY PROPRIETOR/PARTNERiEXECUTIVE A OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below OTHER 04/11/05 04/11/06 ITO~v"LIM:TS I IOJR- E.L EACH ACCIDENT WC1916104-01 WC1916104-02 04/11/04 04/11/05 LIMITS $ 1000000 $ 500000 $ 10000 $ 1000000 $ 1000000 $ 1000000 $ s $ EAACC AGG $ 500000 $ 500000 $ $ 25000000 $ $ $ S -- ..- --- E.L DISEASE - EA EMPLOYEE S 100000 E.L DISEASE - POLICY LIMIT S 5000 0 0 $ 100000 DESCRIPTION OF OPERATIONS I LOCATIONS! VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT! SPECIAL PROVISIONS CERTIFICATE HOLDER, ITS OFFICERS, AGENTS AND EMPLOYEES ARE NAMED AS ADDITIONAL INSUREDS AS RESPECTS GENERAL LIABILITY POLICY LIMITS ON A PRIMARY /NONCONTRIBUTORY BASIS AND POLICY INCLUDES A WAIVER OF SUBROGATION, PER THE ENDORSEMENT AND FORMS GA4078, GA4094, & CG2988 ATTACHED. *10 DAY NOTICE OF CANCELLATION WILL APPLY FOR NON-PAYMENT. CERTIFICATE HOLDER CANCELLATION CITY OF SANTA ANA PURCHASING DEPARTMENT 20 CIVIC CENTER PLAZA SANTA ANA CA 92701-4010 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILUEKCEXV&iiX~MAIL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT ~H~~XIX~)6HM.K iliQffi~R*JOj{lIi~Xl!i\S!itxm::ilPJOK_~Xil!lll@ijQJ{X ~XSC COSANTA AUTHORIZED REPRESENT A TIVE ALICE BUSCH ACORD 25 (2001/08) @ACORDCORPORATION 1988