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<br />ACDB.D.~ CERTIFICATE OF LIABILITY INSURANCE I DATE (MMlDDlYY) <br />9/1312005 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> JOHN SARGEANT INSURANCE AGENCY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> P. O. BOX 831 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> GLENDALE CA 91209 <br /> (8111)~4~-114~___ INSURERS AFFORDING COVERAGE <br /> ----- - ----------- -- ----------. - <br />INSURED INSURER A: HAI'ITFORD CASlJALTY INSURANCE CQMPANY_ <br />BARTEL-ASSOCIATES, L.L.C. INSURER B: INDIAN HARBOR INSURANCE COMPANY <br /> ~~~.~~ c: HARTFORD UNDERWRITERS INSURANCE -- <br />411 BOREL AVENUE, SUITE #445 --------- ----- <br /> INSURER 0: ---- ------- - <br />SAN MATEO _....__n ----- <br /> CA 94402 INSURER E: <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 CONDITlON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH nilS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POliCIES DESCRIBED HEREIN IS SUBJECT TO ALL niE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POliCIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR' ----..--, -.- <br />fA ! TYPE OF INSURANCE POLICY NUMBER ~k+~Y E:6C11VE : P8i,lfY EXPIRATION <br /> <br />: GENERAL UABIUTY <br />1---] <br />I ~__I;__~MMERCIAL GENEf!~~LtABllITY <br /> <br />; I 1 CLAIMS MADE I__~_ OCCUR <br /> <br />UMITS <br /> <br />A <br /> <br />72SBA AD2098 <br /> <br />9/112005 <br /> <br />9/1/2006 <br /> <br />EACH OCCURRENCE $ <br />f'"!~_E DAMAGE (Any o:e fire) $ <br />MED ~X~ (A~y one person) _ $ <br />PERSONAL & ADV INJURY $ <br />----- <br />GENERAL AGGREGATE $ <br />PROOUCTS - COMPIOP AGG I $ <br />-------. ------ <br /> <br />.2,000,000 <br />300,000 <br />10,000 <br />_~OOO,OOO <br />4,000,()(I0 <br />. _-!,OOO,OOO <br /> <br />: GEN'L AGGREGATE LIMIT APPLIES PER: <br />'X POLICY -1 P~OT LOG <br />AUTOMOBILE UABIUTY <br />ANY AUTO <br />All OWNED AUTOS <br /> <br />I COMBINED SINGLE LIMIT <br />(Ea accident) <br />~-- <br /> <br />$ <br /> <br />2,000,000 <br /> <br />A X <br />X <br /> <br />SCHEDULED AUTOS <br />HIRED AUTOS <br />NON-QWNED AUTOS <br /> <br />72SBA AD2098 <br /> <br />9/112005 <br /> <br />9/112006 <br /> <br />BODilY INJURY <br />(Per person) <br /> <br />$ <br /> <br />BODILY INJURY <br />(Per accident) <br /> <br />$ <br /> <br />PROPERTY DAMAGE <br />(Per accident) <br /> <br />'$ <br /> <br />GARAGE LIABIUTY <br />ANY AUTO <br /> <br />~'FR()VED AS TO F <br /> <br /> <br />AUTO ONLY - EA ACCIDENT i $ <br />---~- <br />EA ACe $ <br />/>I3G $ <br />$ <br /> <br />OTHER THAN <br />AUTO ONLY: <br /> <br />EXCESS LIABILITY <br />i OCCUR I CLAIMS MADE <br /> <br />?-- <br /> <br />EACH OCCURRENCE <br /> <br />I DEDUCTIBLE <br />RETENTION $ <br />I WORKERS COMPENSATION AND <br />, EMPLOYERS' LIABILITY <br /> <br />Iaura ,ti Sh., ,Jy <br />AS:.1SLurH Cit~ At[~){li~Y <br />I <br />! <br /> <br />AGGREGATE <br /> <br />,$ <br />- 1$-- <br />___----L_ ______ <br />$ <br />$ <br /> <br />C <br /> <br />72WBC NS7441 <br /> <br />11/1712004 <br /> <br />11/1712005 <br /> <br />_~_~.BY_L,[MITS L__~~~__ <br />E.~.~ACH ~~_I~~NT___--f--!-___ <br />E.l. DISEASE. EA EMPLOYE $ <br /> <br />OTHER <br />B MISC. PROFESSIONAL <br />LIABILITY <br /> <br />MPP001715201 <br /> <br />9/1112005 <br /> <br />9/1112006 <br /> <br />E.l. DISEASE. POLICY liMIT $ <br />$1,000,OOO/CLAlM <br />$1,OOO,OOO/ANN.AGC <br /> <br />n 1,OllO,O()() <br />1,000,000 <br />1,000,000 <br /> <br />DESCRIPTION OF OPERATlONS/LOCAnONSlVEHICLESlEXCLUSIONS ADOED BY ENOORSEMENTISPECIAL PROVISIONS <br /> <br />See Supplemental Information Page(s) <br /> <br />CERTIFICATE HOLDER ADDITIONAL INSURED; INSURER LETTER: <br />4 <br /> <br />CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAlL ~ DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO so SHALL <br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY laND UPON THE INSURER, ITS AGENTS OR <br /> <br />CITY OF SANTA ANA <br />ATTN: ROBERT CORTEZ <br /> <br />P. O. BOX 1988 <br />SANTA ANA <br /> <br />ACORD 25-S (7/97) <br />lM: lPWv1.9.8on 9/16105 -16:25 by UserName <br /> <br />CA 92702 <br /> <br /> <br />@ ACORD CORPORATION 1988 <br />PFv1.0.1 <br /> <br />LP: lPW v1.9.8 on 9/16105.16:25 by UserName <br />