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<br />Noack & Dean / InterWest <br />401 Watt Avenue <br />Sacramento, CA 95864 <br /> <br />~~ >'f, '"""fc <br /> <br />CE~TIFI~.6.C()~. L1ABILlT~HI~~2~1~~~ED A5l[~~ER OF I~;;~~~~I <br /> <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 />. COMPANIES-AFFORDiNG .COVERAGE <br /> <br />/)- <br /> <br />AGOR <br />i-" '----- <br />PRODUCER .;;. <br /> <br />I _~omfany <br />Company <br />B <br />- - ------.-..- <br />Company <br />C <br />Company <br />_L_~_ <br /> <br />State Compensation Insurance Fund <br /> <br />-- -1 <br /> <br />INSURED <br />, <br />i <br />I <br /> <br />Employers Resource <br />160 Chesterfield Drive <br />Cardiff by the Sea, CA 92007 <br /> <br />, COVERAGES <br /> <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICA TED, NOTWITHSTANDING ANY REQUIREMENTS, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHlCH IHlS <br />CERTlFICA IE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO All THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HA VB BEEN REDUCED BY PAID CLAIMS. <br />I -- T---" ..-----~.- <br />fiCLOT TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION <br />DATE IMMlDDIYY) DATE (MMlDDIVY) <br /> <br />GENERAL LIABILITY <br /> <br />: i I COMMERCIAL GENERAL LIABILITY <br /> <br />r I _J CLAIMS MADE ~ OCCUR <br /> <br /> <br />I. tNER'S&CO-;CT:'SPROT <br /> <br />i AUTOMOBILE LIABILITY <br /> <br />i .~ ANY AUTO <br />I ALL AUTO <br />--- I SCHEDULED AUTOS <br />, <br />I HIRED AUTOS <br />i. NON-OWNED AUTOS <br /> <br />--I <br /> <br />UMlTS <br /> <br />, <br />I <br />I <br /> <br />.~ <br />I <br />i <br /> <br /> <br />GENERAL AGGREGATE , $ , <br /> <br />. ::~~;::~~::;~~::G__~{_= .J <br /> <br />EACH OCCURANCE -- -+-i- - ! <br /> <br />::~=f~~ :Yp:;o:71.r~--~~ -~ <br />CO~~~~~_~~~~LE ~I~~~---'l.-$ I <br />.___1 <br />BODILY INJURY I ! <br />(Per person) I' · <br /> <br />i BODILY INJURY <br />I__~_~r_~~~dent) I $ <br /> <br />i PROPERTY DAMAGE $ <br />I <br />1---- <br />AUTO ONLY. EA ACCIDENT <br /> <br />. <br /> <br />ANY AUTO <br /> <br />i <br />I <br />I <br /> <br />OTHER THAN AUTO ONLY: <br /> <br />GARAGE LIABILITY <br /> <br />i <br />, <br />i <br />IExCESS LIABILITY <br />~----, <br />I UMBRELLA FORM <br />I-~ <br />i i OTHER THAN UMBRELLA FORM <br />1 W~RKERSCOM;'ENSA;'ION AND <br />EMPLOYERS' LIABILITY <br /> <br />i <br />I <br />f-- <br />I <br />! <br /> <br />1604493-01 <br /> <br />, <br /> <br />[ <br /> <br />i <br /> <br />-1 <br /> <br />---4 <br />AGGREGATE $ I <br />r- ---. <br />EACH OCCURANCE ' $ I <br />1 i AGGREG^,:"- - J · - --~-=::-j <br />- --- il~o~l ro~f_~ --=---1 <br /> <br />11/11/2001 -11/1112002 ELEACHACCIO",,~ _ __1_$_1.000.000._ _ I <br />l I_.:_:~~S~SE.~?~I~YL_I~IT I $1.:.~~,000 --j <br />I EL DISEASE. EA EMPlOYEE $1.000,000 I <br /> <br />.,.--+-- I --- I <br />i l <br />, <br /> <br />EACH ACCIDENT <br /> <br />. <br /> <br />A <br /> <br />THE PROPRIETOR! i INCL <br />PARTNERSIEXECUTIVE <br />OFFICERS ARE: [J_~CL <br />OTHER <br /> <br />i _____ <br />: DESCRIPTION OF OPERATIONSIVEHICL.ESlSPECIAL. ITEMS <br />I CLIENT: CHRISTMAS IN APRIL License No.: NIA <br />i ONL v EMPLOYEES OF EMPLOYERS RESOURCE AS LONG AS THEY ARE PERFORMING WORK WITHIN THE NATURE AND SCOPE OF THEIR <br />EMPLOYMENT ARE INSURED UNDER EVIDENCE OF COVERAGE PROVIDED. <br /> <br />___._._L __ <br /> <br />i <br />IACORO 25-8 (1/95) <br /> <br />City of Santa Ana <br />Altn: Community Development Agency <br />P. O. Box 1988 APPROVED AS TO FORM <br />Santa Ana, CA 92702-1988 <br /> <br />_~1ur~~+ <br />Laura Sheedy <br />Deputy City Attorney <br /> <br />CANCELLATION -10 d.ys for non-payment ofprtmium <br />I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL MAIL 30' DAYS <br />, WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAME TO THE LEFT, - <br /> <br /> <br />f- <br /> <br />iCERTIFICATE HOLDER <br /> <br />I <br />I AUTHORIZED REPRESENTATIVE <br /> <br />I William O'Keefe <br />, <br />ACORD CORPORATION 1988 <br /> <br />~~ <br />