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i <br />ACORD CERTIFICATE OF LIABILITY INSURANCE <br />DATE <br />/ ' <br />PRODUCER (714) 836 -9945 FAX: (714) 836 -9946 <br />The Empire Company <br />550 Parkcenter Drive <br />Suite 205 <br />Santa Ana CA 92705 -3521 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />INSURED <br />Peranich Reporting, Inc. 02���' roo fl�� <br />5241 E Santa Ana Canyon #100 <br />Anaheim Hills CA 92807 <br />INSURER A: Preferred Employers Ins. <br />Santa Ana, CA 92701 <br />INSURER B: <br />INSURER C: <br />AUTHORIZED REPRESENTATIVE <br />INSURER D: <br />INSURER E: <br />OVERAGES <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 LIMIT H N MAY H V E N REDUCED BY PAID CLAIMS. <br />INSR <br />ADD'L <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POLICY E (MM DDIYYE <br />POLICY <br />DATE MM /DD/YY) <br />LIMITS <br />GENERAL LIABILITY <br />CLAIMS MADE FI OCCUR <br />ff—c:01MMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ <br />DAMAGE TO RENTED <br />PRE I rr n <br />$ <br />MED EXP An one person) <br />$ <br />AL A V INJURY <br />$ <br />GENERALAGGREGATE <br />$ <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRO - <br />POLICY JECT LOC <br />- COMP /OP AGG <br />$ <br />-PRODUCTS <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) P-4 <br />$ C7 <br />BODILY INJURY <br />(Per person) C <br />CJ� <br />CD <br />BODILY INJURY N <br />(Per accident) 00 <br />mfi r`.,"_ , <br />f— - <br />PROPERTY DAMAQ� <br />(Per accident) <br />GARAGE LIABILITY <br />ANYAUTO <br />1Y�� <br />AUTO ONLY - EA ACCIDENT <br />$ <br />OTHER THAN QJ& A <br />AUTO ONLY: AGG <br />$ �'- <br />$ <br />EXCESSIUMBRELLA LIABILITY <br />OCCUR FI CLAIMS MADE <br />DEDUCTIBLE <br />RETENTION <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />S <br />$ <br />A <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER /MEMBER EXCLUDED? <br />If yes, describe under <br />SPECIAL PROVISIONS below <br />WKNI17683 -5 <br />9/1/2007 <br />9/1/2008 <br />X O STIMIT O R <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 <br />$ 1,000,000 <br />OTHER <br />DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS _ <br />*10 day notice of cancellation shall apply for non - payment of premium. <br />CERTIFICATE HOLDER CANCELLATION <br />ACORD 25 (2001108) © ACORD CORPORATION 1988 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />City Of Santa Ana <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL <br />Attn : Rosa Flores <br />30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT <br />P.0 BOX 1988 <br />Santa Ana, CA 92701 <br />FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE <br />INSURER, ITS AGENTS OR REPRESENTATIVES. <br />AUTHORIZED REPRESENTATIVE <br />Michael Condy /ERICA <br />ACORD 25 (2001108) © ACORD CORPORATION 1988 <br />