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+ .19;20/2005 09:17.. FAX 8059820652 <br />q v 9 <br />LIABILITY INSURANCE <br />IZ002/002 <br />CERTIFICATE OF INSURANCE <br />Prvduvror issue Dau:: 0 912012 0 0 5 <br />Thin Cmtif;ars is iamed as a , tow of informadod only and <br />LIABILITY INSURANCE ADMINISTRATORS7: confers no rlghs upon lite Cerdlicam Holder. This Certificate <br />P.O. Box 13'19 does nor amend, extend or alter die coverage afforded by the <br />Sant Barbara, CA 93102-1319 policy below, <br />I <br />Insured: 115805 COMPANY AFFORDING COVERAGE <br />HENNESSEY & EBNNESSEY, LLC <br />17300 17di Street. Supe J-251 Liberty Insurance Underwriters, Inca <br />Tustin, CA 97780 h — 07 �C?5— I3 rl <br />Fax Number 714730.0221 <br />Autboriaed Representative <br />i i I <br />This is to cert* that the policy of inn+rmo a listed below has ban issued so the Insured named above for the policy period <br />indicated. Nutwithimading any requiremlit. term of condition of any comrset or outer documcm with respect to which this <br />Ccriificr•bs may be issued or may pertain, the insurance afforded by the policy described herein is subject to all d+e terms, <br />exclusions and conditions of such policy. Limits shown may have been reduced by paid elatmt. <br />TYPE UP INSURANCE POLICY NUMBER E.FFEMWE DATE EXMUTION DATE LIMITS <br />PI'ofmiond Liability LIUO00069-004 11/0112004 11103.2005 General AgLnaCate $ 1,000,009 <br />_ Each Claim S 1.000.000 <br />. Iljj r <br />�' Dc�cripiion�afQ� ratiotrslLoca nslSpeciaihems: <br />> [+At BS7'A�E' RAISERS �ROFES9IONAL LIABILITY INSURANCE EVIDENCE OF INSURANCE <br />i <br />�I <br />Canificate Holder: Cancellation: <br />� City of Santa Ana - Public Works Agency Should the above described poky be eaneelled before the <br />Attn: Kent Jorgensen expiration slate thereof, the ismang Company will endeavor to <br />20 Civic Center Plane, M36 - PO Box 1988 men 30 days notice, except 10 days notice for nonpayment of <br />Santa Ana. CA 92702 premium, to the octiificafe holder named to the hdL however, <br />APPROVED AS FO FO'ZM ri&Ure to mail sucb notice Shea impose no obligation or liability <br />or any kind ppen the Company, its agents or repretcn" <br />St.[, <br />fis,istant Cay AtLOf'ICj' <br />1 LIA0001 (11197) Cartlticate Horner Copy <br />