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<br />From Alison K,ent fc: Mindy
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<br />Da~e 1/2/02 TI'TIe: 10:33:14 AM
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<br />Page 5 of5
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<br />ACORD CERTIFICATE OF LIABILITY INSURANC~ OPID ~ OAlElMM/llIlJYY)
<br /> -~._--..._._--,.._-... ~-1 12/31/01
<br />PRODUCER THIS CERTlFICA TE IS ISSUED AS A MATTER OF INFORMATION
<br />e. S. Levine Insurance ONLY ANO CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />Servicea, Inc. HOLDER. THIS CERTFICA TE DOES NOT AMEND, EXTEND OR
<br />3377 Carmel Mountain Iload ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />San Dieqo ~ 92121 INSURERS AFFORDING COVERAGE
<br />Phone: 858-481-8692
<br />INSURliiO : NSUR::R A: CNA :Insurance com:Dany
<br /> !NSLRERB
<br /> W. Koo AafOCiates, Inc INSLRERC
<br /> 600 The C t! Parkway, hl0 iNSI...RERO
<br /> Oranqe ~ 9 868
<br /> 'NSURER E
<br />
<br />COVERAGES
<br />
<br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING
<br />ANY REQUIREMENT, TERM OR CONDITION OF mv CONTRACT OR OTHER DOCUMENT WITl-l RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
<br />MAY PERT....IN, TI4;: INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
<br />POLICIES. AGGREGATE LIMITS SHO~ MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />".. TYPE Of INSURANCE POLICY NUMBER ~i*CiM~b~lii PDOA~~~?N LIMITS
<br />LTR
<br /> ~NERAL LIABllJTV EACH OCCU~REN:E ,
<br /> c- 3MERCIAL GENERA.. L1Jl8IL1TY FII'E DAMAGE (My Q.1e fire) ,
<br /> - CLAIMS I,1A[lE D OCCUR MED EX? r A.ny one person) ,
<br /> PERSONAL &PDV IN~~Y ,
<br /> GSNERALA(,GREGATE ,
<br /> ~~ ACB~~n ~ MIT A?Pn PER PRODUCTS - COf,P,iCP AGG ,
<br /> "'OLICY ~~8i LOC
<br /> ~TONOBlLE LIABILITY COMBINED Sl~-.GL;::: LMIT ,
<br /> ANY AUTO (EElElcGidenl)
<br /> f-
<br /> f- A:...L OW"JED AUTOS BODILY I~Jl.JRY
<br /> IP8rper,on) ,
<br /> c- SCftDULED AUTOS
<br /> c- rllREDAUTOS ; BODILY INJURY
<br /> NON-Q\r\,oNED AUTOS ear accident] j'
<br /> c-
<br /> I-'ROPI:I~TY D4.MAGE I,
<br /> (PeraCCldant] j
<br />~'~."' AUTO ONL r - EA A::::C1DEM 'I
<br /> ,llr-.rAllTO APPR ).VJ J) A~ITO FORM OTHER THAN EAA::::C ,
<br /> - ,.' AUTOONLr AiOG ,
<br /> D~SS lIA.8IUTV ( '.5Y "'- -fa. FACHocrURRfNCF ,
<br /> OCaJR D CLAIMS MADE CRIS'IjlNE L~E SH W AGG~EGATE , --
<br /> Depu y City Altorr ey ,
<br /> R ~EDUCTIBLE 1
<br /> RETENTIO,.., , ,
<br /> WORKERS COMPENSAllON AND I ~~~L~M~TS I lUst
<br /> EMPLO'VI:RS' LIABIUTY EL_ =.A.Crl ACCIDENT ,
<br /> E L DISEASE EA EMPLOY3: $
<br /> E L. DISE.A.SE - POLICY LIMIT ,
<br /> OTHER
<br />A Professional AEI!:114056591 03/01/01 ' D3/01/02 Claim $1,000,000
<br /> Liabilitv Aqqreqate $2,000,DOO
<br />DESCRIPTION OF OPERATIONSILCCAllONSNEHICLESfEXCLUSlONS ADDED BY EP<<JORSEMENTISPECIAL PROVISIONS
<br />Re: ~l Operations of the Named Insured
<br />Proof of Insurance
<br />'10 day notice of cancellation applies for non-payment of premium.
<br /> XX
<br />CERTIFICATE HOLDER I N I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION
<br /> CITYOSl SHOULD AN'( OF THE ABOVE DESCRIBED POLICIES BE CANeS-LED BEFORE THE EXPIRATION
<br /> cit.y o~ Sant.a Ana DATETHEREDF, THE ISSUING INSURER Wlll-.--"'~" ~~ "AIL ...3Jl!. DAYS WRITTEN
<br /> Public Works Agency NOTICE TO ne CERTlFICATE HOLOER NAAlEO TO THE LEFT, .'~r.'b 'AIi- ---- A"" ,
<br /> steve WOrral PI!: t..----. - -- '-.-i. j-t"-' - -~ , . rl "Illlllllllill<l,l'rl .. R'lln
<br /> 220 Daisy Avenue IlIflllll!lPr! 'Ff.I!!.
<br /> Santa Ana ~ 92703 ~
<br /> .
<br />
<br />ACORD 25,$ (7197)
<br />
<br />~
<br />
<br />~ACORD CORPORATION 1988
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