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ACORD CERTIFICATE OF LIABILITY INSURANCE OF ID L DATE (Mnv4/ 05 HAROL -2 03/24N OS PRODUCER BOSWELL INS AGENCY ( #OA96080) Agents & Brokers, Inc. P.O. Box 4648 Mission Viejo CA 92690 Phone:949- 855 -0430 Fax:949- 837 -5528 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# INSURED Harold Wells Associates Inc. 741 E. Ball Rd. Ste. 166 Anaheim CA 92801 -5952 INSURER A: CNA Insurance Companies A INSURER R: Landmark American Ins Co B1017696473 INSURER C. 12/01/05 INSURER D: $1,000,000 INSURER E. 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 CONDITION OF ANY CONTRACT 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. Halt RUU`L LTR NSR TYPE OF INSURANCE POLICY NUMBER OCYEFFECTIVE DATE MM /DDM' POLICY DATE MM /DDKY PIRATION LIMITS A GENERAL LIABILITY X GOMMERCIALGENERALLIABILITY CLAIMS MADE " OCCUR B1017696473 12/01/04 12/01/05 EACH OCCURRENCE $1,000,000 PREMSES(Eaccoorence) $100,000 MED EXP (Any one person) $ 5 , PERSONAL 8 ADV INJURY _000 $ 1,000,000 GENERAL AGGREGATE $2,000,000 GENT AGGREGATE LIMIT APPLIES PER POLICY E PRO- LOG JECT PRODUCTS- COMPIOP AGG $1,000,000 AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS APPROVED �\ L� Ar r RO y Eye AS � T T-� 1 0 FOR COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANYAUTO Assistant City Attorney AUTO ONLY - EA ACCIDENT $ OTHER THAN AACC AUTO ONLY: AGG $ $ EXCESWUMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ EACH OCCURRENCE $ AGGREGATE $� $ ' $ A WORKERS COMPENSATION AND EMPLOYERS`LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below WC173347435 10/01/04 10/01/05 X TORY LIMITS ER j E.L. EACH ACCIDENT $1000000 E.L. DISEASE - EA EMPLOYEE $ 10000 00 E.L. DISEASE - POLICYLIMIT $1000000 B OTHER Professional Liab LHR803012 07/10/04 07/10/05 Ea Claim $1,000,000 Agg Limit $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS *10 days notice of cancellation for non - payment of premium CERTIFICATE HOLDER CANCELLATION CITYA -1 SHOO LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City Attorney DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30* DAYSWRITTEN City of Santa Ana NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TORO SO SHALL 20 Civic Center Plaza (M-29) P.O. Box 1988 IMPOSE NO OBLIGATION OR LIAB OFAN Y KIND UPON THE INSURER, ITS AGENTS OR Santa Ana CA 92702 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE 'I Joe A. Boswell - ail) ACORD 25 (2001/08) © ACORD CORPORATION 1966