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ACORD,. CERTIFICATE OF LIABILITY INSURANCE I DATE (MMlDDIYYYY) 7/20/2004 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Venbrook Insurance Services ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 22801 Ventura Blvd, Third Floor HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Woodland Hills, CA 91364 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Phone 818-225-6200 Fax 818-225-6210 INSURERS AFFORDING COVERAGE NAIC# INSURED Overland, Pacific & Cutler, Inc. INSURERk Great American E & S Company 100 West Broadway INSURER B, The Hartford Insurance Company Suite 500 INSURER c: Everest National Insurance Long Beach, CA 90802 INSURER'" illinois Union Insurance Company I INSURER E, RSUllndemnitv ComDanv COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAJMS. INSR ADD' POUCY NUMBER POLICY EfFECTIVE POUCY EXPIRATION LIMITS $ 1,000,000 $ 50,000 $ Excluded $ 1,000,000 $ 2,000,000 PRODUCTS-COMP/OPAGG $ Excluded AUTO ONLY. EA ACCIDENT $ EA Ace $ AGG $ $ 1,000,000 $ 1,000,000 $ $ $ E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE. EA EMPLOYEE $ 1,000,000 E.L. DISEASE. POLICY LIMIT $ 1,000,000 EPL: $1,000,000 . $15,000 Retention E & 0: $2,000,000 . $50,000 Retention A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE [!] OCCUR EACH OCCURRENCE 6/24/2004 6/1/2005 PL 5574310-01 PREMISES MED EXP An one person) PERSONAL & ArN INJURY GENERAL AGGREGATE GEN'LAGGREGATE LIMIT APPLIES PER: PRO- LOC AUTOMOBILE UABIUTY ANY AUTO 6/24/2005 COMBINED SINGLE LIMIT (Eaaccident) 72 UECUM6536 6/24/2004 B ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per person) X HIRED AUTOS X NON-QWNED AUTOS BODILY INJURY (Per accident) PROPERTY DAMAGE (Peraccidenl) GARAGE UABILITY ANY AUTO OTHER THAN AUTO ONLY: E EXCESsnJMBRELLA LlABIUTY X OCCUR D CLAIMS MADE EACH OCCURRENCE AGGREGATE NHA212256 119/2004 8/1/2005 UE:.uv{,;¡.¡8LE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS'LIABIUTY C ANY PROPRIETORIPARTNERlEXECUTIVE OFFICERlMEMBER EXCLUDED? YES g~c¡¡~s~~J¡~~~~s below D g~~royment Practices Liab & Errors & Omissions Prof Llab 3900048305-041 6/1/2004 6/1/2005 BMI20010437 6/24/2004 6/1/2005 DESCRIPTION OF OPERATIONS J LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PR .10 Days Notice of Cancellation for Non-Payment of Premium. AS TO FORM CERTIFICATE HOLDER City of Santa Ana Public Works Department Alln: Taig Higgins 20 Civic Center Plaza Santa Ana, CA 92701. Itlonallnsured CANCELLATION " $ 1,000,000 $ $ $ OT\<. SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTteE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAlWRE TO DO so SHALL IMPOSE NO OBUGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25 (2001/08) \..-1 I--l @ACORD CORPORATiON 1988