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<br />ACORD". <br /> <br />CERTIFICATE OF LIABILITY INSURANCE <br /> <br />I DATE (MMllJlJfYY) <br />2/2106 <br /> <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY <br />AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE <br />AFFORDED BY THE POliCIES BELOW. <br /> <br />PRODUCER <br />PARKER, SMITH & FEEK, INC. <br />22331121h Avenue N.E. <br />Bellevue. Washington 98004 <br /> <br />Phone: 425-709-3600 <br /> <br />Fax: 425-709-7460 INSURERS AFFORDING COVERAGE <br />INSURER Ie PACIFIC INDEMNITY INSURANCE COMPANY A++XV <br /> <br />INSUReo <br /> <br />MILLIMAN, INC. <br />1301 5th Avenue, Suite 3800 <br />Seattle, WashIngton 98101-2506 <br /> <br />INSUAER 8 <br />INSURER c: <br />INSURER 0: <br />INSURER E: <br /> <br />COVERAGES <br /> <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FORTHE POUCY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER OOCUMENTWITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY <br />PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDJTJONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR TYPE OF INSURANCE pOLICY NUMBER POLl~~~FFECn~le POl]~ f~PIRAnaN LIMITS <br />LTR DATE MMfODNY DATE MMlDOIYY} <br /> GENERAL LIABILITY EACH OCCURRENCE S <br /> ..::.= COMMERCiAl GENERAL lIABILllY FIRE DAMAGE (Any 0fI9 lira) S <br /> I CLAtMS MADE D OCCUR MEO EXP (Anyone pel5oo) S <br /> PERSONAL&ADV INJURY S <br /> GENERAL AGGREGATE S <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG S <br /> I' n.PRO- n <br /> POLICY JEeT LOC <br /> .M[OMOBILE LIABIUTY COMBINED SINGLE LIMIT S <br /> - ANY AUTO (Eaeccldenl) <br /> - ALL OWNED AUTOS BODILY INJURY <br /> (Per person) S <br /> - SCHEDULED AUTOS <br /> f- HIRED AUTOS BODILY INJURY S <br /> NON-OWNED AUTOS IPeraccldenll <br /> f-- <br /> PROPERTY DMtAGE S <br /> (PeralXident) <br /> RRGELlABIUTY AUTO ONLY - EA ACCIDENT S <br /> ANY AUTO OTHER THAN EAACG . <br /> AUTOONLV: AGG S <br /> EXCESS LIABILITY EACH OCCURRENCE $ <br /> b OCCUR D CLAIMS MADE AGGREGATE . <br /> S <br /> R ~EDUCTIBLe $ <br /> RETENTION S S <br /> WORKERS COMPENSATION AND I,WGSTATU-,I 10TH- <br /> EMPLOYERS' UABIUTY X TORY LIMITS ER <br />A 71719457 6/3012005 613012006 E.L EACH ACCIDENT S 1.000,000 <br /> E.L DISEASE - EACH EMPLOYee S 1.000,000 <br /> E.L DISEASE- POLICY LIMIT S 1,000,000 <br /> OTHER S <br /> S <br /> S <br />DESCRIPTION OF OPERATIONSlLOCATIONSlVEHIClESlEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br />Contract No. N~20D6.DO.q. <br /> ,~ '() "Zi'vl <br /> ~(-"- (CJ/ -.--------,.-,-.--.. <br /> .. .- :. <br />CERTIFICATE HOLDER I I ADD/TIONALlNSURmtIN$mERJ.entk:, ,\. i:,' CANCELLATION .10 days fDr nDflwpayment of premium <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br /> BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL <br /> CITY OF SANTA ANA ENDEAVOR TO MAIL~ DAYS WRfITEN NOTICE TO THE CERTIFICATE <br /> HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO <br /> 20 Civic Center Plaza, M-24 OBU~~;ION OR LIABILITY OF ANY KIND U~NTHE INSURER,ITS AGENTS <br /> Santa Ana, CA 92701 <6iillE RESENTATIVES. <br /> AUT~OR1Z"\R""R.SENTATlVE ~ ~ iJ <br /> ( T 7"~d-r1), c;; .,'/ , JI ~ n 'A <br /> <br />ACORD 25-S (7/97) <br />MILLlMAN\CERT05(MD9) <br /> <br />@ACORDCORPORATION1966 <br />CERT #30B <br />