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<br />ACORD CERTIFICATE OF LIABILITY INSURANCE 6/1 0o'9 '
<br />PRODUCER (818) 598-8900 FAX: (818) 598-8910 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br />Venbrook Insurance Services CA Lie ODS0832
<br />, ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br />6320 Canoga Avenue ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />
<br />12th Floor
<br />Woodland Hills CA 91367 INSURERS AFFORDING COVERAGE NAIC #
<br />INSURED INSURERA Hartford Fire Insurance 19682
<br />Overland Pacific & Cutler Inc. wsURERB:The Hartford
<br />100 West Broadway Suite 500 INSURER a Westchester Fire
<br /> INSURER D:
<br />Long Beach CA 90802 INSURER E:
<br />.OVERAGES
<br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTVNTHSTANDING ANY
<br />REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT MATH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,
<br />THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.
<br />SHOWN D CLAIMS.
<br />INSR ADD'L TYPE OF INSURANCE POLICY NUMBER DAT (MMIDD YI PDAT£ MWDDNY) LIMITS
<br /> GENERAL LIABILITY EA ENCE $ 1,000,000
<br /> X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED
<br />
<br />Sr
<br />tC MI
<br />Ea occurrent 300,000
<br />
<br />
<br />$
<br />A X CLAIMS MADE .? OCCUR 72UUNTR7659 6/1/2009 6/1/2010 MEOFxP An one arson $ 10,000
<br /> X $10,000 BIGPD Ded. PER INJURY S 1,000,000
<br /> Per Claim GENERA AGGREGATE $ 2,000,000
<br /> GENLAGGREGATE LIMIT APPLIES PER:
<br />- PRODUCTS - COMPIOP AGO S 2,000,000
<br /> 1 POLICY X M LOC
<br />1
<br /> AU TOMOBILE LIABILITY
<br />COMBINED SINGLE LIMIT
<br />
<br />S 1,000,000
<br /> X ANY AUTO (Ea aoddenl)
<br />A ALLOVMEDAUTOS 72UUNTR7859 6/1/2009 6/1/2010 BODILY INJURY
<br /> X SCHEDULEDAUTOS
<br />}lZM (Pet Pecs-) $
<br /> X HIRED AUTOS
<br />?
<br />?S ?U ?(
<br />YI
<br />RY
<br />s
<br /> X NON-OVMED AUTOS v Y
<br />APP?U ((Perao
<br />Ment))
<br /> N Comp Ded. $1,000 rl!
<br />PROPERTY DAMAGE
<br /> x Coll Dad. $1,000 (Peracddenl) S
<br /> OARAGELU161LITY _j CF -7 BLltt z
<br />
<br />Y
<br />T'fl AUTO ONLY -EAACCIOENT $
<br /> H ANY AUTO SIS C;iLY (.
<br />aIIL OTHER THAN EAAC S
<br /> NS AUTO ONLY:
<br /> AGG $
<br /> EXCESSIUMBRELLALIABILITY EACH OCCURRENCE $ 2,000,000
<br /> X OCCUR CLAIMS MADE _
<br />AGGREGATE $ 2,000,000
<br /> S
<br />B DEDUCTIBLE 72RHUTR7849 6/1/2009 6/1/2010 $
<br /> RETENTION S
<br />B WORKERS COMPENSATION AND
<br />EMPLOYE
<br />S' LI X ll- 0
<br />1
<br /> R
<br />ABILITY
<br />ANY PROPRIETORfPARTNERIEXECUTIVE E.L EACH ACCIDENT $ 1,000,000
<br /> OFFICERIMEMBEREXCLUDED?
<br />U
<br />es
<br />d
<br />b
<br />d 72WETQ9133 6/1/2009 6/1/2010
<br />E.L. DISEASE -EAEMPLOYEE
<br />$ 1,000,000
<br /> y
<br />,
<br />esrn
<br />eun
<br />er
<br />SPECIALPROVISI NS E, L. DISEASE -POLIY LIMIT S 1,000,000
<br />C OTHER Professional Liab. 624412763002 6/1/2009 6/1/2010 Ea. Claim $ 2,000,000
<br /> Claims Made Aggregate $ 2,000,000
<br /> Deductible $ 50,000
<br />DESCRIPTION OF OPERATLONSILOCAT]ONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
<br />The City of Santa Ana, its officers, agents, employees, consultants, special counsel & representatives included as
<br />additional insured per attached endorsement #CG20260704 where required by contract. Subject to policy terms,
<br />conditions, and exclusions.
<br />*10 DAY NOTICE OF CANCELLATION FOR NON-PAYMENT OF PREMIUM
<br />City of Santa Ana
<br />Public Works Agency, M-36
<br />Attn: Sheri Barkley
<br />P.O. Box 1988
<br />Santa Ana, CA 92702
<br />28 I20n•UOR1
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
<br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
<br />30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT
<br />FAILURE 70 DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE
<br />AUTHORIZED REPRESENTATIVE
<br />Chastity Harry/CH
<br />INS025 (moa).osa Page t of 2
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