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<br />ACORD_ CERTIFICA TE OF LIABILITY INSURANCE OP 10 VII DATE (MM/DOIYYYY) <br />MASKS-1 12/D9L05 <br />PRODUCER (.} - .,;;t:O O--CO;> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Andreini & Company-Oxnard fl--c9cC> (Vco.3- ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />License 0208825 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />300 Esplanade, Suite 100 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Oxnard CA 93030 <br />Phone: 805-981-9585 Fax:805-981-0161 INSURERS AFFORDING COVERAGE NAIC# <br />~SURED - INSURER A: Federal Insurance Company <br /> Mask Systems, Inc. INSURER B" <br /> Dorado Products, Inc. ~- <br /> Rosa Sasa INSURER C -- <br /> 11959 Discove~ Ct. INSURER 0" <br /> Moorpark CA 93 21 -- <br /> 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. NOTV\llTHSTANDrNG <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WitCH 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 /> P L E ~r;. PDkTEY(MMib~Jl..'j'1't LIMITS <br />LTR NSR TYPE OF INSURANCE POLICY NUMBER .D~MMIDDIYY <br /> GENERAL LIABILITY EACH OCCURRENCE .1,000,000 <br />A X TI COMMERCIAL GENERAL LIABILITY 3533-99-03 12/18/05 12/18/06 PREMISES (Ea occurence) .1,000,000 <br /> FP CLAIMS MADE ~ OCCUR MED EXP (Anyone person) '10,000 <br /> PERSONAL & ADV INJURY .1,000,000 <br /> ~..== GENERAL AGGREGATE .2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG .2,000,000 <br /> "I 'llPRO. n Emp1 Benf 1,000,000 <br /> POLICY JECT LOC <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT .1,000,000 <br />A X ANY AUTO 7322-50-49 12/18/05 12/18/06 (Eaaccidenl) <br /> r- -- <br /> ALL O\tVNED AUTOS BODILY INJURY <br /> r- (Per person) . <br /> SCHEDULED AUTOS <br />A ex HIRED AUTOS BODILY INJURY <br /> ex . <br />A NON-OWNED AUTOS (Peraccidenl) <br /> r- <br /> ,- --- PROPERTY DAMAGE . <br /> (Per accident) <br /> GARAGE LIABILITY AUTO ONLY - EAACCIDENT . <br /> ~ ANY AUTO OTHER THAN EAACC . <br /> AUTO ONLY AGG . <br /> EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE . 5,000,000 <br />A ~ OCCUR D CLAIMS MADE 7972-98-79 12/18/05 12/18/06 AGGREGATE .5,000,000 <br /> . <br /> ij;EOUCTIBLE . <br /> X RETENTION .0 . <br /> WORKERS COMPENSATION AND '$~ ITORY"lIMiiU IVER <br /> EMPLOYERS' LIABILITY ~~L3 <br /> I ANY PROP",ETGRlPARTi~[R:EXECUTIVE E.L. EACH ACCIDENT . <br /> ' OFFICER/MEMBER EXCLUDED? E L DISEASE _ EA EMPLOYEE $ <br /> If yes, describe under EL DISEASE - POLICY LIMIT <br /> SPECIAL PROVISIONS below . <br /> OTHER / { <br /> I <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br />Certificate holder is additional insured under the general liabili ty per <br />endorsement #80-02-2305 to be issued by the company <br /> <br />CERTIFICATE HOLDER <br /> <br />CANCELLATION <br /> <br />City of Santa Ana <br />60 Civic Center Plaza <br />Santa Ana CA 92703 <br /> <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ 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 KIND UPON THE INSURER, ITS AGENTS OR <br />REPRESENTATIVES. <br />AUT 0 ZED RE"~ATlVE <br />'..(,t.V.AQ.,~ <br /> <br />ACORD 25 (2001/08) <br /> <br />f. <br /> <br />o <br /> <br />@ACORDCORPORATION1988 <br />