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.- ACORD. CERTIFICi -0:: - .UJo OF LIABILITY INSU:'"' ,,-,Nce OPID OATE(NMIIlOIYY) . ~AYLE-1 06/13/02 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE "~ PRODUCER Chapman , Associates License #0522024 P. O. Box 5455 Pasadena CA 91117-0455 Phone: 626-405-8031 Fax:626-405-0585 INSURED Dayle McIntosh Center 13272 Garden Grove Bl. Garden Grove CA 92843 INSURER A:. INSURER s- , 'I INSURER C INSURER 0 INSURER E NIAC 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 OESCR!8ED HEREIN IS SUBJECT TO All THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POllCIES_ AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. lrf~: TYPE OF INSURANCE I POLICY NUMBER ~ .~~NERAL LIABILITY I A f_>;:....:..._~~~MERCIALGENE'~:~~~L~IA8111TY I 200202327NPO , I CLAIMS MADE X: OCCUR I riTP;ofessional i-~' .----- --..- -.---.------ ~~t~CTM~bt7f}yE OS/25/02 PJl}+~~~~fJW'J}?N , LIMITS ~ EACH OCCURRENCE : $ 1000000 -- ~ OS/25/03 FIRE DAMAGE (Any one fireJ i $ 50000 : MED EXP (Any ~~~ person) --I s,500-6---- ! PERSONAL&ADVINJURY $1000000 I~ENERAlAGGREGATE $ 3000000 PRODUCTS - COMPtOP AGG $ 1000000 Emp Ben _ 1000000 COMBINED SINGLE LIMIT I $ 1000000 OS/25/03 (Eaaccldenl) -----+-=- BODILY INJURY I $ (PerpersOl1) I. II i BODll YINJURY (Peraoodent) , I I PROPERTY DAMAGE {Per accident) I AUTO ONLY - EA ACCIDENT $ I OTHER THAN EA ACC i $ : AUTO ONLY: -- ..- : GEN'L AGGREGATE LIMIT APPLIES PER: i-: i-l PRO- I I : i POLICY I ,JECT I ! lOC i A~OMOBILE LIABILITY A ~ ANY AUTO :1 ALL OWNED AUTOS L-i SCHEDULED AUTOS ! -Xl HIRED AUTOS r-, ~.!J NON-OWNED AUTOS , ! 200202327NPO i I I i I 0 ~C()Rlvl .'~,/' :_> ,Co , I ,:~,~/.;j ~~~,<~, ~/-.--T >'F;V City Atlorney ! OS/25/02 .-- ~ ---.---- -.- --------- i GARAGE LIABILITY ! , ANY AUTO i . , : EXCESS LIABILITY I A I OCCUR CLAIMS MADE , - , . AGG! $ ~ --...-..-.-- : . 1000000 1.1000000 -i $ ---~- .-- 200202327UMBNPO , OS/25/02 i EACH OCCURRENCE OS/25/03 i AGGREGATE DEDUCTIBLE X-, RETENnQN .10000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ;$ I. ; : ~JR~l~~YTS iU~~- i ___'---_______..1_____ E L EACrl ACCIDENT S . E L DISEASE - EA EMPLOYEE S : E' ~__;ISEA;-~---~O~~~y LIMIT: S OTHER : DESCRIPTION OF OPERATIONSfLOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS The City of Santa Ana, their respective officers, employees, agents, volunteers and representatives are named as additional insured with respect to the operations of the named insured. CERTIFICATE HOLDER I y I ADDITION LINSURED INSURER LETTER CANCELLATION , A CITYSAN SHOULD ANY OF THE ABOVE OESCRIBED POLICies BE CANCelLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURERWllL~ MAil ...3.L DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE lEFT, BU~DO". --'1"'r'lt City of Santa Ana ...." ..~~_I",;g- 1 ~~'#<"""~"~~r_LJ~Jlllie )I;~~ -A""Llio Attn: Mike Linares ~1ll""1PrL9, 20 Civic Center Plaza Santa Ana CA 92701 AUTHORIZED REPR'~0TIVE O)!J,,.& ... ~ ./ifif . -." ",...,"~ I <9ACORO CORPORATION 1988 ACORD 25-S (7/97)