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<br />~coib' 1..CERT'f"leA'fEiOELI.JA.~1L.r(",Y.INslJRA~E5." ! Date (mmfddfyy) <br /> .. ... . 12/12/2005 <br />Producer Gina Gradillas THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. <br />Wood Gutmann & Bo~art Insurance Brokers THIS CERTIFICATE DOES NOT AMEND. EXTEND OR ALTER THE <br /> COVERAGE AFFORDED BY THE POLICIES BELOW, <br />15901 Red Hill Ave., uite 100 J1~ERS A~F <br />Tustin CA 92780 <br />714505.7000 INSURER Hartford Insurance Company <br />www.wgbib.com A of the Midwest <br />License No. 0679263 <br /> INSURER <br />Insured B <br />Tom Malloy Corporation II -;;00&- oor! INSURER <br />DBA: Trench Shoring Company C <br />636 Rosecrans INSURER <br />Los Angeles CA 90059 D <br />COVERAGES -cc 'i.;. / . . <br />'..;" ..... ....../.. .. '. <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. <br />NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE <br />TERMS EXCLUSIONS AND CONDITIOriS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> POLICY POLICY <br />INSR EFFECTIVE EXPIRATION <br />TYPE OF INSURANCE POLICY NUMBER DATE DATE LIMITS <br />LTR M <br /> GENERAL LIABILITY EACH OCCURRENCE $ <br /> ::J~MERCIAL GENERAL LIAS FIRE DAMAGE An'" 1 fire} $ <br /> CLAIMS MADE OOCCUR MED EXP (Anv one oerson) $ <br /> PERSONAL & ADV INJURY $ <br /> GENERAL AGGREGATE $ <br /> GEN'L AGG LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ <br /> I POLICY nPROJECTnLOC $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> ANY AUTO . <br /> ALL OWNED AUTOS BODILY INJURY <br /> SCHE.DULED AUTOS I?~)'" (Perpersonl $ <br /> HIRED AUlDS '; ~---ejC /; BODILY INJURY <br /> f- NON-OWNED AUTOS (Per accident) $ <br /> PROPERTY DAMAGE <br /> (Peraccidentl $ <br /> R~RAGE LIABILITY AUTO ONLY - EA ACCIDENl . <br /> ANY AUTO OTHER THAN EAACC $ <br /> AUTO ONLY' AGG $ <br /> EXCESS L1ABIUTY EACH OCCURRENCE $ <br /> P~CCUR 0 CLAIMS MADE AGGREGATE $ <br /> $ <br /> H~EDUCTIBLE $ <br /> RETENTION $ $ <br /> WORKERS' COMPENSATION & STATUTORY LIMIT' I h-rHER 6 <br /> EMPLOYERS' LIABILITY EL EACH ACCIDENT $ <br />, 72WEOA8670 12/9/2005 12/9/2006 EL DISEASE - EA EMPLOYEE $ <br /> EL DISEASE - POLICY LIMIT $ <br />DESCRIPTION OF OPERATIONS/LOCATIONSNEHIClES/EXClUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br />This certificate is evidence of Workers Compensation renewal coverage only. <br />CERTIFICATE HOLDER '>' .. CAI\lCEl..LATION../J< ...... .' '.' <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEllED BEFORE THE <br /> City of Santa Ana EXPIRATION DATE THEREOF, THE ISSUING COMPANY Will ENDEAVOR TO MAil <br /> ~DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE <br /> LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHAll IMPOSE NO OBLlGA lION <br /> OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRE. <br /> 20 Civic Center Plaza SENTATIVES. * 10 Davs for Non-Pa"ment of Premium <br /> Santa Ana CA 92701 AUTHORIZED <br /> REPRESENTATIVE ~~/~~ <br /> Donald L. Wood <br />ACOIlOil!s.s (7/97) 712 '.. ci"ea~$datWJNW,~~'C'ertsoNUNE.cOt1'\:~? (;)..ACORD CORPORA riOt.! 1988 <br /> <br />>- ' <br />