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<br />lili:~~II...II.IIIIIII.III!I..II!'!~~!!!!!4"!!I]~!!!I![I:;~=:'::: <br /> <br /> <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 />COMPANIES AFFORDING COVERAGE <br /> <br />Glend,le Insurance Agancy <br />750 F.lr.ont AVlnu. <br />P. O. Box 831 <br />6Iand,l, CA 91209-0831 <br />18181 244-1144 <br />INIURED <br /> <br />COtd'ANY <br />A <br /> <br />Hartford Fir. Insuranol Co. <br /> <br />Pholnlx &roup Information Sys. <br />2870 N. Main Str..t, Suit. ZOO <br />Santa Ana, Cl 92705 <br /> <br />./1- .7 a:P- 05 '1 <br />A-dOo5 - 037-0/ <br /> <br />COMPANY <br />B <br /> <br /> <br />COMPANY <br />C <br /> <br />National Union Fir. In.urane. Com an <br /> <br />THISIS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICA TED,NOTWITHST ANDINGANYREQUIREMENT, TERMORCONDITIONOF ANYCONTRACTOROTHERDOCUMENTWITH RESPECT TOWHICHTHIS <br />CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />co TYPE OF INIU..NCE POUCY.....CYIVI! POLICY IXP'IR:ATlON <br />LT1l: PDLlCYNLlMIIR DATI (MMlDDIVY) DATI (MMlDDIYY) LIMITe <br /> <br />A GINI""L L1"ILITY 72SBAAB211315 <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE [!] OCCUR <br />OWNER'S & CONTRACTOR'S PRQT <br /> <br />10/01108 <br /> <br />10/01108 <br /> <br />GENERAL AGI3REGA TE S <br />PRODUCTS.COMP lOP AGG $ <br />PERSONAL & ADV INJURY $ <br />EACH OCCURRENCE $ <br />FIRE DAMAGE (Anyone fire) $ <br />MED EXP (Anyone person) $ <br /> <br />2,000,000 <br />2,OOO,DOO <br />1,000,000 <br />I,OOO,ODO <br />300,ODD <br />5 000 <br /> <br /> <br />AUTOMOILE L1ABA.ITY <br />ANY AUTO <br />All OWNED AUTOS <br />I SCHEDULED AUTOS <br />X HIRED AUTOS <br />X NON-OWNED AUTOS <br /> <br />72S8U82838 <br /> <br />10/01105 <br /> <br />10/01106 <br /> <br />COMBINED SINGLE LIMIT $ <br /> <br />2,000,000 <br /> <br />BODilY INJURY <br />(Per person) <br /> <br />$ <br /> <br />BODilY lNJl.JlY <br />(Per accident) <br /> <br />1$ <br /> <br />PROPERTY DAMAGE $ <br /> <br />GAIIAGE LIABLITY <br />ANY AUTO <br /> <br />THE PROPRIETOR/ <br />I PARTNERS/EXECUTIVE <br />OFFICERS ARE: <br />OTHEII <br />C Caamerclel Crlm. Polley <br /> <br />INCl <br />EXCl <br /> <br /> <br /> <br />AUTO ONl V - EA ACCIDENT $ <br />OTHER THAN AUTO ONLY: <br />EACH ACCIDENT <br />AGGREGATE <br />EACH OCCURRENCE <br />AGGREGATE <br /> <br />EXCEII LIAILITY <br />U~REllA FORM <br />OTHER THAN LJ..1BREllA FORM <br />WOIIKIltI COMPUIATION AND <br />EMPLOYERI'LIABLITY <br /> <br />Laura <br />I S.'ilstant <br /> <br />tt\)rn~\ <br /> <br />El DISEASE-EA EMPLOYEE <br /> <br />5520888 <br /> <br />11118/04 <br /> <br />11115/05 <br /> <br />51,000,000 Limit p.r ooourrence <br />525.000 Deduotlble <br /> <br />DUCIIPTION OF OPIIIATIONIA..OCATIONIIYEHICLEIIIPECIAL ITEMS <br /> <br />It Is a.r..d thet the City of Sent. Ane Is n...d Additional <br />Insur.d ./re.erd to &.n.rel LI.blllty cov.r.... end p.r the etteoh.d Additional Inlur.d Endorlem.nt. <br /> <br />JIMmlitt:.tu.nt .. :.:.,:;:::;.;:;:;:;::)/;,.,::::91tnm~\l#H1@nl%U@Ml:dtH%Mtdtt.:: . <br /> <br /> <br />'.. ... ......... <br />IHOlLD ANY OF THE AIDVI DIICfIIIIID POLlOl.I II CANClLUD IEFOIII TNE <br />IXPIIIATIDN DATI THEIIIDF, THE IIIUING COMPANY WLL INDEAVOII TO MAL <br />30 DAYI MlmlN NOTI~TO THE ClllTlPlCATI HOLDIII N...,..D TO TNILEFT, <br />IUT ,ALUII. TO MAL IUCH NOTl~ IHALL IMPOI. NO OIUGATlON 011 UAILITY <br />0' KIND U MPANY, ITI "QINTS OR ..IPRUINTATlVU. <br />IPIIII <br /> <br />City of S.nt. An. <br />Att.ntlon: Laure Sh.ddy <br />20 Civic Cent.r Plez. <br />S.nt. An., CA 82701 <br /> <br /> <br />.ul Tr.u.hber <br />V::':'::"':'''':''':y:~~.: .:'~'.~'~:":": :'::":m.f'~ :::":iili <br /> <br />CERTIFICATE: D02/D01/ D01DS <br />