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<br />
<br />ACORD~ CERTIFIC
<br />
<br />
<br />9)Z61-19U
<br />
<br />E OF LIABILITY INS
<br />
<br />
<br />NeE
<br />
<br />l"N';~l,IiCR (349) 251 .5335 FAX
<br />T~ttoh I".U~ance Se~vi~e$f Ih~.
<br />2913 S, Pullman S~,
<br />S_nta Ana, CA 92705
<br />
<br />1J,lS;URm Oa y Int.t"nat,onill
<br />Daly Project Services. Inc.
<br />a Corporate Park #300
<br />Irvine, C4 9~60G
<br />
<br />INSURERS AFFORDING COVERAGE
<br />
<br />COVERAGES
<br />TH. PC",CIES OF INSUMNCE L1STE~ aELcw HAVE BEEN ISSUED TO .".INSURED NAMl<O ABoVE FOR THE .Ollcy .ERIOO INO/CATED. NOTWlfH.TANe>lNG
<br />ANy REQUIREMENT, T.~M o~ cQNOrTION OF MY CONT"""T "R OTH'R DOCUMENT WITH """PECT TO WHICI1 TIiIS C.R1lF!CATE MAY BE ISSUED OR
<br />MAy OERTAlN, THO INSURANcO A",OROEO BY THE ""ClCIE. DE'''"",o HE~EjN I; SUBJECT TO ALL THO .ERIIlS, EXClUSIONS ..NO CONCHTIONo OF SUCH
<br />POUC:t::s. AGGRf:.GAiE UMJTS SHOWN ~y HAlve aEeN REOIJCED BY PAlO ClAIMS,
<br />1~1: TYPE OF INSURANCE ~~L.lOY NUMBER flCU~V
<br />~~eftAL.l.i"BfL(TY PI049636
<br />X C:lMM!O:RcIA1, ~I;;:N;'R"'L I,.!Akt'r'r
<br />CLAIMS MADE 0 OCCUR
<br />
<br />INSURJ;;R A:
<br />I~SVRER 8;
<br />f\i.9<J~~RC.
<br />INSUIil!IiR D~
<br />fNSURER €;
<br />
<br />~ulcrum Insurance Company
<br />t;AINSCO
<br />State Camp. I"sa~a""e Fand
<br />ROyal SU~plU5 Lines Ins. Co.
<br />
<br />
<br />QUcy EXPIRATION
<br />DA
<br />OS/25/2002
<br />
<br />EAel-l oer:U~Fl.~NC!e
<br />
<br />llM/7oS
<br />,
<br />
<br />A
<br />
<br />RPie OAMAGE (Al'ly (111"18 fifl!lJ
<br />
<br />,
<br />
<br />1,000,001
<br />.100 I 001
<br />1,001
<br />1 000,001
<br />1 000,001
<br />1,000 I OO!
<br />
<br />
<br />MED EXP (^nyon. P41rIiQtl)
<br />Pe~.:SONAl & J.OV lNJuA-y
<br />GENI!RALAGGR!;;:G....T5 S
<br />FlRODUCTS ~ COM~JOP AOG 5
<br />
<br />,
<br />
<br />.
<br />
<br /> ppa00621
<br /> ~~ AUTO '."-
<br /> ALL aWNGD AUTO.t:
<br />B ' SCkECULEO AUTOS
<br /> X HIRSQ ,AlUTQ.$
<br /> X NON..o.NNSO ....UT4Ia
<br /> GARAOe lIABIL.ITY
<br /> ANV AUTO
<br /> I!XCess LIABILITy
<br /> QC;ClJPl o ,"LAIMa M~DE
<br /> DEDUCllBLE
<br /> ftETENTlON .
<br /> WOf'lKI!~~ <;;fi:tMPliN&ATlQN PlNI;l 927466
<br /> EMPLO'fERS'LfABILlTV
<br />C
<br />
<br />OS/25/2001 OS/25/2002
<br />
<br />COM81NI!D SlNGLIO! UMIT
<br />(Ea~l#.,;dB"l)
<br />
<br />.
<br />
<br />1,000,001
<br />
<br />eo;llt. 'Y' 'NJURY
<br />(~erperaon)
<br />
<br />.
<br />
<br />BODILY INJUIii!Y
<br />(~erl!leeld","i)
<br />
<br />I'RO"I!!"-TY OAUACIj.' $
<br />(PllTjH;lih:k-I1t)
<br />
<br />AUTO ONL. V _ EA ~eC:!OM
<br />
<br />Oll1EfI TMN
<br />AlITO ONLY'
<br />
<br />II!;AACC !Ii
<br />^C3G ;;
<br />
<br />EACH oo;;UftRENCIi
<br />AGGREGATE
<br />
<br />,
<br />$
<br />,
<br />$
<br />.
<br />
<br />05/02/2001 05/02/2002 X
<br />
<br />
<br />en
<br />
<br />OTHER.
<br />
<br />KZDSV166
<br />
<br />, l,OOO,DOI
<br />EL. OISEA5E. I!:A I!:MFlLOY f 1 000 ODe
<br />E.\.. DISe1ISe;. PCl.lcY L.IMIT I: 1 000 OOt
<br />OS/25/2001 OS/25/2002 $1,000,000 Ea<:h CllIim
<br />$1,000,000 - Agg~egate
<br />$5,000 Ded. Per Claim
<br />
<br />o
<br />
<br />
<br />DESC"rPTlON Q" OP!A:ATjCN:ofL.g~TIc)NBNEHIGll!!tlII!!XClU5rON$ADOEO IIY E)fDOASliMfNnsPEClAl. PROVISIONS
<br />E CITY OF SANTA ANA, ITS OFFI~ERS, EMPLOYEES, ACENTS VOLUNTEERS AND
<br />EPRESENTATIVES ARE NAMED AS ADDITIONAL INSUREDS WITH REGARD TO LIABILITY WITH REGARD
<br />NO DEFENSE OF SUITS ARISING FRoM THE OPERATIONS AND USES PERFORMED BY OR ON
<br />EHALF OF THE NAMED INSURED.
<br />10 OAY NOnC!; W:r;I,L BE MAILED FOR NON-PAYMENT OF PREMIUM,
<br />
<br />CERTIFICATE HDLD!!R
<br />
<br />ADDITIONAL IHSUIilI!O: INSURER LETTER!
<br />
<br />CANCELLA TlGlI/
<br />
<br />llCOf<O 25.5 (7tqn
<br />
<br />,(_'1 /A
<br />'La ura Sheedy
<br />Deputy City Attorney
<br />
<br />
<br />
<br />SHOULD ANY 01= THE ABOVE DI;;SeftIIllEeJ,"OLrCII!'S Be CANCELLED BEFORE THIe
<br />eXf"'IItATION DATe THeR.EOF. 1H!! ISSUING COMPANY WlL.L. ~~MAIL.
<br />1: 30 01\'(6 WRITTeN NOTiCe: to THE CERl1f"ICAT.e.1oI0L.OGR NAMED to THE Lur,
<br />lllWtl( ~~DOO:XX
<br />Jf.ItJQOO()(XXXXXX
<br />
<br />CITY OF SANTA ANA
<br />ATTN: ESTHER AKHAVAN
<br />888 W. SANTA ANA BLVD..
<br />SUITE 200 APPROVED AS TO FO
<br />SANTA ANA, CA gaOl
<br />
<br />(;/J 38\1d
<br />
<br />NOI1\1~~8~~ ON\1 S~~\1d
<br />
<br />68(;p,LSp,L
<br />
<br />8S:" ,88(;/80/98
<br />
<br />
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