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<br />. . <br />ACORD. <br /> <br />CERTIFICATE OF LIABILITY INSURANCE <br /> <br />OP 10 VII DATE (MMIDDNYYY) <br />MASKS-1 ~I 01/07/05 <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 />Andreini & Company-Oxnard <br />License 0208825 <br />300 Esplanade, Suite 100 <br />Oxnard CA 93030 <br />Phone:805-981-9585 Fax:805-981-0161 <br /> <br />Mask Systems, Inc. <br />11959 Discove~ Ct. <br />Moorpark CA 93021 <br />COVERAGES <br /> <br />INSURERS AFFORDING COVERAGE <br /> <br />INSURER A: AIG Insurance Graue <br />INSURER B <br />INSURER C' <br />INSURER 0 <br />INSURER E <br /> <br />NAIC# <br /> <br />INSURED <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 I/IIHICH 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 SHO\tVN MAY HAVE BEEN REDUCED BY PAID CLAIMS <br />INS NSRa POLICY NUMBER D'-AiErJ'~rJ.f,w\E f)gk~~YI~,J;6~J!,'1N I LIMITS <br />LTR TYPE OF INSURANCE <br /> GENERAL LIABILITY EACH OCCURRENCE . <br /> --'-- <br /> COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurenoo) . <br /> I CLAIMS MADE D OCCUR MED EXP {Anyone person) $ <br /> PERSONAL & AOV INJURY $ <br /> f-- <br /> GENERAL AGGREGATE $ <br /> f-- <br /> GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/DP AGG $ <br /> n. ,hpRO n <br /> , POLICY JEer LOC <br /> ~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> ANY AUTO (Eaaccident) <br /> f-- <br /> f-- ALL OWNED AUTOS BODILY INJURY <br /> $ <br /> SCHEDULED AUTOS (Per person) <br /> f-- <br /> e- HIRED AUTOS BODilY INJURY <br /> $ <br /> NON-OWNED AUTOS (Per accident) <br /> f-- <br /> e- PROPERTY DAMAGE $ <br /> (Per accident) <br /> ~~GE LIABILITY AUTO ONLY - EAACCIDENT $ <br /> ANY AUTO OTHER THAN EA Ace $ <br /> AUTO ONI. Y AGG $ <br /> EXCESSfUMBREL.LA LIABILITY EACH OCCURRENCE $ <br /> .::.J OCCUR 0 CLAIMS MADE AGGREGATE $ <br /> $ <br /> =1 ~EOUCTIBLE $ <br /> RETENTION $ $ <br /> WORKERS COMPENSATION AND X I Tb'~/~,~:~S I IVE.' <br />A EMPLOYERS' LIABILITY 9276304 12/18/04 12/18/05 $ 1000000 <br />ANY PROPRIETOR/PARTNER/EXECUTIVE E.L EACH ACCIDENT <br /> OFFICER/MEMBER EXCLUDED? EL. DISEASE - EA EMPLOYEE $ 1000000 <br /> If yes, describe under $ 1000000 <br /> SPECIAL PROVISIONS belOW EL DISEASE - POLICY LIMIT <br /> OTHER <br />I <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br />Proof of insurance <br /> <br />CERTIFICATE HOLDER <br /> <br />CANCELLATION <br /> <br />CITYSAA <br /> <br />SHOUL.D ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRA liON <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAil ~ DAYS WRlTIeN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 SO SHALL <br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR <br />REPRESENTATIVES. <br />AUTHORIZED REPRESENTATIVE <br /> <br />'-LL ~ <br /> <br />City of Santa Ana <br />So. Civic Center Plaza <br /> <br />Santa Ana CA 92703 <br /> <br />ACORD 25 (2001/08) <br /> <br />@ACORD CORPORATION 1988 <br />