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<br />,- AC:QJ{~~: 2Cu,=~r,vf'CA;,j~L'AB-!i,'TY"NSUR "C~f:1~;~ l~;;O~
<br />
<br />PROOU<<R THIS CERTIFICATE I~ EO ~ A MATTER OF INFORMATION
<br />Brlilkke,-Sc:ho.fnitz Ins. Brokers ONLy ANQ CONFERS ND RICH.s UPON TIiE CERTIFICATE
<br />Licen"" #0428915 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br />28202 Cabot R"ad, Suite 500 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW,
<br />Laguna Nigue1 CA 92677-1251
<br />Phone: 949-365-5100 Fax:949-347-7067
<br />
<br />IN3UREP
<br />
<br />INSURERS AFFORDING COVERAGE
<br />
<br />i~erial Hotel Group LL~
<br />
<br />Doubl~tree Hotel S~ta
<br />201 E MacArthur Blvd,
<br />Santa Ana CA 92707
<br />
<br />\'/;
<br />An.. /lfJOL-'
<br />
<br />INSURER A:
<br />INSURE:R.3:
<br />INSURER C'
<br />INSURER D:
<br />II\tSU,",~.'l.f;'
<br />
<br />Zu=ich Amerioan In5uranc~
<br />
<br />COVERAGES
<br />
<br />THE POLICIES OF' INSuRANCE LISTED BELOw HAVE SEEN ISSUEO TO THE INSURED NAMED ABOvE FOR THE POLICY PSRJOO INDlCATEO. NOT'NITHSTANOl/''lG
<br />ANY REQUIREMENT TERM OR CONDITiON OF ANY CONTRACT OR OTtiER DOCUM~~TwrT"" RESP=CT TO WH[CH 11'iIS CERTIFlCA.TE t..u,v ElE ISSUED QR
<br />MAY PERTAIN, THE INSURANCE AFFOROED a'f' THE POLICIES DESCRIBED HEREIN IS SUeJECT TO ALL THE TERMS, EXCl.USIONS .o\NO CQNOlTlOHS OF SUCt-i
<br />POI.lCIES. AGGREGAT!;: LIMITS .sHOWN MAY HAVE. BEE:N REOOUCED By PA.lO CLAIMS.
<br />':'fR'1 TYPE OF INSURANCE I rouey NUMBER OAT'~c.l~"'1001YY\ t: i "'ok+'f(~~ 1.IMrTS
<br /> GENERAL Ll.ABIUTY I I ~Cj.( OCC;;~RE,'JC;;; '. 1000000
<br /> - I I ! . 1000000
<br />A X COMMERCIAL GENERAL UABI"1Y I CPP0299091101 06/01/02 ! 05/01/03 FIRE DAMAGE (M, ':l!'1e rire)
<br /> 1 CLAIMS MAOE 0 OCCUR MED EXPlAr1YQoe~) I 'excluded
<br /> X Liquor Liability PERSONAL & Ar:V INJURY 1'1000000
<br /> I GENERALAGGREGAie , 2000000
<br /> GEN'L AGGREG.o\TE LIMIT APPLIES PER: I PROOUCTS . COMPtOP AG~ I $ 1000000
<br /> 'I ,neRO IXl Emp Ben, I 1000000
<br /> POLICY JEeT X LOC
<br /> Al1TOMOBll.E LIABIL!"r( COUaIN6:0 SINGL.lO. ~IMlT 1'1000000
<br />A rx ANY A.UTO BAP299092001 06/01/02 05/01/03 (Eaacclllenl)
<br /> r- i
<br /> ALL OWNED AUTOS BODily INJURY
<br /> r- .
<br /> SCHEDULED AUTOS (~r..~)
<br /> X HIREo AUTOS aooll. Y INJURY
<br /> X 1
<br /> NON-QWNED AUTOS (P-erllCl:ldI!MI)
<br /> ~ i
<br /> PROPERTY OAMAG';;: !.
<br /> (per4'CCldeNJ
<br /> GARAGE LIABILJTY I AUTO ONLY - , AC::iDENT I S
<br /> ~ ANY AuTO I OTHER 'THAN EAACcj ~
<br /> , I AlITO ONLY:
<br /> AG~! So
<br /> ExCESS lIABII,.Irr EACH OCCIJRRE"OC=. 1110000000
<br />A ~ OCCuR o CLAI"1S MADE CC299094801 06/01/02 05/01/03 AGGREGAjf: is 10000000
<br /> I.
<br /> ~ O'DUCTIBL' Ii
<br /> X ~TE,'mON . 10000 c A FORM I'
<br /> WORkERs COMPENSA,710H AND APPRO 'EU n~' J--- f roR~'U~Y~: iV,,,"
<br /> EMPt..OYI:?:RS' i.1A.BILIT"(
<br /> .;!i E.I.. EACH ACCIOE~';' I.
<br /> {~ e.L. DISEASE: . bo1. SMPLOVS~ S
<br /> I I ii:.L. DISEASE - ,,"OllCY LJMJT J S
<br /> OTHER ;,;'1t1ra ..;Ill AtWrlll~" I
<br /> . Oeputy ( ity I
<br />DESCRIPTION OF OPEAATIONSlI..OCATlONSlVEHICLESlEXCLUSIONS ADOEO BY ENCORSEMENT/SPECIAI. PROVISIONS
<br />City of Santa Ana, its officers, agents, employees I consultants, speC1al
<br />counsel and representativGs and County of Orange are named as adcli tional
<br />insured in regards to operations of the Doublatree Hotel - Santa Ana Orange
<br />COUll ty AiIport located at 201 E MacArthur Blvd. , Santa Ana, CA 92707 as per
<br />atta.ched a.dditional insured endorsement
<br />CERTIFICATE HOLDER I N J AllOITIO"AL INSURED: ,"SU.ER LffiER: CAN CElLA TION
<br /> CJ;TYSAN SHOVI..O ANy OF THE ABOYE DESCRlBEO POUC1ES BE c.u.;CElLEO BEFORE THE EXptRAll0N
<br /> DATE THERE:CF, T\oiE ISSUING INSURER INtLL p-__ MAIL ....3.L OA YS WRlTIEN
<br /> City of Santa Ana I and Nonce TO THe c-~f1CATE '"'OLDER NAf.1eO TO THE I.:;:r, e.r-r _ j 1.t"
<br /> County of Oranae ...ff,lpo~e: liS ;1l[,,1& "fie.. 6", ~)_~,~JV, 8F Ad.
<br /> 20 Civic Center ",Plaza urIS -; 1."1'<;:' 'tj '~'C~,'"'1J ',;~:r':rQeR
<br /> Sa.nta Ana CA 92702 R;l;r" ;;R'M..
<br /> AUTHORIZ2.l REPlii.E3ENTAnve
<br /> I ,
<br />
<br />ACORD 25,S (7/97)
<br />
<br />@ACORDCORPORATlON1988
<br />
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