|
<br />~I'- CERTIFICA. OF LIABILITY INSURAae I
<br />ACORD,. DATE (.....1>IYVVYl
<br />7/20/2004
<br />PR.ODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br />Venbrook Inauranee services ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />22801 Ventura BlvdJ Third Floor HOLDER. THIS CERTIFICATE OOES NOT AMEND, EXTEND OR
<br />WOodland Hills, CA 91364 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />Phona 818.225-8200 Fax 818-225-8210
<br /> INSURERS AFFORDING COVERAGE NAIC.
<br />INSURED Overland, Paclllc & Cutler, Inc. INSURE" A, Great American E & S Company
<br /> 100 West Broadway INSURER B, The Hartford Insurance Companv
<br /> Sulle 500 INSURERC, Everest Nstlon811nsurance
<br /> Long Beach, CA 00802 INSURER 0, illinois Union Insurance ComDany
<br /> 1 INSURER Eo RSUllndemnlty Company
<br />
<br />COVERAGES
<br />
<br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
<br />ANY REQUIREMENT, TERM OR CONDITION OF AN'( CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
<br />MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRiBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
<br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />II~:: = ""_ , POLICY NUMBER POLICY ~"'fEcnVI! POLICY EXPIRATlOH UIIITS
<br /> ~erw.. LLABIUTY ~~ ' 1,000,000
<br /> X COMMERCIAL GENERAL LIABILITY PL 5574310-01 6/24/2004 6/1/2005 . 50,000
<br />A I CLAIMS MADE. []] OCCUR PolED EXP IAr,,, one....-.on) . Excluded
<br /> PEf\SONltL & ADV INJURY . 1,UOO,000
<br /> OENER.'J.AGGREGATE S 2,000,000
<br /> ~~AGGREn ~ILtIT APn PER; PRODUCTS. COMP/OP Aoo . Excluded
<br /> POLICY ~ lOC
<br /> .!!:!JOMOIIlL!. UABLJTY COMBINED SINGLE LIMIT . 1,000,000
<br /> _ Aurn 72 UECUM6536 6/24/2004 6/24/2005 (EllIC:~dtnl)
<br /> -
<br /> - All OWt-ED AUTOS BOOIL Y INJURY
<br />8 S
<br /> SCHEDUlED "urns (Per penon)
<br /> X HIRED AUTOS
<br /> it BODILY INJURY $
<br /> - NON-ov';'NED AlJTOS (P.raccidef1l:)
<br /> - PROPERTY DAtwV3E $
<br /> (Per accllHnt)
<br /> =fGlUAIIlUTY AlJTO ONLY. EA ACCIDENT $
<br /> ANY AUTO OTHER THAN SA ACe $
<br /> AUTO ONLY: AOO $
<br /> 9:CESSAl...RnLA UAIILJTY EACH OCCURRENCE $ 1,000,000
<br /> :!f OCCUR 0 CLAIMS MADE NHA212258 7/9/2004 6/1/2005 AGGREGATE $ 1,000,000
<br />E
<br /> =1 =~,':: I
<br /> I
<br /> $ $
<br /> WOItK9.S COIIPEHSATlOH AND 3900048305-041 6/1/2004 6/1/2005 X I we STATU-, I 'OJ);<-
<br /> EIIPLOYERS' UABlUTY $ 1,000,000
<br />C ANY PROPRlETORIPARTNERlEXfCUTIVE E.L. EACH ACCIDENT
<br /> OIFICE:RlMEMSER EXCLUDED? YES E.L. DISEASE. EA EUPLOVEf:: $ 1,000,000
<br /> ~~I~~vlS1bNS below E.L. DISEASE . POLICY UNliT $ 1,000,000
<br /> g::::,roym.nt PracU",s Llab " BMI20010437 6/24/2004 6/1/2005 EPL: $1,000,000 - $15,000 Relentlon
<br />0 EI'J'Of'1I & Omlealonl Prof Llab E & 0: $2,000,000 - $50,000 RetenllDn
<br />De:5CRIPT1ON Of' OPI!RA.TIOHS/l.OCAllONS IVEHlCLES IEXCLUIIONI ADD!D BY 9DQRSIIUn:NT /8PECIAL PIt 'y I.1tIJ AS TO FOR.M
<br />"10 Days Notice of CancallatJon for Non-Payment of Premium" )/{~o..Q.[
<br /> .J '" ,J}.
<br /> v Laura 51,!t S~~e
<br /> Assistant City A r::1ey
<br />ERTlFICA TE H Additional Insured
<br />
<br />c
<br />
<br />OLDER
<br />
<br />City of Santa Ana
<br />Public Work. Department
<br />Attn: 1alg Hloglns
<br />20 Civic Cenler Plaza
<br />Santa Ana, CA 02701-
<br />
<br />CANCELLATION
<br />SHOULD MY OP THI. AllOW: OeSCRlBED POLICIES 8~ CANCEllED !!U'QRI! 1HI! EXPlllATlCNI
<br />DAn THEIlEOF, THE IS8U"'Q "SURM WILL ENDEAVOIt TO MAlL~ DAYS WRJTTUI
<br />NOTICI!!: TO THI!! CeRTIFICATE HOLDER. NAIIeo TO THE LUT, IIl,JT PALURe TO DO sa lHALL
<br />llIPOBI! NO OBUGAllON OR llAlllLITY OF ANY KIIlID UPON THE INSURER, rrs ....GeNTS OR
<br />MPIU!:SI!NTATI"~S,
<br />AUTHOItIm.D RI!!PRI!Sl!NTAilVE
<br />
<br />ACORD 25 (2001/06)
<br />
<br />
<br />1-4.
<br />
<br />
<br />~ACORD CORPORATION 198.
<br />
<br />o
<br />
|