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<br /> 1). - J-Cl'''j-(1 "7-z... <br />.-- . <br />ACORD_ CERTIFICATE OF LIABILITY INSURANCE OP 10 K~ DATE (MMID01YYYY) <br />PRGIN-1 03/22/05 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />CTK Insurance Services, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />1240 N. Lakeview, Suite 240 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW_ <br />Anaheim CA 92807 <br />Phone: 714-779-2000 Fax: 714-779-4129 INSURERS AFFORDING COVERAGE NAIC# <br />INSURED INSURER A: Insurance Corp of Hannover <br /> PRG Insurance Staffing INSURER B: Traveler's Insurance <br /> dba: West Coast Insurance INSURER C National Casualtv Co. <br /> Consultants <br /> 125 E Baker6ASuite 290 INSURER 0 I <br /> Costa Mesa 92626 I <br /> INSURER E <br /> <br />COVERAGES <br /> <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDA80VE FOR THE POLICY PERIOD INDICAlED. 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 lNSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SU6JECTTO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS <br />lTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MMfDDIYY Pg,kl{e'(r~~~D~~K LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $1,000,000 <br /> - <br />A ~ :=]Mtv\ERC1AL GENERAL lIABILITY H67P052504 06/05/04 06/05/05 PREMises (Ea occurence\ . <br /> - CLAIMS MADE [!] OCCUR MED EXP (MY one person) .$ 5,000 <br /> PERSONAL &. ADV INJURY $1,000,000 <br /> GENERAL AGGREGATE .2,000,000 <br /> i-l'~ AGG~~t~L1MIT AP~~tIPER: PRODUCTS - COMP/OP AGG $2,000,000 <br /> X POLICY ~~8T LOC <br /> ~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 <br /> ANY AUTO (Eeaccidenl) <br /> ,- <br /> - ALL OWNED AUTOS BODILY INJURY <br /> . <br /> SCHEDULED AUTOS (Per person) <br /> ,- <br />A ~ HIRED AlJTOS H67P052504 06/05/04 06/05/05 BODILY INJURY <br /> ~ NON-OWNED AUTOS (f'eraccident) . <br /> PROPERTY DAMAGE . <br /> {Peracc\tlen\) <br /> ~RAG' LIABILITY AUTO ONLY - EA ACCIDENT . <br /> ANY AU10 OTHER THAN EA ACC . <br /> AUTO ONLY. AGG . <br /> ~ESS1\JMBRELl..A lIABILITY EACH OCCURRENCE $1,000,000 <br />A X OCCUR 0 CLAIMS MADE H67X052504 06/05/04 06/05/05 AGGREGATE Sl,OOO,OOO <br /> I' PROVED} S TO FO, , <br /> ~ ~'DUCTIBLE , <br /> X RETENTION .10,000 \/A/ ! ! /~ . <br /> WORKERS COMPENSATION AND /' , - I To~iLI~lf's I IV ER- <br /> EMPLOVERS' LIABIUTI ---- Sti Sheedy <br /> [_aura <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE EL. EACH ACCIDENT . <br /> OFFICER/MEMBER EXCLUDED? ",>IS[(lnt 42i y Attorney E,L. DISEASE - EA E.MPlO'fE . <br /> If yes, describe under -> <br /> SPECIAL PROVISIONS below El. DISEASE. POLICY LIMIT . <br /> OTHER <br />B Crima Coverage 104350558 08/17/04 08/17/05 Ded: $10k $1,000,000 <br />C Errors & Omissions THOOOO0481 01/27/05 01/27/06 Occ./Acc. Slmil/$2mil <br />DESCRIPTION OF OPERATIONS I LOCATIONS 'VEHICLES I EOXCLUSIONS ADDED BY ENDORSEMENT' SPECIAL PROVISIONS <br />Additional Insured per Attached Endorsement as Respects to General Liability <br />Only <br /> <br />CERTIFICATE HOLDER <br /> <br />City of Santa Ana <br />20 Civic Center Plaza (M-41) <br />PO Box 1988 <br />Santa Ana CA 92702 <br /> <br />CANCELLATION <br />SANTA03 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELL.ED BEF'ORE THE EXPIRATION <br />DATE THEREOF', THE ISSUING INSURER W1LL~MAtL 30 DAVS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LeFT~ <br /> <br />ACORD 25 (2001/08) <br /> <br /> <br />c ACORD CORPORATION 1988 <br />