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ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID L DATE(MMIDDIYYYY) <br />PRODUCER BAROL -2 05 15 06 <br />BOSWELL INS AGENCY ( #OA96080) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Agents S Brokers, Inc, ONLY AND CONFERSNO RIGHTS UPON THE CERTIFICATE <br />P.O. Box 4648 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />Mission Viejo CA 92690 AL TER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Phone:949- 855 -0430 Fax:949 -837 -5528 <br />INSURED INSURERS AFFORDING COVERAGE NAIC M <br />INSURER A: Admiral Insurance Co._ <br />INSURERS Everest National <br />Harold Wells Associates Inc. jINSURERC Landmark American Ins Co <br />741 E. Ball Rd. Ste. 166 r - <br />Anaheim CA 92 8 05 -5 95 INSURER D. <br />COVERAGES INSURER E: _ <br />THE POLICIES OF INSURANCF LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY NEDUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BYIHE POLICIES DESCRIBED HEREIN IS SUBJECTTOALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />LTR NRR TYPE OF INSURANCE PoLICY NUMBER DATES MMIODM! OATS MM/DOIYY <br />GENERAL LIABILITY LIMITS <br />A X� COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 <br />� CANCELLED 05/15/06 12/23/05 05/15/06 PREMIS s�o� $50,000 <br />CLAIMS MADE X OCCUR <br />MED EXP(my one PertnrJ ,$Excluded <br />PERSONAL S ADV INJURY $1,000,000 <br />GENE AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 <br />POLICY( JECT LOC ~PRODUCTS- COMPIOP AGO $2,000,000 <br />AUTOMOBILE LIABILITY <br />ANYAUTO COMBINED SINGLE LIMIT <br />ALL OWNED AUTOS <br />(Ea eccidenl) �$ <br />SCHEDULED AUTOS DODILV INJURY <br />HIREDAUTOS �ODLL INJURY $ <br />NON -OWNED qU IOS (Per accrdenQ $ <br />PROPERTY DAMAGE <br />GARAGE LIABILITY (Per eccitlenU $ <br />ANY AUTO AUTO ONLY - EA ACC IDENT $ <br />OTHER THgN EA ACC $ <br />AUTO ONLY: qGG $ <br />EXCESSIUMBRELL4 LIABILITY <br />OCCUR CLAIMS MADE EgCHOCCURRENCE $ <br />AGGREGATE $ <br />DEDUCTIBLE $ <br />RETENTION $ $ <br />WORKERS COMPENSATION ANO $ <br />B EMPLOYERS LIABILITY XTORYLIMITS ER <br />ANY PROPRIETORIPARTNERIEXECUTWE 5900001020051 10/01/05 10/01/06. E L. EACH ACCIDENT $1,000 000 <br />OFFICEWMEMBER EXCLUDED? <br />R yECIAL PROVISIO E.L. DISEASE - EA EMPLOYEE <br />SPECIAL PROVISIONS below s 1,000,000 <br />OTHER E . DISEASE - POLICY LIMIT ' $ 1.000.000 <br />C (Professional Liab LHR804296 07/10105 07/10/06 Ea Claim <br />$1,000,000 <br />DESCRIPTION OF OPERATION$/ LOCATIONSIVEHICLES IEX CLUSIONS ADDED BY ENDORSEMENT I SP ECIALPROVISIONS Limit $1,000,000 <br />*10 days notice of cancellation for non - payment of premium non <br />CERTIFICATE HOLDER CANCELLATION <br />CITYA -1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHEEXPIRATION <br />City Attorney DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30+ <br />City of Santa Ana DAYS WRITTEN <br />20 Civic Center Plaza (M -29) NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />P.G. BOX 1988 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURE R, RS AOENTS OR <br />Santa Ana CA 92702 REPRFSFUieiwcc �� _ <br />