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CORD. CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD YYYY) 'PRODUCER (305)822-7800 FAX (305)827-0585 Collinsworth, Alter, Fowler, Dowling & French Group Inc. P. 0. Box 9315 1Q/I8/2QQS THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURERA: Sentry Insurance a Mutual Co mpan NAIC # A+ XV Miami Lakes, FL 33014-9315 INSURED W. Koo & Associates, a division of PBS&3 2001 NW 107 Avenue Miami, FL 33172-2507" INSURERS: Steadfast Insurance Company A XV INSURERc: Lloyds of London A XV INSURER D' I I " D Y INSURER E: CtlVFRAC.PS THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUEDNS OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND C POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ONDITIOOF SUCH INSRFGAR�AGELIABILIW TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION Antractual AL LIABILITY MMERCIAL GENERAL LIABILITY CLAIMS MADE L I OCCUR LTab 90-15807-03 09/30/2005 09/30/20DAIE 06 LIMITS EACH OCCURRENCE $ 1,000,00( DAMAGE TO RENTED $ 1,000,00( $ 2S,000 MED EXP(Any one person) PERSONAL&ADV INJURY $ 11Q00100 GENERAL AGGREGATE $ 2,000,00( GGREGATE LIMIT APPLIES PER: LICY X PRO- JECT X LOC PRODUCTS- COMPIOP AGG $ 2,000,00( BILE LIABILITY ANY AUTO OWNED AUTOS 90-15807-04 90-1S807-OS 09/30/2005 09/30/2006 COMBINED SINGLE LIMIT (Ea accident) $ 11000,00 BODILY INJURY (Per person) $ AHEDULED AUTOS ED AUTOS BODILY INJURY (Per accident) $ N-OWNED AUTOS ntractual Liab PROPERTY DAMAGE (Per accident) $ LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ B EXCESS/UMBRELLA LIABILITY X OCCUR CLAIMS MADE AUCS08762101 Q9/30/2005 09/30/2006 EACH OCCURRENCE $ 2S,000,000 AGGREGATE $ 2S,000,000 DEDUCTIBLE X RETENTION $ a WORKERS COMPON AND 9O-ISSO7-Ol EMPLOYERS' LIABILITY 09/30/2005 09/30/2006 A ANY PROPRIETOR/ R/EXECUTIVE 90-IS807-02 OFFICER/MEMBER E%CLUDED7 EXCLUDED? X WC STATU- OTH- E.L. EACH ACCIDENT g 1,000,00 If yes, describe under SPEOTHCIAL PROVISIONS below NO roVessional/ LDUSA0500811 09/30/2005 09/30/2006 C ollution Liability CLAIMS -MADE FORM DESCRIPTION OF OPERATIONS (LOCATIONS / VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS e: 1st Sth Street & McFaden Avenue Bridge. E.L. DISEASE - EA EMPLOYE $ 1,000,000 ELDISEASEE-POLICY LIMIT $ 1,000,00 $1,000,000 Limits Ea Claim and Annual Aggregate 11/11/1961 Retrodate Santa Ana, City of Public Works Agency and City of Orange are named additional insured on the General liability, excluding professional services. Insurance evidenced by this certificate shall be primary and non-contributory to that of the named additional insured; said coverage contains severability of interest provision. Issuing companies will provide 30 days written notice of cancellation. Santa Ana, City of Public Works Agency Attn: Mindy Ly 20 Civic Center Plaza Santa Ana, CA 92707 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL X MAIL Y 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, � , KXii�6KI[SFXd(30fn1tX44kKNd(ifdd6lGXC[7fi(iOCI€l4)06Md(diA570fd06XYAl5XM)(XX ©ACORD CORPORATION 1988