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<br />12
<br />. CERTIFICATE OF L ILIT
<br />12/OAT11/07 FYI
<br />PRODUCER 1-066-220-8625
<br />Holmes Murphy and Anaociates - Omaha
<br />THIS CERTIFICATE W ISSUED AS A MATTER OF INFORMATION
<br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />2637 South 158th PISS&
<br />Suite 200
<br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />INSURERS AFFORDING COVERAGE
<br />Omaha, R$ 69130
<br />€N Post, Buckley, Schuh 6c Jernigan, Inc.
<br />€NSURERA Xlaricil Ameri'LfL' Ts'S ranca COa �Ry/` 16535
<br />€NSURERa Zurich AmeriOan Inauraasca Company / #16535
<br />__ _ _..__......__._.....___
<br />d/b/a PBSaT
<br />2001 BW 107th Avenue
<br />Miami, FL 53172-2507
<br />INSUREND:_..
<br />INSURER E• ....
<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 REDUCER BY PAID CLAIMS.
<br />—�
<br />INSR
<br />TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTlYE POLICY EXPIRATION LIMITS
<br />A
<br />GENERAL LIABILITY
<br />GLO 9139458-01
<br />09/30/07
<br />09/30/08
<br />EACH OCCURRENCE
<br />$1,000,000
<br />X COMMERCIAL. GENERALLIABIUTY
<br />X �UGCUR
<br />FIR EDAMAGE(Anyunafiro�..$l,_000,OOO
<br />CLAIMS MADE
<br />MkU EXP�Myonn Eurson)_
<br />5_35, 000
<br />X Contractual Liability
<br />PERSONAL B ADV INJURY
<br />_......__... ........... _
<br />S1,000,000
<br />........ _......_..._..._.,.. ..
<br />__7 ,._T�._____.._._......... ._.___.._
<br />GENERAL AOORFG_ATE
<br />S2 0-00,000
<br />GEN'L hGGREGATE UMH APPLIES PER:,
<br />PRODUCTS-CGMPX)PAGO
<br />52, 000,000
<br />POLICY X PRO- JFCT X" LOC
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />BAP 9139457-01
<br />09/30/07
<br />09/30/08
<br />.._x."
<br />..
<br />ANY AUTO
<br />COMBINED
<br />EBE SINGLE LIMIT
<br />S2,000,000
<br />ALL OWNED AUTCtS
<br />-"
<br />BODILY INJURY
<br />3
<br />SCHEDULED AUTO$
<br />(Pet Parson)
<br />X
<br />HIREDAUTOS
<br />X
<br />BODILY INJURY
<br />S
<br />NON -OWNED AUTOS
<br />(PoI awdonl)
<br />X
<br />Contractual Liability
<br />__......__
<br />PROPc_€LTY DAMAGE
<br />$
<br />{Pat atx,adaxt#)
<br />GARAGE LIABILITY
<br />AUTO GiiLY-ER AGCIOENT
<br />S
<br />144Y AUTO ^ k
<br />oxi� ra n AN
<br />....._...._._........._......__...__._._.....
<br />AUTO ONLY:
<br />C
<br />EKLCS5LIAUWIY
<br />AUC 508762103
<br />09/30/07
<br />09/30/06
<br />FACLI( URRENCE
<br />S 25, 000, DOD
<br />7
<br />AC#OREGATE
<br />g25,000,000
<br />X OCCUR ..._!CLAWS MADE
<br />DEDUCT#BR.E.—
<br />RETENTI.ON $ 0
<br />A
<br />W09NERSGOMPEN3ATTONANO
<br />WC 9139459-01
<br />09/30/07
<br />09/30/08
<br />X WCSTAT I OT#€
<br />I .
<br />EMPLOYERS` LIABILITY
<br />E1.tAMI AOVJDENT
<br />51, 000,000
<br />FA..DISEASE. -."-.AEMNOYEIt
<br />S1,000,000
<br />.
<br />•ce
<br />F.L.€}ISEASE-POUCYL€MIT
<br />�1,000,000
<br />OTHER
<br />n
<br />3
<br />s
<br />s
<br />DESCRIPTION OF OP ERATIONStLOCATIONSNERtCLESIEXCLUSIONS ADOEO BY ENDORSfMENTISPECLAL PROMSION5
<br />Rwf A50550.05 9 A2005-012; Santa Ana Hrid a Rehabilitation
<br />Heass Snsrare Includes: T4". o 4, Aaaooiatas, TnO., a v a On of PSiSAJ. The City of 8auts Ana, PDblio
<br />Works Agency, and the City 6f Orange County on the Oanara Liabil—Tt—y—wnh respect to the Operations Of the insured on
<br />the above project.
<br />Gees attached for addition#sl wording,
<br />_- •. •... •......... ..........ee..w.. wsauncv ramuvnvs �.ce acn: bnParYitt:„i.F..N1 I Rial
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
<br />City Of Santa Aaa DATE THEREOF, THE ISSUING INSURER WILL MAR. 90 DAYS WRITTEN
<br />Public works Agency NOT)CE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, X
<br />Attn, Mindy Ly ,K
<br />2D Civic Center Plaza
<br />CiDtxxxx XY.XXXXXXX=XXX
<br />Banta .Ana, CA 92702 F: A°JTHORIiEDREPRESENTATNE _ �w '=1
<br />USA t'J'4'•L'"
<br />I
<br />ACORD 25-S (7/97) rflatoaicx '� 5 N21=4:1V 7w"r (DACORD CORPORATION 1988
<br />i.S..s.�..ta A. ks..v..,wv
<br />
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