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FEB. -17' 05 (THU) 10:32 <br />TEL:7I4 373 1134 P.00,1004 <br />Ttji <br />,ACM. CERTIFICATE OF LIABILITY INSURANC9ARAGR3TR °"05/1210 <br />DODGER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />ka Doughea4y Company, I a, HOLDER. THIS CERTIFICATE DOES NOT AMENP, 9XT6ND OR <br />0. Box 1277 I' ' � ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Ing Beach CA 90807 iINSURERS AFFORDING COVERAGE <br />Dne:562-424-1621 Sax:1562-490-0432 <br />tlREP INSURER A, Hartford Insurance Co=anv of <br />ElEagon Partnera, Ltd, Wi <br />2 Pala& Avai Sy ite g01 INSURen D: <br />Huntington Beach 6A 92649 <br />THE POLICIES Or• INSURANCE LISTED PELOW 4IAVE SEEN 166110 TO THE IN3UREP NAMED ABOVE FOR THE P061GY PERIOD INPICATEP. NOTWrTI+SrANOWc <br />ANY REQUIREMENT, TERM 00 CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY RE ISCOCO 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 LIMIYS SHOWN NLAY HAVE BEEN RcoUCEO BY PASJ CLAIMS. <br />57 <br />TYPEOP14BUAAN6p <br />06LICY NUMBER <br />0 B MNIOom' N <br />LIMITS <br />A <br />GENERAL LIABILITY <br />X CO►IMERCIALGENERAL LIABILITY <br />CLAIMS MADEOCCUR <br />72 UUN UR1666 <br />05/01/04 <br />05/01/05 <br />EACH OCCURRENCE <br />$1, 000, 000 <br />FIRE DAMAGE (My one lira) <br />1300 000 <br />;MEO; EXP�am p-ncpeneP) <br />310 0001 <br />PERSONAL A APV INJURY <br />52,000,000 <br />OENERAL AGGREGATE <br />92 000 000 <br />01VI. AQOREOATE LIMIT APPLIES PER <br />X POLICY M P C - M LOC <br />PRODUCTS - COMPJOP AGG <br />62 000 000 <br />fC <br />AVTOMOIRLE <br />LIABILITY <br />ANrA1fID �, <br />ALL OWNED MITOS <br />SCHEDULED AUTOS <br />HIRED AUTOS <br />NON•OWNBG AVTO3 <br />72 UUN UR1666 <br />I <br />APPROVED <br />05/01/04 <br />AS TO F <br />05/01/05 <br />RM <br />iEadm ISINGLE LIMIT <br />31,000,000 <br />BODILY INJURY <br />(P-r Psm-) <br />6 <br />If <br />X <br />BODILY INJURY <br />(Pet exlmnD <br />` <br />X <br />IPMRO=Qw6NOA RAGE <br />` <br />. MRAOF LIARAM <br />ANY AUTO <br />AUfO ONLY -EA ACCIDENT <br />i <br />OTHER THAN �ACG <br />AUTO DNLC AGO <br />3 <br />E%CEBS LIABILITY <br />OCCUR CLAMS MADE <br />DEDUCTIBLE <br />RETENTION 310.000 <br />ASSLStanT <br />itY Xttornev <br />EACH OCCURRENCE <br />3 <br />AGGREGATE <br />P <br />6 <br />_ <br />3 <br />S <br />i <br />I <br />�C <br />'D <br />WORNE116 COMPENSATION AMC <br />EMPLOYERS' UABIUT/ <br />T¢ WE PPS1167-CXCC L'1' CA <br />CA - 1763833-03 <br />12 /31/09 <br />12/31/03 <br />% <br />12/31/04 <br />12/31/04 <br />X TOR A EA <br />E,L EACH AGCIDENY <br />$1 DOO OOO <br />EL.D16FASE-EAEMPLOYEE <br />61 000 GOO <br />EL. OISEA9E• PCLICYLIMrr <br />31 000 DOD <br />i <br />OTHER <br />PEBCRIPTION OF QFEAATIONSN.00ATI°NBNBNMLEWEJICLUSI°NB AODEO BY ENOORREMPMISPECULL PROVISIONS <br />O,N1aya notica,Eo cancellation for nonpayment of premium. Certificate holder <br />}a ihamed ds! aelQit:ional insured per the attached endorsement. <br />I � I <br />I I <br />r <br />City of Santa Ana <br />Public Works Agency <br />20 Civic Center Plaza, X-36 <br />P 0 Reg 1999 <br />Santa Ana CA 92702 <br />SHOULD ANY OF 7N5 ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE BXPIRATI01 <br />DATETHEIROF,YHCIGGU1NOINSURERVALLEN ek BITO MAIL .3.0—OAYSWRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LINT, IIYFFNEnRCT000'OearyAli <br />