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ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID C DATE (MMIDDIVYYY) TRUCP-1 04/23/03 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE ISU Ins Sry - Fullerton Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1150 E Orangethorpe Ave , #101 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Placentia CA 92870 Phone: 714-577-5800 Fax:714-577-5888 INSURERS AFFORDING COVERAGE NAIL INSURED, INSURER A: Golden Eag surance Cc 10375 VENDOR NAME INSURER B: ADDRESS INSURER C: INSURER D: 0.1 INSURER E: RPI\/FRAf:FS THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY.r4RIOD INDICATED. TWITH ANOING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RES PECT TO WHICH T ERTIFICATE MAY BENSU96 OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TER , EXC SIGNS AND F OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 'NSRLTR YNSR TYPE OF INSURANCE POLICY NUMBER DATE (MM/DDIYY EFFEUTIVLAgTE MMIDD I LIMITS GENERAL LIABILITY - CH OCCURRENCE S 1,000,000 A X X COMMERCIAL GENERALUABIUTY CLAIMS MADE I X I OCCUR CBP95037320 07/ /02 7/ PREMISES (Ea ocwrence) s 1,000,000 MED EXP (Any one person) S 5,000 X Owner/Copt Prot. O PERSONAL BADVINJURY S 1,000,000. GENERAL AGGREGATE S 2,000,000 GEML AGGREGATE LIMIT APPLIES PER POUCY PRO- JECT LOC PRODUCTS -COMPIOP AGG S 1,000,000 - . A AUTOMOBILE X LIABILITY ANY AUTO CBP95037320 07/01 07/01/03 COMBINED SINGLE LIMB (Ea accident) $ 1,000/000 ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per person) S HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) S PROPERTYDAMAGE (Per accident) S. _ GARAGE LIABILITY X ANY AUTO - C.BP95 .07/01/02 07/01/03 AUTO ONLY -EA ACCIDENT S 1,000,•000 07NERTHAN EAACC AU70 ONLY: AGG S .1�000 DOO S A DCCESSIUMBRELLA LIABILITY OCCUR CLAIMS a 393 07/01/02 07/01/03 EACH OCCURRENCE S1,000,000 AGGREGATE $1 , 000 , 000 S DEDUCTIBLE S X RETENTION s 1 D 0 0 S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORlPARTNERlEXECUTIVE OFFICERIMEMBEREXCLUDED7 If yes, describe under SPECIAL PROVISIONS below �9�08649021 12/01/02 12/Ol/03 TORY LIMBS ER E.L. EACH ACCIDENT S / 000 1- 000 E.LDISEASE- EAEMPLOYEE s 1,000,000 E.L. DISEASE -POLICY LIMB s 1 / 000 - 000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Certificate holder, its officers, agents and employees are named as additional insureds as respects to general liability policy limits per attached GECG601. *10 Day notice of cancellation will apply for non-payment of premium. ** MUST ATTACH SEPARATE "ADDTTIONAL INSURED ENDORSEMENT,, CERTIFICATE HOLDER CANC171 I AnnN City of Santa Ana Attn: Purchasing Dept 20 Civic Center Plaza Santa Ana CA 92701-4010 ACORD 25 (2DD9/08) CITY-21 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL PUZOM TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, P. 998E