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r--- I I ACORDw CERTIFICATE OF LIABILITY INSURANCE DATE (MM/ODfYYYY) ~RODUCER 1 0/27/04 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION John Burnham Insurance Svcs 11 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE CA Lic 0099753/750 B St, #2400 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. San Diego, CA 92101 619231-1010 INSURERS AFFORDING COVERAGE NAIC# INSURED Ace Parking Management, Inc. N - do05 -0 II INSURER A: Federal Insurance Co. 20281 INSURER B: Great American Insurance Co. 16691 Ace Parking, Inc. N-~col-oolc INSURER c: 645 Ash Street INSURER D: San Diego, CA 92101-3299 INSURER E' Client#. 795 ACEPAR1 COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR COND!TION OF ANY CONTRA.CT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I Pc?A~~:~~6g~,E Pg~~ tit~,6~~N LTR NSR TYPE OF INSURANCE POLICY NUMBER LIMITS A ~NERAL LIABILITY 35776481 11/01/04 11/01/05 EACH OCCURRENCE '900 000 X COMMERCIAL GENERAL LIABILITY $100,000 SIR ~~~~~~J9~~ENTED n ..\ .900 000 I CLAIMS MADE CKJ OCCUR MED EX? (Anyone person) . - PERSONAL & ADV INJURY .900 000 - GENERAL AGGREGATE .2 000 000 GEN'L AGGREn LIMIT APrlS PER: PRODUCTS - COMPIOP AGG .2 000 000 ~ PRO- POLICY JECT LOC A ETOMOBILE L1ABIUTY 73500390 11/01104 11/01/05 COMBINED SINGLE LIMIT A X ANY AUTO 73508989TXAUT 11/01104 11/01105 (Eaaccidenl) '1,000,000 ~ $100,000 Deduct - ALL OWNED AUTOS BODILY INJURY (Per person) . X SCHEDULED AUTOS HIRED AUTOS BODILY INJURY f'-'- . r2L NON-DWNED AUTOS (Peraccidenl) r- PROPERTY DAMAGE . - (Per accident) A RRAGE LIABILITY 35776481 11/01104 11/01105 AUTO ONLY - EA ACCIDENT . ANY AUTO GarageKeep Legal Limit $2,900,000 OTHER THAN EA ACC . $100,000 SIR AUTO ONLY: AGG . B ~ESSlUMBRElLA LIABILITY TUU3578454 11/01104 11/01105 EACH OCCURRENCE .10000000 X OCCUR D CLAIMS MADE AGGREGATE .10000000 . M DEDUCTIBLE . X RETENTION .0 . A WORKERS COMPENSATION AND 71603581 11/01i04 11/01/05 X I T~;~J"!~r~; I m EMPLOYERS' LIABILITY .1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L EACH ACCIDENT OFFICER/MEMBER EXCLUDED? E.l. DISEASE. EA EMPLOYE .1,000,000 If yes, describe under .1,000,000 SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT A OTHER Property 35776481 11/01/04 11/01105 Blkt Equipment Special Form $2,000,000 Deductible $2 500 DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES J EXCLUSIONS ADDED BY ENDORSEMENT f SPECIAL PROVISIONS f\r KVVDJJ 1-\.) IU rv RE: Lot 721, 722, 723 & 724: 3rd & Broadway, 5th & French, 310 N. Birch '~/l I 1/3 St., and 410 N. Main, Santa Ana, CA Certificate Holder is Additional Insured for General Liability as respects " I v"'- el-tl . Laura Slill S'~~dy premises leased/managed by named insured per policy (form attached). AS:::ilswnt Citty>\I\'"ir" CERTIFICATE HOLDER CANCELLATION City of Santa Ana 20 Civic Center Plaza M-25 Santa Ana, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TIlE EXPIRATION DATE TIlEREOF, THE ISSUING INSURER W1LlcrIBE.I...SR "'FS MAIL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE lEFT, BI:IT r,\IU:JRE: TS Be 3" 311A~L IMPS5/:: 1.6 or:.I:.IS""FIetI51\ Uf\CIUI , vr M.I~, IOIJElI:IF'6N-'f11E: 11.::'.JI\r.I\",~ AGeHTS-oR ACORD 25 (2001108) 1 of 2 LCR @ ACORD CORPORATION 1988 #M22232