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Rug 04 OS 1O:55a Tllagl <br />p.3 <br />OFID J DATE (MMIDOnYVY) <br />CERTIFICATE OF LIABILITY INSURANCE CASTL-1 07/29 OS <br />A~ORD <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />pgODUCER ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />Insurance Services HOLDER. THIS CERTIFICATE DOES NOT AA'END, EXTEND OR <br />Of Thousand Oaks, Inc. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW- <br />PO Box 7329 <br />Thousand Oaks CA 91359 <br />605-495-4634 Fax: 305-494-0781 <br />INSURERS AFFORDING COVERAGE _. NAIC# <br />- <br />Phone: <br />~-/ <br />ED INSURER A: CBIC Insurance Co. _ __ <br />r G <br />INSVR <br />~`-aLiV~-UO / <br />1 v INSURER B: _. _ __. <br /> INSVRER O _ ._--- <br />Ca$tt2le Mason4gry _ <br />A <br />c <br />r <br />n <br />wsuRERO: __... <br />92649 <br />h <br />C <br />Bea <br />8untington INSURER E. <br />COVERAGES <br />NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />THE POLICIES OF iNSVRANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED <br />ER DOCUMENT WTD7 RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR <br />ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT Oft OTH <br />E%LLUSIONS AND CONDITIONS OF 6UCH <br />IN IS SUBJECT TO ALL THE TERMS <br />, <br />THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HERE <br />MAV PERTAIN <br />. <br />POLICIES. AGGREGATE LIMITS SHOWN MAV HAVE BEEN REDUCED BV PAID CLAIMS. - <br /> _ 6 <br />D LIMITS <br />IN <br />LTR N D <br />SR TYPE OF INSURANCE POLICY NUMBER pATE M DDM' OIYY <br />DATE M <br />V <br />SOOOOOO <br /> EACH OCCURRENCE S <br /> GENERAL LIABILITY <br />1326 <br />02/28/05 <br />02 ~26~D6 <br />PREMI6ES (~a $ 300000 <br />A X COMMERCWL GENERAL LIABILITY INSCE 5000 <br /> MED EXP (Any one person) _ <br />5 <br /> CIAIMS MADE OCCUR PERSONALBAOV INJURY S lOOOOOO _ <br /> -J ------ '_-- GENERA'. AGGREGATE $ 2000000 <br /> J - __ PNUUUGTS-COMP/OP AGG $ ZOOOOOO <br />_ <br /> GENL AGGREGATE LIMIT APPLIES PER: <br /> POLICY PRO LOC <br />JECT <br /> AUTOMOBILE LVIBILTTY GOM~INE~DI' INGLE LIMIT $ <br />- <br /> ANY AUTO - <br /> Au.OWNEO AlJtt15 BODILY INJURY <br />(Per person) S <br /> SCHEDULED AUTOS <br /> HIRED AUTOS BODILY INJURY <br />' $ <br /> (Pet amlEenl <br />r <br /> NON~OWNED AUTOS <br /> PROPERTY DAMAGE $ <br /> (Perew~aonq <br /> - <br /> AUTO DNLV-EA AGCiDENT $ <br /> GARAGE LIABILITY EA ACC $ <br /> ANV AUTO <br />_ OTHER THAN <br />AUTO ONLY. AGG - _ <br />$ <br /> EACH OCCURRENCE $ <br />'- <br /> EKCEBBNMBRFILA LIABIl1TV - <br /> AGGREGATE $ <br />_ <br /> OCCUR ~ CLAIMS MADE _- - <br /> $ <br /> -" <br /> OEDVCTIULE -' <br /> RETENTION 8 ~ ? V U AS 3 ~ ~' ll;°/0 $ <br /> ER <br />TORY LIMITS _.. __ _ <br /> WORKERS COMPENSATION AND . <br /> EMPLOYERF'LIABILITV <br />~ e ~ - E. L. EACH ACCIDENT $ _ _ <br /> ANV PROPRIETOPIPARTNERIEXEOVTNE <br />CER/MEMBERE%CLUDEO? <br />F ~ T ' r <br />-=~-`""- <br />---' <br />E.L. DISEASE-EA EMPLOYE <br />ES ____ <br /> ~OF <br />I ____. <br /> Il yes tleealpe vber <br />' .G[8 ~ L I'~-~JY EL DISEASE-POLICY LIMIT $ <br /> ~ <br />_ <br />SPECLAL PROVISIONS below <br />' ~- <br /> " _ <br />OTHER •.•.. r-.r <br />..~.. <br />OPEMTIOXS / LOCATION9l VEHK;LW I EXCLUSIONS ADDED BY ENDORSEIAENT I SPECULL PROVISIONS <br />DEBCRIPPON V P <br />T1Te city o£ Santa Ana, its officers, agents and employees are named <br />additional insured. 10 day notice o£ cancellation may apply for non--payment <br />of premium. <br />CERTIFICATE HOLDER "^"""`^"-" <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />SAN•PAAN DATE THEREOF, THE ISSUING INSURER WILL BHBG,WBR#O MAIL 3O DAYS WRRTEN <br /> NOTICE TO TXE CeRTIPICATE HOLDER NAMED TO THE LEFT, ~ <br />The Depot at Santa Ana RePr~e~airves., <br />1000 E Santa Ana Blvd p108 IVE <br />Santa Ana CA 92701 AUTHORIZED REPRESENTAT <br />_ <br /> Tim McClain <br /> i n ACOR^ CORPORA/ION 1988 <br />ACORD 25 (2001108) <br />