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ACCORD,, CERT1 ATE O) <br />DATE IMM <br />f `i14S14[TY <br />.. ... <br />fk�uk C ::,.08/12/2005005 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />PRODUCER Stephen Nourse <br />Hub International of California <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />6101 W Centinela Ave <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Culver City, CA 90230 <br />COMPANIES AFFORDING COVERAGE <br />COMPANY Golden Eagle Insurance Corporatio <br />(310) 568-5900... fax(310) 568-9.098 <br />A <br />INSURED <br />LaBelle - Marvin, Inc. <br />i— <br />AN <br />COMP� y Houston Casualty Company <br />B <br />2700 S. Grand Avenue <br />Santa Ana, CA 9270s <br />COMPANY Granite State Insurance Co. /AIG <br />C <br />COMPANY <br />T� <br />� . ` <br />D <br />D <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />LTH <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />DATE IMM/DDIYY) <br />POLICY EXPIRATION <br />DATE IMM/DD/YY) <br />LIMITS <br />A <br />GENERAL <br />LIABILITY <br />CBP9491248 <br />06/16/2005 <br />06/16/2006 <br />GENERAL AGGREGATE 8 2,000,000 <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE XX OCCUR <br />PRODUCTS - COMP/OP AGG 92,000,000 <br />PERSONAL&ADV INJURY 31,000,000 <br />EACH OCCURRENCE 51,000,000 <br />OWNER'S& CONTRACTOR'S PROT <br />FIRE DAMAGE (Any one ins) $ 100,000 <br />MED EXP (Any one person) $ 5,000 <br />A <br />AUTOMOBILE <br />LIABILITY <br />CBP9491248 <br />06/16/2005 <br />06/16/2006 <br />ANY AUTO <br />COMBINED SINGLE LIMIT 91,000,000 <br />X <br />BODILY INJURY 9 <br />(Per peisonl <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />BODILY INJURY $ <br />(Per accident) <br />HIRED AUTOS <br />NON -OWNED AUTOS <br />PROPERTY DAMAGE a <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT $ <br />ANY AUTO <br />OTHER THAN AUTO ONLY: <br />X <br />EACH ACCIDENT 5 <br />AGGREGATE a <br />EXCESS LIABILITY <br />CU9492251 <br />06/16/2005 <br />06/16/2006 <br />EACHOCCURRENCE $5,000,000 <br />A <br />X UMBRELLA FORM <br />AGGREGATE $5,000,000 <br />OTHER THAN UMBRELLA FORM <br />5 <br />C <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br />WC1515245 <br />06/16/2005 <br />06/16/2006 <br />X I TORY IMIT OETH- <br />EL EACH ACCIDENT S 1,000,000 <br />THEPROPRIETOR/ INCL <br />PARTNERS/ERS/E%ECUTIVE <br />EL DISEASE - POLICY LIMIT 51,000,000 <br />B <br />OFFICERS ARE: EXCL <br />Professional <br />Liability <br />HCO51008401 <br />01/04/2005 <br />01/04/2006 <br />EL DISEASE - EA EMPLOYEE s 1,000 , 000 <br />1,000,000 Limit <br />25,000 Deductible <br />DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS <br />certificate Holder is Listed as Additional Insured per Form CG 20 10 10 01 Attached <br />cT,rcaT x©Lb�R <br />�nA1C A7lt1 <br />A <br />City of Santa Ana A PROVE r;1 (' ) j (j <br />`P,, <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />f' <br />20 Civic Center Plaza- M36 , I <br />'�""'"-"'L'--• I'1•:�-- � � i�:? ..._ <br />Santa Ana, CA 92701 r JU[' SC!if <br />AS511}i7 �ltb iIi I <br />A400L'A£QRRt1RP£S <br />EXPIRATION DATE THEREOF, THE ISSUING COMPANY WIU-Xd"A?2a7 XX MAIL <br />3 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />a s notice fo no�n��-pa nt <br />XIX QCX>}0M➢C7�SBC�1�}6�fa7G}4L¢�x9€7abC;ffiXC6Xd0}0%N36D[4QX <br />DC7CMX¢QffiXI]Eb6X31D€XC6M14C94X}tY.IIXLfOC]I�!@ffi16SADiaKX <br />AUTHORIZED REPRESENTATIVE <br />®ds42401860 62319CA <br />