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I Ite: 9/7/2005 Time. 11:24 AM To: ® 96476515 <br />714-905-1910 Page: 005-006 <br />ACORDM CERTIFICATE OF LIABILITY INSURANCE 09 /07/2 00 51 <br />PRODUGTER (714)905-1923 FAX (714)905-1910 <br />Hayward Tilton & Rol app Ins. Assoc., Inc. <br />License #0614365 THIS CERTIFICATE IS ISSUED ASAMATTER OFINFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />P.O. Box 25529 <br />Anaheim, CA 92825-5529 <br />INSURERS AFFORDING COVERAGE <br />NAIC# <br />INSURED CYCOm Data Systems, Inc. ~.wuIRERn Hartford Casualty Insurance Co 29424 <br />6835 Roberta Rd SW IN`,IRERe Continental Casualty <br />Ocean Isle Beach, SC 28469 INSURERr <br /> INSURER o <br /> ~SLIPCR r <br />THE POLICIES OF INSURANCE LISTED BELWV HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR <br />MAV PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS <br />EXCLUSIONS AND CONDITIONS OF SUCH <br />, <br />POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR DD' TYPE OF INSURANCE POLICY NUABER POLICY EFFECTNE POLICV E%PIRATON LIMITS <br /> cENERAUTAee-rrv 72SBANJ1649DX 06/04/2005 06/04/2006 EACH ~~~:aRRENCE R 1,000,000 <br /> X ~.UMMERCIAL6ENERAwABIUrV DAMA6ET~~RENTEG a 300,000 <br /> A._AIMS MHDE ~OCOLR MEM EXF Nny onx VAU,cnl $ 10 DDD <br />A PERSUNALZ ADV IN~uuv s 1 <br />000 <br />000 <br /> eENERHL Ao:gREGATE , <br />, <br />a 2 <br />DOO <br />000 <br /> _ <br />eENLAC„RE~;HTEUMIT APPLIES PER <br />l PROOU~TS-~oMP/VP AGG , <br />, <br />$ 2,000,000 <br /> POLICI JC~T Lni_ <br /> AU TOMOBILE LIABILITY <br /> ~.OMBINED~NoLE LIMIT $ <br /> ANY AUTO (Ea a_am~tl <br /> ALL a WNEG RUTS b <br /> BOpILr VJduRY $ <br /> 3,.HEUIR FR AI OO`~ IPer RB(SOPI <br /> HIRFEi AI IIOti _ <br /> enolL~ nlduuv F <br /> NoN nwNEn HUI~~a fPe: acodtiuq <br /> - PRnP <br />RT~ <br /> E <br />DAMAGE f <br /> Pyr aCSltl9nl) <br /> GARAGE LIABILffY HI IT ~ pNL+ <br />-H'~A~CIGENT <br />$ <br /> HNY AUTO E/AA~~ <br />T~iHER TI IAV $ <br /> AUTO ONLY hG~. $ <br /> E%CESSIUMBRELLA LIFBILfTY EHCH Vt.C_IRRENIE $ <br /> GCUR ~ CLAIMS MACE 4s~,RESATE 4 <br /> <br /> DEUIJ LTI BLE <br />R <br /> ReTENTION $ ~ <br /> WORKERS COMPENSATION AND WC STATLI 0TH. <br /> EMPLOVERS'LIABILITY T~ RY IMIT R <br /> ANY PROPRIETOR/PARTMERIEXE~LTIVE <br />~:FFIC <br />R EL EP~H H~CIDENT $ <br /> E <br />/MEMBER Ex~TUDFG^ <br />Il ye des!~Ibe un Jer <br />EL GISEASE-CA EMPL~~YE <br />$ <br /> <br />?PENAL PRON310N;belwr <br />EL [)ISFA9E-P/'i'~.VIIMT _ <br />$ <br /> ro~essional Liability 267898038 07/16/2005 07/16/2006 f1, 000,000 Aggr. Incl Expenses <br />B !1,000,000 Each Wrongful Act <br /> !10,000 Deductible <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES 1 E%CLUSIONS ADDED BV ENDORSEMENT I SPECIAL PROVISIONS <br />ertificate holder is named as additional insured as respects to general liability but only as respects <br />o services provided by the named insured. /~~'~'I~',~;}`IILL <br />` <br />~ <br />_ <br />, <br />, ;,; t,,,:,,, <br />%" <br />.. i, <br />CANCELLATION: 10-day notice for non- <br />t <br />f <br />i <br />~---~--- <br />~ <br />paymen <br />o <br />prem <br />um. <br />----- <br />---i __ :_.__-_. _. <br />~,. <br />SHOLLD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />Clty of Santa Ana EXPIRATION DATE THEREOF, THEISSUING INSURER WILL ENDEAVOR TO MAIL <br />Office of the City Attorney 3O=DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT <br />Attn: Juanita Hernandez BUT FAILURE TO MAIL SUCH NOTCE SHALL IMPOSE NO OBLIGATION OR LIABILITY <br />20 Cl V1C Center Plaza OF ANY KING UPON THE INSURER, ITS AGENTS OR REPRESENTATNES <br />Sanid Ana, CA 92701 AUTHORIZED REPRESENTATIVE ~~ <br />Valerie Gallardo NMG <br />ACORD 25 !2001/0el FAX: (714 <br /> <br />