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To: City of Santa Ana From: Bobbie Detki 12-21-05 11:15am p. 2 of 3 <br />1 . I <br />�4 <br />P rodu Bobbie Detki <br />IHIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. <br />Wood Gutmann & Bogart Insurance Brokers <br />THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE <br />COVERAGE <br />15901 Red Hill Ave, Suite 100 <br />AFFORDED By THE POLICIES BELOW, <br />INSUIRIERS AFFORDING UC)VFRAQF <br />Tustin CA 92780 <br />714 505.7000 <br />www.wgbib.com <br />INSURER Indian Harbor Ins. Company <br />License No. 0679263 <br />A <br />INSURER <br />B <br />Insured <br />Fieldman, Rolapp, & Associates <br />INSURER <br />C <br />19900 MacArthur Blvd, #1100 <br />Irvine CA 92612 <br />INSURER <br />D <br />.... .... . . T ..... <br />11 <br />'gxqQ, '411 .. <br />T "" <br />POLICIES O INSURANCE LISTED BELOW HAVE BEEN ISSUE <br />ABOVETHE <br />TO THE INSURED NAMED FOR THE POLICY PERIOD INDICATED. <br />NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF <br />ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAV PERTAIN, THE INSURANCE <br />AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE <br />TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE <br />LIMITS SHOWN MAY AVE BEEN REDUCED BY PAID CLAIMS. <br />POLICY <br />POLICY <br />NSR <br />EFFECTIVE <br />EXPIRATION <br />LTR <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />LIMITS <br />MM/DO%VY <br />MNVDD/YY <br />GENERAL LIABILITY <br />EACH OCCURRENCE S <br />COMMERCIAL GENERAL LIAB <br />CLAIMS <br />CLMS <br />FIRE DAMAGE (Ay lore ) <br />MED EXP (AW .. Rer.n) <br />MADE <br />PERSONAL & ADV INJURY <br />GENERAL AGGREGATE <br />GEN, AGG UMIT APPLIES PER <br />PRODUCTS-COMP/OP AGG $ <br />POLICY PROJECTLDC <br />$ <br />AUTOMOBILE <br />LIABILITY <br />MY AUTO <br />COMBINED SINGLE UMIT <br />ALL OWNED AUTOSBODI <br />LY INJURY <br />SCHEDULED AUTOS <br />(Per Person) $ <br />HIRED AUTOS <br />BODILY INJURY <br />NON -OWNED AUTOS <br />(Per amid <br />PROPERTY DAMAGE <br />GARAGE LIABILITY <br />AUTO DAILY - EA ACCIDENT <br />RMY AUTO <br />OTHER THAN EA ACC $ <br />AUTO ONLY: AGG $ <br />LEXCESS LIABILITY <br />n <br />EACH OCCURRENCE $ <br />AGGREGATE <br />OCCUR CI -AIMS MADE <br />DEDUCTIBLE <br />�RIETMTION <br />$ <br />$ <br />$ <br />STATUTORY LIMIT T —H -�,,77� <br />E� $ <br />WORKERS' COMPENSATION & <br />EMPLOYERS' LIABILITY <br />EL EACH ACCIDENT <br />EL DISEASE EA EMPLOYEE $ <br />EL DISEASE - POLICY UMIT <br />tA <br />Errors & Omissions <br />ELU09090105 <br />12/20/2005 <br />12/20/2006 <br />Limit $1 000 000 <br />Ded. $1b0,060 <br />DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS <br />F I <br />II Si -ti fes 11 `%VbI vrtJ�SO ­Nslul . . ...... .... 7; <br />IN .J'".: ma, ME <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />City of Santa Ana EXPIRA ION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR To MAIL <br />j <br />Attn. Clerk of the Court 30 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) SENTATIVES. 10 Days for Non -Payment of Premium <br />Santa Ana CA 92702-1988 AUTHORIZED <br />REPRESENTATIVE n CG <br />.Dan Gorman <br />