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<br />, Mar ,06 06 OS: 52a Tllagl <br />03/03/20D6 FRI 11:19 FAX 714 46' 8731 Professional ChC?ice <br /> <br />p.2 <br /> <br />rdJ002/00 2 <br /> <br />ACORD~ <br /> <br />CERTIFICATE OF LIABILITY INSURANCE <br /> <br />I DATE.{MMIDDNYYY) <br /> <br />01/25/2006 <br /> <br />THIS CERTIFICATE IS ISSUED AS A MATTER Of INFORMATION <br />OHL Y AND CONFERS NO RIGHTS UPON THE Ce:RTIFrCA TE <br />HOlDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, <br /> <br />'.OOUCE. (714) 467-8726 <br />Professional Ch02ce Insurance SV$ <br />500 N State College Blvd, M550 <br /> <br />OranCl"@ <br />INSURED <br />Tol~rico's Electric <br />12321 Moana Way <br /> <br />CA 9:2B6B-1613 <br />N-(}.,ooif-080 <br />N - d.oi:J'I -OJ'O -0/ <br /> <br />INSURERS AFFORDING COVERAGE <br />INSURER A: L;~co~Q~en~_;:a}.__!n.~_.__~o. <br />INSURER B: <br /> <br />NAIC;' <br /> <br />lNSUReRC <br /> <br />Garden Grove <br />COVERAGES <br /> <br />CA 92840- <br /> <br />~g~n:,. <br />I'~'D'R' <br /> <br />THE PQlJCtES OF INSURANCE USTEO BElOW HAVE 6EEN ISSUED TOlHE INSURED NAMED ABQVE FOR THE POliCY PERIOO INDICATED. NOTWlTHSTANDING ANY <br />REQllIREMEN", TERM OR CONDITION" OF ^~ CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, <br />THE INSURANCE A.FFORDED BY THE POlICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXClUSlOOS AND CONDITIONS OF SUCH POLICIES <br />AGGRI:GAT I: LIMITS SHOWN MAY HAVE BEEN REDUCED BV PAID CLAIMS <br />l!'l~~ I~~: TYPE Of INSURANCE PQUtY NUMBER P8A~,:'~8~1! "&'i~(~~ lIMITS <br /> ~NERAl UAelllTY 0200'19976 01 01/15/2006 01/15/2001 EACH OCCURRIONCE . 1,000,000 <br /> '-"- D~ERClAl GENERAL LlABtlITY ~~~~~?e~~~~nce\ , 100,000 <br />A X - ClAIMS MADE [!] OCCUR 1 f f f Ml"DEXfl'tAnvonepernoo) , 5,000 <br /> - PERSO~'''' . ~...." INJURY I l,OOO.OQ() <br /> - 1 1 1 1 GFNERAl A6GREG~TE , 2,000,000 <br /> ~'lAG~EnLIMll n~PEr~: PRODUcrs-~-';:';;oP""'''' $ 2,000,000 <br /> X POLlCY m?-i loe 1 1 1 1 <br /> ~rONoBILE llABILllY 1 1 1 1 COMBINED SINGlE llMlT <br /> I <br /> - Nf'fAUTO (EaaCClderll) <br /> - All OWNED AUTOS 1 1 1 1 BOna Y If>LJIJRY <br /> (petplitSQl1) , <br /> - SGHEWlEDAUTOS <br /> - ~IREO AUTOS 1 1 1 1 eODllY INJU~Y <br /> (r'eraoxident) , <br /> - NON-OWNEO AUTOS -'-~ -- <br /> 1 f 1 f PROPER7YOM.......Gt: <br /> (Per ~c~H1el'll) , <br /> R~GE lIMlUTY _~~Tt::'ONLY -~ACCIDENT I <br /> ...."lVAUTO f 1 1 f OTJ.lERTUAN -.!.~A(:C I ,~~ <br /> AUTO ONlY: AOG I <br /> D~SJU"BRl!lLA lIABILITY f f 1 1 EA,CH OCCtJRRENCE . <br /> OCCUR 0 CLAltIIS MAOr AGGREGATE , <br /> , <br /> R ~UCTIBLE 1 f f f . --- <br /> RETENTION $ I <br /> WQRKERS COMPENSA nON AND I' fO, iV11 1 IT'(\~~lil.lNsl JOJ;!' .- <br /> EMPLOY2RS' UABlUTY ;f;fJv eEl <br /> ANY PROPRIETORlPARTNERlEXECUTlVE di~__ FL EACH ACCIDENT , <br /> OFFICER/MEMBER EXCWDCO? 1 1 E.L DISEASE. EA EMPLOYEE S <br /> Uyes.des.r.rihAundl'l' -.-- <br /> SPEClALPROVISIONSbeltlW E.1. llISE...sE. POUCY LIMIT 5 <br /> OTHER (/ ,7 'I 1 1 <br /> , 1 /' 1 1 <br /> 1 1 1 1 <br />DESCRIPTION OF O~RAT1ONSlLOCAnoNSM;HICl~XClUSlDNSAO[)I:O 8Y ENOORSEMENTlSPeClAl PROVlSIDNS <br />Certif~cat9 Ho~de~, 1t~ orricers, Ulployeas, ag&nc~ and rs~e~.ntaL~v.. ~e named ~$ Addi~iQn~~ In.ou:sdfi'. <br />RE: All oparations as covered by this policy. uCOVERAGE IS PRIMARY AND NON-CONTRIBU'rORYu <br />R)~: Molintanancwhvpair 41. ~Oi)O I. Santa AncI. Bl.vd. 11.08 <br />10 day notice cancellation for non paymont o~ prlQllliUJ.ll. <br /> <br />CERllACATE HOLDER <br />(714) 565-2690 TQl <br /> <br />(714) 565-2693 Fax <br /> <br />CANCELLATION <br />SHOULD ANY Of THE ABOVE DESCRIBED POUCIES 1If; CANCElLED BEFORE IHt <br />EXPIRATION DATI!: THEREOF, TtI!' ISSUING INSURI!!R WILL .........-,,^.. TO MAIL <br />10 D"YS WRlTTl"H NOlJC.. TO THE CERTIFICATE HOLM'R NAIlED TO THE LEI'T. IMI:I' <br /> <br />ELECTRONIC LASER FORMS, INC.. (1100)327.0545 <br /> <br /> <br />WJ.- <br /> <br />City of Santa Ana <br />1000 E. S~nt4 Ana Blvd. <br />Santa Ana CA <br />ACORD 25 (20U1/06) <br />ftn.-INS02S\010&).OS <br /> <br />il08 <br />92701 <br /> <br />ACORD CORPORATION 1188 <br />Pagelofl <br /> <br />c y- <br />