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<br />-:...-,
<br />ACORD",
<br />
<br />CERTIFICA.OF LIABILITY INSURA.E DATE;;.o";~;;)
<br />
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />
<br />PRODUCER
<br />Venbrook Insurance Services
<br />22801 Ventura Blvd, Third Floor
<br />Woodland Hills, CA 91364
<br />Phone 818-225-6200 Fax 818-225-8210
<br />
<br />INSURED
<br />
<br />Overland, Pacific & Cutler, Inc.
<br />100 West Broadway
<br />Suite 500
<br />Long Beach, CA 90802
<br />
<br />INSURERS AFFORDING COVERAGE
<br />INSURER A, Great American E & 5 Company
<br />INSURER B, The Hartford Insurance Company
<br />INSURER C: Everest National Insurance
<br />INSURER 0: Illinois Union Insurance Company
<br />INSURER E: RSUllndemni Com an
<br />
<br />NAIC#
<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 ANY 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~: -hJ~~; -- POLICY NUMBER P'p&Ll~Y EFFECTIVE POLICY EXPIRATION LIMITS
<br /> ~NERAL l.iABILlTY EJ\CH OCCURRENCE , 1,000,000
<br /> X COMMERCIAL GENERAL LIABILITY PL 5574310-01 6/24/2004 6/1/2005 I ~~~~is lEa occurence , 50,000
<br />A I CLAIMS MADE [K] OCCUR MEO EXP (Anyone person) , Excluded
<br /> - PERSONAL & ADV INJURY , 1,000,000
<br /> - GENERAL AGGREGATE , 2,000,000
<br /> ~'~ AGG~EnE ILlMIT APnS [PER: PRODUCTS. COMPIOP AGG , Excluded
<br /> POLICY ~~9.;. LOC
<br /> ~TOMOBILE LIABILITY COMBINED SINGLE LIMIT , 1,000,000
<br /> ANY AUTO 72 UECUM6536 6/24/2004 6/24/2005 (Eaaccident)
<br /> -
<br /> - ALL OWNED AUTOS BODILY INJURY
<br />B ,
<br /> SCHEDULED AUTOS (Per person)
<br /> X HIRED AUTOS
<br /> ex BODILY INJURY ,
<br /> NON-OWNED AUTOS (Per accident)
<br /> f--
<br /> f-- PROPERTY DAMAGE $
<br /> (Peraccidenl)
<br /> RRAGE LIABIUTY AUTO ONLY - EA ACCIDENT ,
<br /> ANY AUTO OTHER THAN EAACC ,
<br /> AUTO ONLY: AGG ,
<br /> t!JESSIUMBRELLA LIABILITY EACH OCCURRENCE , 1,000,000
<br /> X OCCUR D CLAIMS MADE NHA212256 i /91200 4 6/1/2005 , 1,000,000
<br /> AGGREGATE
<br />E
<br /> ,
<br /> R "e"e" ""LC $
<br /> RETENTION , $
<br /> WORKERS COMPENSATION AND 3900048305-041 6/1/2004 6/1/2005 X I.WCSTATU- I IOJbl-
<br /> EMPLOYERS' LIABILITY , 1,000,000
<br />C ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT
<br /> OFFICERlMEMBER EXCLUDED? YES E.L. DISEASE - EA EMPLOYEE $ 1,000,000
<br /> ~~~CI~~s~W>o~s1gNS below E.L. DISEASE - POLlCY LIMIT $ 1,000,000
<br /> gTHEr, BMI20010437 6/24/2004 6/1/2005 EPL: $1,000,000 - $15,000 Retention
<br />D mp oyment Practices Liab & E & 0: $2,000,000 - $50,000 Retention
<br />Errors & Omissions Prof Liab
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PR l)VI~D 1\;, '1'0 FORM
<br />-10 Days Notice of Cancellation for Non-Payment of Premium-
<br /> .7:{u..s{( ,'1: ^....I .' J)
<br /> Lat.;ra SCU :it",!}! ,
<br /> ASi:)J.sta.H Cily i\t~'{;r:,cy
<br /> . .
<br />
<br />CERTIFICATE HOLDER Additional Insured
<br />City of Santa Ana
<br />Public Works Department
<br />Attn: Taig Higgins
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92701-
<br />
<br />CANCELLATION
<br />
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
<br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAlL ~ DAYS WRITIEN
<br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
<br />IMPOSE NO OBLIGATION OR UABILlTY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
<br />REPRESENTATIVES.
<br />AUTHORIZED REPRESENTATIVE
<br />
<br />\.-1
<br />
<br />t---t 0--
<br />
<br />ACORD 25 (2001/08)
<br />
<br />e
<br />
<br />o e
<br />
<br />@ACORD CORPORATION 1988
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