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<br />ACORD CERTIFICATE OF INSURANCE ISSUE DATE <br /> ~' <br /> 9/28/05 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS <br />DICKERSON EMPLOYEE BENEFITS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT <br />~918 RNERSIDE DR. AMEND EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />[Los ANGELES, CA 90039 COMPANIES AFFORDING COVERAGE <br /> COMPANY <br />INSURED LETTER A ..~ <br />PHOENIX GROUP INFORMATION I <iDMPANY <br />LETTER B <br />2670 N. MAIN STREET COMPANY <br />SUITE #200 LETTER C <br />SANTA ANA, CA 92705 COMPANY <br /> LETTER 0 <br /> : <iOMPANY <br /> LETTER E <br />COVERAGES THiS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE <br />FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT <br />WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR PERTAIN, THE INSURANCE AFFORDEO BY THE POLICIES DESCRIBED HEREIN <br />IS SUBJECT TO ALL THE TERMS, excLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE SEEN REDUCED BY PAID CLAJMS. <br />CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS <br />LTR DATE ,M".,,1lIYY1 DATE'MMlDD/YV) <br /> GENERAL UA8IUTY GENERAL AGGREGATE $ <br /> r- COMMERCIAL GENERAL LIABILITY PROD\JCTS.COMP/DPS AGG $ <br /> f- ~ CLAIMS MADE 0 OCCUR PERSONAl. ADV,INJURY $ <br /> r- OWNER'S' CONTRACTORS PROTo EACH OCCURRENOE $ <br /> r- FIRE DAMAGE (Any llIMI fIrw) $ <br /> - " , MED, EXPENSE (Anyone P8/SOfI $ <br /> AUTOMOlllLE L1ABJrrv J -Do ~i>'-'-' COMBINED SINGLE <br /> - ANY AUTO LIMIT $ <br />" - . .---- - - .. .~ <br /> ALL OWNED AUTOS 'I.' ,'; <br /> ':.- ,~.. '-' - cl :... -~-'~J' BODILY INJURY <br /> - SCHEDULED AUTOS 1,'l..J;)[d.u City .f-\.tlor .cy (porptm>nl $ <br /> r- HIRED AUTOS PROPERTY DAMAGE $ <br /> r- GARAGE LIABIliTY <br /> EXCESS LIABILITY EACH OCCURRENCE $ <br /> q UMSRELLA FORM AGGREGATE $ <br /> OTHER THAN UMBRElLA FORM <br /> I STATUTORY <br /> WORKERS' COIIPENSATlC>>I SA81- LIMITS <br />A AND 1005- 10/1/05 10/1/06 I!ACH ACCIDENT $1,000,000 <br /> EMPLOYERS' LIABILITY 24364 DISEASE POLICY UMIT $1 000 000 <br /> DISEASE EACH EMPLOYEE $1 000 000 <br /> OTHER <br />DESCRIPTION OF OPERAT1DNSILOCATIONSNEHICLESISPECIAL ITEMS <br />CEI'tIlFICATE HDLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLlCIED BE <br /> <br />City of Santa Ana <br />Attn: LaLlra Sheddy <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 <br /> <br />CANCELLED BEFORE THE EXPIRATION ~tE THEREOF, THE ISSUING <br />COMPANY WR.L ENDEAVOR TO MAIL 30 DAYS WRITTEN NonCE TO <br />THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAlLURl! TO MAIL <br />SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND <br />UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. <br /> <br />~ ~-<<-A-~- "'w <br />AUTHORIZED REPRESENTATIVE <br />