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<br />. . DATE (MMfDDIYYYY) <br /> ACQRD. CERTIFICA TE OF LIABILITY INSURANCE OP 10 A~ <br /> ORRIC-1 06/09/05 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Jenkins/Athens Ins Concord ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />License No. 0545478 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />P. O. Box 5668 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Concord CA 94524-2029 <br />Phone: 925-798-3334 Fax: 925-609-5381 INSURERS AFFORDING COVERAGE NAIC# <br />---._--- <br />INSURED ;Y- qvo5- oGS INSURER A Vigilant Insurance Company <br /> INSURER B: Federal Insurance Company <br /> Orrickf. Herrington & Sutcliffe INSURER c: <br /> LLP and Bond Logistix LLC <br /> 2121 Main St. INSURER 0- <br /> Wheeling WV 26003 <br /> INSURER E: <br /> <br />COVERAGES <br /> <br />THE POLJCIES 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 VvHJCH 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 />I P LI E~f...t:~^~t: P~,L E w," I -- <br />LTR NSR TYPE OF INSURANCE POLICY NUMBER 'DAlliMMfDDIYY D~Mtf)DIYY LIMITS <br /> GENERAL LIABILITY I ~~~~ OCCURRENCE .1,000,000 <br />A X X COMMERCIAL GENERAL LIABILITY 35821151 01/01/05 01/01/06 PREMISES (Ea occurence) .1,000,000 <br /> J CLAIMS MADE ~ OCCUR , - -- <br /> l;D EXP (Any or_e person) '10,00C __ <br /> X Emp1 benefits PERSONAL & ADV INJURY . 2,000,000 <br /> r- I GENERAL AGGREGATE .2,000,000 <br /> r- <br /> GEN'l AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ incl <br /> n ,nPRO D Emp Ben. 1,000,000 <br /> POLICY JECT LOC <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> r- .1,000,000 <br />B ANY AUTO 74996569 01/01/05 01/01/06 (Eaaccident) <br /> r- <br /> All OWNED AUTOS BODilY INJURY <br /> - . <br /> SCHEDULED AUTOS (Per person) <br /> X HIRED AUTOS BODilY INJURY <br /> X (Per accident) . <br /> NON-OWNED AUTOS <br /> - <br /> PROPERTY DAMAGE . <br /> (Per accident) <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT . <br /> R ANY AUTO OTHER THAN EA ACC . <br /> AUTO ONLY: AGG . <br /> EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE . <br /> P OCCUR D CLAIMS MADE AGGREGATE . <br /> . <br /> R DEDUCTIBLE A r i)P~() \; 1:'\ " i\,.'. l;) '., <br /> . <br /> RETENTION . . . <br /> WORKERS COMPENSATION AND .---~-41L':d,,-c{ 1_-1ili~y''L'IMiTS I IVEF{ <br /> EMPLOYER(;' LIABILITY 7~-:i----- - <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE r EL EACH ACCIDENT . <br /> LILri, \l :1 j E.L DISEASE - EA EMPLOYEE <br /> OFFICER/MEMBER EXCLUDED? . <br /> ffyes, describe under '.', hi " " . - <br /> SPECIAL PROVISIONS below E.L DISEASE - POLICY LIMIT . <br /> OTHER ! <br /> I <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES f EXCLUSIONS ADDEO BY ENDORSEMENT I SPECIAL PROVISIONS <br />10 day notice of cancellation will apply if cancelled for non-payment of <br />premium. City, its officers, agents, volunteers, and employees are named as <br />Additional Insured (s) per attached endt. <br /> <br />CERTIFICATE HOLDER <br /> <br />CANCELLATION <br /> <br />City of Santa Ana; Francisco <br />Gutierrez Fin & Mgmt Svcs Agcy <br />20 Civic Center Plaza M17 <br />POBox 1988 <br />Santa Ana CA 92701 <br /> <br />SANTA-7 <br /> <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />REPRESENTATIVES. <br />AT RIZED~ '14 <br /> <br />ACORD 25 (2001108) <br /> <br />@ACORDCORPORATION 1988 <br /> <br />