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ACORD CERW - - - -- - <br />PRODUCER (714)836-994E <br />The Empire Company <br />550 Parkcenter Drive <br />Suite 205 <br />INSURED <br />Peranich Reporting, <br />5241 E Santa Ana Canyon nluu <br />- - -- - - --E <br />Post-it' Fax Note 7671 <br />Dale <br />pages 1. <br />To <br />From <br />Co. /Dept. <br />Phone # I t N& 61 <br />P a # <br />Fax # <br />Fax # <br />^twee s n,,i <br />DATE (MLVDDryYYYJ <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY <br />REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, <br />THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. <br />AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />III A00'L POLICY EFFECTIVE POLICY IXPIRATION <br />LfR INSIPID TYPE OF INSURANCE POLICY NUMBER DATE (Mill MMlDD LIMITS <br />GENERAL <br />LIABILITY <br />COMMERCIAL GENERAL LIABIL'TY <br />CLAIMSMADE OCCUR <br />RRENCE <br />$ <br />RENTED Ea occurrence <br />$ <br />n one arson <br />$ <br />WRENTED <br />ADV INJURY <br />$ <br />GREGATE <br />$ <br />GEN'L AGGREGATE LIMIT APPLIES PERpq0- <br />POLICY JECT LOC <br />- COMP /OP AGG <br />$ <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />HIRED AUTOS <br />NON -OWNED AUTOS <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />$ <br />BODILY INJURY <br />(Per person) <br />$ <br />BODILY INJURY <br />(Per accident) <br />$ <br />PROPERTY DAMAGE <br />(Per accident) <br />$ <br />GARAGE LIABILITY <br />ANY AUTO <br />A C <br />1/ A <br />ED <br />i, <br />O FORM <br />AUTO ONLY - EA ACCIDENT <br />$ <br />OTHER THAN EA ACC <br />AUTO ONLY ADS <br />$ <br />$ <br />EXCESS/UMBRELLA LIABILITY <br />OCCUR ❑ CLAIMS MADE <br />DFDDCTIBLE <br />RETENTION $ <br />BUTU. 5(11.1 $1 <br />/1SC15tanL City <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />S <br />$ <br />$ <br />S <br />A <br />WORKERS COMPENSATION AND <br />EMPLOVERS'LIABILITY <br />ANY PROPRIETORiPARTNER /EXECUTIVE <br />OFFICER /MEMBER EXCLUDED? <br />If yea. describe under <br />SPECIAL PROVISIONS below <br />OTHER <br />WKN117683 -3 <br />9/1/2005 <br />9/1/2006 <br />WC STATUS OTH- <br />TORN LIMITS ER <br />E.L. EACH ACCIDENT <br />$ 1,000,000 <br />E.L. DISEASE - EA EMPLOYEE$ <br />1,000,000 <br />E.L. DISEASE - POLICY LIMIT $ 1,000,000 <br />DESCRIPTION OF OPERATIONS /LOCATIONSIV EHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS <br />rcoTClnaTC uni ncn <br />City of Santa Ana <br />Attn:Mary Radcliffe <br />P. 0. Box 1968 <br />Santa Ana, CA 92702 <br />%CORD 25 (2001/08) <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL <br />DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT <br />FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE <br />AUTHORIZED REPRESENTATIVE <br />:herryl Young /ERICA <br />0 ACORD CORPORATION I CRR <br />