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To: City of Santa Ana From: Blanca Roque 10-04-05 10:25am p. 2 of 3 <br />�iARIL r <br />IT- NSU <br />ru-. <br />Otte tl "I <br />10/4/2005 <br />Protlucer Blanca Roque THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, <br />THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE <br />Wood Gutmann & Bogart Insurance Brokers COVERAGE AFFORDED BY THE POLICIES BELOW. <br />15901 Red Hill Ave., Suite 100 INSURERS AFFORDING COVERAGE <br />Tustin CA 92780 <br />714 505.7000 INSURER Indian Harbor Ins. Company <br />www.wgbib.com A <br />License No. 0679263 <br />INSURER <br />Insured B <br />Fieldman, Rolapp & Associates INSURER <br />C <br />19900 MacArthur Blvd, #1100 INSURER <br />Irvine CA 92612 D <br />i vrlP. �. o, ,faro iwrv: r, .! nv,d .� ar I.,I..... <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR I HE POLICY PERIOD INDICATED. <br />NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE <br />TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />POLICY <br />POLICY <br />NSR <br />LTR <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />EFFECTIVE <br />MM/DD/DDYV <br />EXPIRATION <br />M DATEYV <br />LIMITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE $ <br />FIRE DAMAGE An 1 Pre $ <br />COMMERCIAL GENERAL LIAB <br />MED EXP A one rson $ <br />CLAIMS MADE OCCUR <br />PERSONAL a ADV INJURY $ <br />GENERAL AGGREGATE $ <br />GEN'L AGG LIMIT APPLIES PER <br />PRODUCTS-COMP/OP AGG $ <br />$ <br />POLICY 7PROJECT 7LOC <br />AUTOMOBILE LIABILITY <br />AUTO <br />$ <br />COMBINED SINGLE LIMITANY <br />BODILY INJURY <br />(Per person) $ <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />BODILY INJURY <br />(Per ercldem) $ <br />HIRED AUTOS <br />NON -OWNED AUTOS <br />PROPERTY DAMAGE <br />(Per accident) $ <br />GARAGE LIABILITY, <br />AUTO ONLY - EA ACCIDENT $ <br />OLDERT AN EAAUTO AGG$ <br />ANY AUTO <br />tC,. <br />EXCESS LIABILITY <br />EACH OCCURRENCE $ <br />AGGREGATE $ <br />OCCUR ❑ CLAIMS MADE <br />$ <br />$ <br />DEWCTIBLE <br />$ <br />RETENTION $ <br />WORKERS' COMPENSATION & <br />ISTATUTORY LIMIT THERI �r i1 ! <br />EL EACH ACCIDENT $ <br />EMPLOYERS' LIABILITY <br />ELDISEASE- EAEMPLOVEE $ <br />EL DISEASE - PCUCY UMIT $ <br />Errors & Omissions <br />ELU08776504 <br />12/10/2004 <br />12/10/2005 <br />Limit: $1,000,000 <br />Ded. $100,000 <br />DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br />„�, t YT�AL ect a Yh Lr rr rr r , w r, rr Pryd'�.WI�1' <br />Y. f'. tl,�r:r \� i?Yv inv a r �11e llsN¢ <\ X11 . �.I 1.11ro\ <br />rti_ t n. <br />\ ,LRS': .VYL lx�.S..A� <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />City of Santa Ana <br />Attn: Clerk Of the Court <br />EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL <br />. DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE <br />LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION <br />OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRE- <br />20 Civic Center Plaza (M-30) <br />Santa Ana CA 92702-1988 <br />SENTATIVES. 10 Days for Non -Payment of Premium <br />AUTHORIZED <br />REPRESENTATIVE <br />Dan Gorman <br />^� <br />A'° r7'0101011 , a <br />\ \ <br />rr�ryydy r r t +. A�Py <br />kMM4 �i I1r kM1�1!. <br />