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<br />I ACORDm CERTIFICAV OF LIABILITY INSUvNCE I DATE (MMlDDfYY) <br /> 07/13/2001 <br />'",CDUCER (909)793-2373 FAX (909)798-6983 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Davis & Graeber Insurance Services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />470 E. Highland Ave. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />P.O. Box '40 <br />Redlands, CA 92373 INSURERS AFFORDING COVERAGE <br />INSURED Gold Coast Water Company, LLC INSURER A: Travelers Indemnity Co. of CT <br /> 13231 Slover Ave INSURER B: Travelers Indemnity Co. of IL <br /> Fontana, CA 92337 . INSURER c: State Compensation Insurance Fund <br /> INSURER 0: <br /> , INSURER E: <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD IN IGATED. DING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTlFIC ,~, R <br /> MAY PERTAIN, THE INSURANCE AFFORDED BY THE PQLlCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAlMS. <br />INSR TYPE OF INSURANCE. POLlCV NUMBER P8.k+i~~~58~E Pgi!ft~~~~N LIMITS <br />LTR <br /> ~NERAL LIABILITY 660693X6870TCTOO 11/28/2000 11/28/2001 EACH OCCURRENCE $ l,OOO,OO( <br /> X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Anyone fire) $ 100,000 <br /> l CLAIMS MADE [!] OCCUR MED EXP (Anyone person) $ 5,000 <br />A PERSONAL & ADV INJURY $ 1,000,000 <br /> - GENERAL AGGREGATE $ 2,000,000 <br /> ~'L AGG~EnELlMlT APnS PER: PRODUCTS. CQMP/OP AGG $ 2,000,000 <br /> POLICY ~~8T lOe <br /> ~TOMOB1LE LIABILITY COMBINED SINGLE LIMIT $ <br /> ANY AUTO (Eaaccident) <br /> l- <br /> I-- ALL OWNED AUTOS BOOIL Y INJURY <br /> {Per person) $ <br /> I-- SCHEDULED AUTOS <br /> I- HIRED AUTOS BODILY INJURY <br /> (PeraCCidenl) $ <br /> I-- NON-OWNED AUTOS <br /> - PROPERTY DAMAGE $ <br /> (Per accident) <br /> ~RAGE LIABILITY AUTO ONLY. EA ACCIDENT $ <br /> ANY AUTO OTHER THAN EAACC $ <br /> AUTO ONLY: AGG $ <br /> EXCESS LIABILITY ~UPOO07W564TILOO 11/28/2000 11/28/2001 EACH OCCURRENCE $ 5,000,00( <br /> ~~OCCUR 0 CLAIMS MADE AGGREGATE $ 5,OOO,OO( <br />B $ <br /> ::;rl DEDUCTIBLE $ <br /> X RETENTION. S 10,OO( $ <br /> WORKERS COMPENSATION AND 160329600 11/18/2001 11/01/2001 X I T':\'i\JLf..1Ns I IOJ~' <br /> EMPLOYERS' LIABILITY $ 1,000,000 <br />C E.L. EACH ACCIDENT <br /> E.L. DISEASE. EA EMPLOYE $ 1,000,000 <br /> E.L. DISEASE - POLICY LIMIT $ 1,000,000 <br /> OTHER <br />DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESJEXClUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br />e: Operations of the Named Insured - Location: 2614 Oak St., Santa Ana, CA 92707. <br />ertificate holder is an additional insured/vendor per terms/conditions of the policy. <br />en days notice of cancellation for non-payment of premium. <br />CERTIFICATE HOLDER I X I ADDITIONAL INSURED; INSURER LETTER: A CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEL.LED BEFORE THE <br /> "-.J City of Santa Ana, its officers, employees, EXPIRATION DATE THEREOF, THE ISSUING COMPANY WilL ENDEAVOR TO MAIL <br /> agents, volunteers & representatives JL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br /> Attn: Nancy Bailey/Public Works Agency BUT FAILURE TO MAlL SUCH NOTICE SHALL IMPOSE NO OBL]GATION OR LIABILITY <br /> 220-A S. Daisy Avenue OF ANY KINO UPON THE COMPANY, ]TS AGENTS OR REPRESENTATIVES. <br /> Santa Ana, CA 92703 AUTHORIZED REPRESENTATIVE ~ <br /> Frederick Yauaer CIC/FML <br /> <br />ACORD 25-S (7/97) FAX: (714)647-6515 <br /> <br />@ACORD CORPORATION 198B <br />