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<br />ACORD.. CERTIFICATE OF LIABILITY INSURANCE OP 10 7~ DATE (MM/DDIYYYY)
<br />UNITE-7 06/13/05
<br />I-RODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br />Acordia of California (soc) ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />Ins Services, Inc. Lic#0352275 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br />15303 Ventura Blvd., 7th Floor ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />Sherman Oaks CA 91403-3197
<br />Phone: 818-464-9300 Fax:818-464-9398 INSURERS AFFORDING COVERAGE NAIC#
<br />INSURED INSURER A: Zurich American Ins. Grp.
<br /> INSURER B: State Compensation Ins.
<br /> United Storm Water, Inc. INSURER C: Steadfast Insurance Co
<br /> Attn.: Paul Corn
<br /> 14000 E. Valley Blvd. INSURER 0:
<br /> City of Industry, CA 91746 INSURER E:
<br />
<br />COVERAGES
<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 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 />LTR NSR[ TYPE OF INSURANCE POLICY NUMBER DATE (MM/DD~ll: I p~kfl(MM/DDNY1' LIMITS
<br /> GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> f-- 11/16/04 11/16/05 PREMISES (E~~~~~nce)
<br />A X X COMMERCIAL GENERAL LIABILITY GL0525843202 $50,000
<br /> I-- ~ CLAIMS MADE ~ OCCUR
<br /> MED EXP (Anyone person) $ 5,000
<br /> f-- $1,000,000
<br /> X CG-20-37-10-01 PERSONAL & ADV INJURY
<br /> I--
<br /> GENERAL AGGREGATE $1,000,000
<br /> f-- $1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS. COM PlOP AGG
<br /> n .nPRO- n
<br /> POLICY JECT LOC
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000
<br /> -
<br />A X ~ ANY AUTO BAP525843302 11/16/04 11/16/05 (Ea accident)
<br /> ALL OWNED AUTOS BODILY INJURY
<br /> - $
<br /> SCHEDULED AUTOS (Per person)
<br /> - i\..i'iIROVl AS FORM
<br /> ~ HIRED AUTOS U 1'0 BODILY INJURY
<br /> $
<br /> X NON-OWNED AUTOS (Per accident)
<br /> - . .//(j.
<br /> ~ MCS-90 ~: /~') PROPERTY DAMAGE
<br /> ,~" .I " I ,j $
<br /> X CA9948 /' -<. (Per accident)
<br /> v
<br /> GARAGE LIABILITY ""L<U, Q ."" II ,jl<\2:: AUTO ONLY - EA ACCIDENT $
<br /> =l ANY AUTO i\:,>tsra 'H City Atfop' 'Y
<br /> ,. . . EA ACC $
<br /> OTHER THAN
<br /> AUTO ONLY: AGG $
<br /> EXCESs/UMBRELLA LIABILITY EACH OCCURRENCE $4,000,000
<br />A X tJ OCCUR D CLAIMS MADE SE0525843802 11/16/04 11/16/05 AGGREGATE $4,000,000
<br /> $
<br /> ~ DEDUCTIBLE $
<br /> X RETENTION $10,000 $
<br /> WORKERS COMPENSATION AND X ITO'~Y:;LI~:i'S I IOJ~'
<br />B EMPLOYERS' LIABILITY 157136405 01/01/05 01/01/06 $1,000,000
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT
<br /> OFFICER/MEMBER EXCLUDED? EVIDENCE ONLY E.L. DISEASE. EA EMPLOYEE $1,000,000
<br /> If yes, describe under E. L. DISEASE. POLICY LIMIT $1,000,000
<br /> SPECIAL PROVISIONS below
<br /> OTHER
<br />C PROF LIABILITY/ PEC525842902 11/16/04 11/16/05 TOTAL LIM $1,000,000
<br /> E&O (CLAIMS MADE) POLLUTION LIAB (oee FORM) ANN AGG $25,000 DED
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
<br />WAIVER OF SUBROGATION APPLIES. RE: FOR CATCH BASIN CLEANING SERVICES. CLERK
<br />OF THE CITY COUNCIL, CITY OF SANTA ANA IS NAMED AS ADDITIONAL INSURED AS
<br />RESPECTS ALL OPERATIONS AS PER ATTACHED CG 20 01 10 01, FORM MCS-90, FORM
<br />MCP-65, FORM CA 9948.
<br />*EXCEPT 10 DAYS NOTICE FOR NON-PAYMENT OF PREMIUM.
<br />
<br />CERTIFICATE HOLDER
<br />
<br />CANCELLATION
<br />
<br />CCCCCCC
<br />
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
<br />DATE THEREOF, THE ISSUING INSURER WILL !::Il!l!!....ell 18 MAIL *30 DAYS WRITTEN
<br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Ii'''T r"Ib.URi: TQ llilllilllll"b.1.
<br />
<br />Clerk of the City Council
<br />City of Santa Ana
<br />20 Civic Center Plaza (M-30)
<br />P.O. Box 1988
<br />Santa Ana, CA 92702-1988
<br />
<br />Ir~POiE: tl9 29b.1~"Tlgtl OR ~1"&lbl~' sr -.If: lUll _. _ . .._ IfJ8ijR,CR,ITB -,81SJJ18 8A
<br />
<br />ACORD 25 (2001/08)
<br />
<br />
<br />
<br />@ACORDCORPORATION 1988
<br />
<br />
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