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<br />" ACORI)_ CERTIFICAT.F INSURANCE. 1 DATE (MY/CONY)
<br /> LIABILITY 12119/2003
<br /> PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br /> .. Andreini & Company ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br /> 300 Esplanade, Suite 100 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br /> ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br /> Oxnard, CA 93030 I
<br /> (805)981-9585 F:(805)981-0161 I INSURERS AFFORDING COVERAGE
<br /> ----- - ". ---1.----.- -----_.---------_.._,._~ ---,--
<br /> INSURED ~NSU~ER A- Federal Insura!'!ce ComP2!J!!I__
<br /> "A-xoi-2i,.O --,.-------- - --
<br /> Mask Systems, Inc INSURER B -, -----.-----
<br /> -.-- ,-......--
<br /> AUn: Rosa Sosa INSURER c-
<br /> i'I;URER D:' - ..---- ---- -- n, -- -
<br /> 11959 Discovery Ct.
<br /> I INSURER E: -.---.--.. ---- --- ---.-....---
<br /> Moorpark CA 93021
<br />
<br />COVERAGES
<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 />I~: TYPE OF INSURANCE POUCY NUMBER ~l?iY =griVE
<br />I GENERAL UABIUTY ,
<br />A X ('CMME"lCIAL GENERAL ll,I\SILlT':' I 3533-l:mC3 12' 18/ n3
<br />['~ CLAIMS MADE r:iJ OCCUR I
<br />
<br />u- -I
<br />
<br />'I_~'l AGGRE~::\!SllMIT APPl~~~_ PER:
<br />I POLICY -_ X ' PRG- lOC
<br />, AUTOMOBilE UABIUTY
<br />
<br />. ~:::=
<br />
<br />~ HIRED AUTOS
<br />
<br />C :~~~O~ED AUTOS
<br />
<br />------,---_.-----'---
<br />! "g~~ ~:~~OON UMlTS
<br />
<br />: EACH OS:;CURRENCE _----t~'-ooo,ooo
<br />I FIRE DAMAGE IArw orle i1rel----+-L ~~
<br />MED EXE. (~_Y_QD~_Q~.!J~)~$ __ 10,000 _
<br />~aNAL & ADV INJU~I ~,000,000
<br />GENERAL AGGREG~JE_ L-_2.000,OOO
<br />PRODU,<;TS _ COMP/OfAGG '$_~,Q.Q_O,OOO.
<br />
<br />1~1a/04
<br />
<br />
<br />7322-5049
<br />
<br />121 18/ 03
<br />
<br />12118/04
<br />
<br />COMBINED SINGLE LIMIT
<br />(Eaacciderlt)
<br />rr-~Dll Y INJURY,,'
<br />(Per perscm)
<br />-------",.
<br />I BODilY INJURY
<br />_ {Per accident}
<br />II' PROPER~" ~~MAGE-" -
<br />(Per accident)
<br />
<br />~~'Ooo,ooO
<br />1$
<br />
<br />+-=~-=-
<br />
<br />,
<br />
<br />I GARAGE llABIUTY
<br />i', ANY AUTO
<br />
<br />: AUTQ_PNL Y - EA -,~ggIDENT . 1___
<br />
<br />OTHER THAN
<br />AUTO ONLY
<br />
<br />!OAi\CC
<br />AGG I
<br />
<br />A
<br />
<br />EXCESS LIABILITY
<br />X OCCUR IJ CLAIMS MADE
<br />
<br />7972-9879
<br />
<br />12118/03
<br />
<br />12118/04
<br />
<br />EACH" QCCURRENCE u ___-----+-.1-. 5,000,000
<br />AGGREGATE "" ,__,~_ 5,0lJ!l,OOO_
<br />
<br />
<br />,
<br />
<br />---1 DEDUCTIBLE
<br />RETENTION $
<br />WORKERS COMPENSATION AND
<br />EMPLOYERS' UABIUTY
<br />
<br />OlMER
<br />
<br />I
<br />~/~L,
<br />I
<br />I
<br />,
<br />
<br />
<br />OTH-
<br />ER ,
<br />----,---- -
<br />I <::.1..-, EACH ALCli.kN I ----t--i--
<br />: EL DI~SASE EA EMPLOY,E_E---1L-__ _ _ ___" _
<br />E.L. DISEASE - POLICY LIMIT $
<br />
<br />
<br />DESCRIPTION OF OPERAOONSlLOCATIONSlVEHICLESlEXCLUSlONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
<br />Certificate holder Is named as Additional Insured under the general
<br />nsblllty.
<br />
<br />CERTIFICATE HOLDER
<br />
<br />X ADDITIONAL INSURED; INSURER LETTER:
<br />
<br />CANCELLATION
<br />SHOULD ANY OF iliE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE iliE EXPIRATION
<br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL --3D- DAYS WRITTEN
<br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO iliE LEFT, BUT FAILURE TO 00 so SHALL
<br />IMPOSE NO OBLIGATION OR UABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
<br />REPRESENTATIVES.
<br />AUTHORIZED REPRESENTATIVE
<br />
<br />U'Dt~
<br />
<br />City of Santa Ana
<br />
<br />60 Civic Center Plaza
<br />Santa Ana CA 92703
<br />ACORD 25-5 (7/97)
<br />
<br />@ACORD CORPORATION 1988
<br />
<br />I' ,
<br />_w-._,
<br />
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