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<br />ACORD,. CERTIFICA:r~ OF L1ABILlTY.INSUP "JNCE I DATE (MM/DDfYYl <br />11/13/2000 <br />PRODUCER (949)859 8111 FAX (~859-8222 THIS CERTIFICATE ISl'!lSUED AS A MATTER OF INFORMATION <br />Comprehensive Insurance Services ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />P.O. Box 3613 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Laguna Hills, CA 92654-3613 <br /> INSURERS AFFORDING COVERAGE <br />INSURED SUSAN QUINN INSURER A: GREAT DIVIDE INS CO C/O R.E. CHAIX & ASSOC <br />DBA: THE QUINN COMPANY INSURER B: <br />246 VIA PRESA INSURER C <br />SAN CLEMENTE, CA 92672 INSURER 0 <br />, INSURER E: <br /> <br />COVERAGES <br /> <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />r~~: TYPE OF INSURANCE POLICY NUMBER P8.k+~~~M~8a'~t: Pgk!fl,~~~~N <br />GENERAL LIABILITY "C030412 11/08/2000 11/08/2001 EACH OCCURRENCE <br />f-'c- <br />X COMMERCIAL GENERAL LIABILITY <br />I CLAIMS MADE 0 OCCUR <br /> <br />LIMITS <br /> <br />FIRE DAMAGE (Anyone fire) <br /> <br />$ <br />$ <br /> <br />500,00C <br />50,oor <br />l,Ooc <br />SOO,OOC <br />500,000 <br />INCLUDE[ <br /> <br />MED EXP (Anyone parson) <br /> <br />$ <br /> <br />A <br /> <br />PERSONAL & /J..DV INJURY <br /> <br />$ <br />$ <br />PRODUCTS - COMPIOP AGG $ <br /> <br />- <br />- <br />~'L AGGRE~E [LIMIT AP~S PER <br />I POLICY I 1 j~g;: I ILOC <br />~TOMOBILE LIABILITY <br />_ ANY AUTO <br /> <br />- <br />SCHEDULED AUTOS <br />- <br />_ HIRED AUTOS <br /> <br />- <br /> <br />GENERAL AGGREGATE <br /> <br />ALL OWNED AUTOS <br /> <br />COMBINED SINGLE LIMIT $ <br />(Eaaccidenl) <br />BODILY INJURY $ <br />(Per person) <br />BODILY INJURY $ <br />(Per accident) <br />PROPERTY DAMAGE $ <br />(Per accident} <br /> <br />NON-OWNED AUTOS <br /> <br />GARAGE LIABILITY <br />~ ANY AUTO <br /> <br />EXCESS LIABILITY <br />:::~rOCCUR D CLAIMS MADE <br /> <br />I DEDUCTIBLE <br />I RETENTION $ <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br /> <br />AUTO ONLY - EA ACCIDENT $ <br /> <br />OTHER THAN <br />AUTO ONLY: <br /> <br />EAACC $ <br />AGG $ <br /> <br />EACH OCCURRENCE $ <br />AGGREGATE $ <br />$ <br />$ <br />. <br /> <br />I {~~-i' lfMI~S I IOJ~- <br />EL EACH ACCIDENT S <br />E.l. DISEASE - EA EMPLOYE $ <br />E.l. DISEASE - POLICY LIMIT $ <br /> <br />OTHER <br /> <br />JlJ::SCRIPTION OF OPERATIONS/LOCATIONSNEHICLESlEXCLUSIONS ADDED BY ENDORSEMENTlSPECIAL PROVISIONS <br />~ERTIFlCATE HOLDER IS NAMED AS ADDITIONAL INSURED PER ATTACHED ENDORSEMENT #S 114 (04/97) <br /> <br />.10 DAY NOTICE SHOULD THE POLICY CANCEL FOR NON-PAYMENT <br /> <br />CERTIFICATE HOLDER I I ADDITIONAL INSURED; INSURER LETTER <br /> <br />CANCELLATION <br /> <br />THE CITY OF SANTA ANA <br />ET AL PER ATTACHED LIST <br />PERSONNEL SERVICES DEPT <br />ATTN: JIM STIKELEATHER <br />20 CIVIC CENTER PLAZA <br />SANTA ANA, CA 92702 <br /> <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL iIa'UX~ MAIL <br />*30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />~1I1(~XJlllOOOO(J(iI(lilOO@t~JCIl:oulJXJXi(X <br />~~X:lOOCdl'llI(MJ(i@tJ(iDXXXXXXX <br />APPROVED AS TO EO REPRESENTATIVE <br />/ ,I Ri~h~.rd Evnon/JEREMY <br /> <br />/7~' fJ/ ( I J Ii ) <br />/ ij(NJAMIN ~UFMAN V - <br />ChiM Assistant City Attorn<lY <br /> <br />;;2b-< ?-.- <br /> <br />@ACORD CORPORATION 1988 <br /> <br />ACORD 25-S (7/97) <br />