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<br />Client#: 16427
<br />
<br />ARROYOINCl
<br />
<br />. ACDBD. CERTIFICATE OF LIABILITY INSURANCE
<br />
<br />DATE (MMlDDNY)
<br />08/26/05
<br />
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<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 />
<br />PRODUCF.:~
<br />JO.rmstrong/Robitaille Bus&lnsSv
<br />535 N. Brand Blvd., 10th Floor
<br />Glendale, CA 91203
<br />818 662-4200
<br />
<br />INSURERS AFFORDING COVERAGE
<br />
<br />Econolite Traffic Engineering
<br />& Maintenance, Inc
<br />3360 E. La Palma Avenue
<br />Anaheim, CA 92806
<br />
<br />INSUAERA; Chubb-Federal Insurance Co.
<br />-------------
<br />, INSURER B: American Guarantee & Liability Ins
<br />r-----------
<br />i INSURER c:
<br />I--I~-~~~~-~-~---------
<br />
<br />INSURER E:
<br />
<br />INSURED
<br />
<br />COVERAGES
<br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
<br />ANY REQUIREMENT, 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 BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
<br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />I~i~ ~ TYPE OF INSURANCE POLICY NUMBER Pgk!fEY ij~~EJ.}~E ~p~~~t~x~C~~N
<br />
<br />LIMITS
<br />
<br />A 'GENEBAL LIABILITY
<br />
<br />,35818716
<br />
<br />04/27/05
<br />
<br />04/27/06
<br />
<br />EACH OCCURRENCE _ _ ~JJ_QQ9-1Q9~~
<br />F~~_~~~GE_('2~~one fire)-=- ~~ct9!!MQQ_
<br />MED ~~~~~_~~~~~___ _$1 0.000 ~____~___
<br />PERSONAL & ADV INJURY _$1.000.000
<br />GENERAL AGGREGATE $~,-()QQ19_(lQ__
<br />PRODUCTS -COMP/OP AGG ~~J99(),9_9_0
<br />
<br />~'
<br />
<br />, X ;COMMERCIAlGENERALLlABILlrY
<br />:_~:~ ~___::_, CLAIMS MADE [_")<] OCCUR ,
<br />i X ;100,000 SIR
<br />I
<br />
<br />~
<br />
<br />: GEN'l AGGREGATE LIMIT APP~_I~S PER:
<br />: POLICY X r:;~8i. X LOC
<br />A i AUTOMOBILE LIABILITY
<br />X I ANY AUTO
<br />ALL OWNED AUTOS
<br />SCHEDULED AUTOS
<br />X HIRED AUTOS
<br />X NON-OWNED AUTOS
<br />
<br />173215072
<br />I
<br />,
<br />i
<br />:
<br />
<br />04/27/05
<br />
<br />04/27/06
<br />
<br />COMBINED SINGLE LIMIT
<br />(Eaaccident)
<br />
<br />BODilY INJURY
<br />(Per person)
<br />
<br />i $1,000,000
<br />i
<br />i$
<br />-1---- -------
<br />!
<br />1$
<br />
<br />BODilY INJURY
<br />(Per accident)
<br />
<br />PROPERTY DAMAGE
<br />(Per accident)
<br />
<br />$
<br />
<br />; GARAGE LIABILITY
<br />, ,
<br />; ANY AUTO
<br />
<br />AUTO ONLY - EA ACCIDENT
<br />
<br />OTHER THAN
<br />AUTO ONLY:
<br />
<br />EA ACC
<br />AGG
<br />
<br />$
<br />$
<br />$
<br />$1,909,000._
<br />$2,Q09,OOO___ _
<br />
<br />B
<br />
<br />EXCESS LIABILITY
<br />
<br />,AUC534614100
<br />
<br />04/27/05
<br />
<br />04/27/06
<br />
<br />! EACH OCCURREN<;:_E__
<br />
<br />! __ X OCCUR
<br />
<br />I
<br />,~__.J CLAIMS MADE
<br />
<br />AGGREGATE
<br />
<br />DEDUCTIBLE
<br />RETENTION $
<br />WORKERS COMPENSATION AND
<br />EMPLOYERS' LIABILITY
<br />
<br />Al'PROVED N',' J-("
<br />. J l'()RA,
<br />
<br />I
<br />.__1______-
<br />
<br />:$
<br />"- -----------------~-----
<br />__ ___ ____;J_~___
<br />'$
<br />
<br />",';-'01:-,(:;:'
<br />
<br />\.1/::' /\.;
<br />
<br />
<br />we STATU- OTH-
<br />____TQ8YLlM!TS , EH _______________
<br />~~--E:ACH-I\C-C~~ENT $
<br />. ..ISEASE -EnEI.1. ~vrI::.Ei$-
<br />_____:~--=m ~___
<br />ISEASE - P&'TeV L1MII-..i.$..
<br />
<br />---
<br />
<br />1/' (-j
<br />/-::J '.,,<_11, "
<br />y . ~ ((
<br />
<br />
<br />--- ---
<br />---
<br />-----
<br />
<br />--,
<br />--
<br />--
<br />--
<br />-
<br />
<br />OTHER
<br />
<br />DESCRIPTION OF OPERATIONSlLQCATlONSlVEHICLESlEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
<br />10 Day Notice of Cancellation for Non-Payment of Premium
<br />For additional insured wording, see form 80-02-2305 (Rev 4-01),
<br />for primary wording and waiver of subrogation, see form
<br />80-02-2000 (Rev 4-01); all are attached and a part of policy 35818716.
<br />(See Attached Descriptions)
<br />
<br />CERTIFICATE HOLDER
<br />
<br />, ADDmONALINSUREDiINSURERLETIER:
<br />
<br />CANCELLATION
<br />
<br />City of Santa Ana
<br />Attn: Vinh Nguyen
<br />P.O. Box 1988/ M043
<br />Santa Ana, CA 92702-1988
<br />
<br />SHOULD ANYOFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
<br />DATE THEREOF, THE ISSUING INSURER WILL &rlliU;:."9R WMAIL3D-,. DAYS WRITTEN
<br />NOTlCETOTHE CERTIFICATE HOLDER NAMED TOTHE LEFT, 8IJTr"l1l1l."RE: 1999S9811 ~l
<br />IMPSBE lIS SB~18 TlSII SA II BI~I;P Sf "f1ul'lHl8 "PSf' -'IE IfIC"Rt:R,IHi "":'~.'~r ')~
<br />P'lEI"RESEI n, ifI. E5,
<br />
<br />AUTHORIZED REPAESENT-\TIVE
<br />A"~ A.JL/~
<br />
<br />ACORD 25-S (7/97) 1 of 3
<br />
<br />#S283182/M 153669
<br />
<br />HSRAJ @ ACORD CORPORATION 1988
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<br />
<br />':?27Ci:2+ i "=it~8
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