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<br />~CORD~ CERTIFICA TF OF LIABILITY INSUR.A NCE I DATE {MM/DDNY) <br />01/17/2002 <br />PRODUCER (949)553-9700 FAX (94 53-9797 THIS CERTIFICATE IS I D AS A MATTER OF INFORMATION <br />Westland Insurance Brokers ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />2192 Martin Street, Suite 130 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Irvine, CA 92612 INSURERS AFFORDING COVERAGE <br />INSURED Oelhl COlll11nunlty Center INSURER A TRAVELERS INSURANCE COMPANY <br />505 South Central Ave. INSURER 8: TRAVELERS PROPERTY CAS INS CO <br />Santa Ana, CA 92707-3504 INSURER C <br /> INSURER 0 This Certificate Super cedes <br />I INSURER E: All Previously Issured. <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 />I~-f: TYPE OF INSURANCE POLICY NUMBER P~kl~~riMI8DtVYf D~!fE f~"MJb'jj~" LIMITS <br /> ~NERAL LIABILITY 660-818X4872 12/14/2001 12/14/2002 EACH OCCURRENCE $ I,OOO,OO~ <br /> X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Any 0118 fire) $ 100,00~ <br /> I CLAIMS MADE [!] OCCUR MED EXP (Anyone person) $ 5,OO~ <br />A PERSONAL & ADV INJURY $ 1,000,000 <br /> GENERAL AGGREGATE $ 2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS. COMP/OP AGG $ 2,OOO,OO~ <br /> II ,nPRO- n <br /> POLICY JEer lOC <br /> AUTOMOBILE LIABILITY 103123W685-01 12/14/2001 12/14/2002 COMBINED SINGLE LIMIT <br /> - (Eaaccidenl) $ I,OOO,OO~ <br /> - ANY AUTO <br /> - ALL OVVNEQ AUTOS BODILY INJURY <br /> (Per person) $ <br /> SCHEDULED AUTOS <br />B X <br /> HIRED AUTOS BODILY INJURY <br /> X (Peraccklent) $ <br /> .:..:.. NON-OWNED AUTOS <br /> - PROPERTY DAMAGE $ <br /> (Per accident) <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ <br /> l ANY AUTO OTHER THAN EAACC $ <br /> AUTO ONLY: AGG $ <br /> EXCESS LIABILITY ..UP 3289W520 12/14/2001 12/14/2002 EACH OCCURRENCE $ 1,000,000 <br /> !J OCCUR D CLAIMS MADE AGGREGATE $ 1,000,00~ <br />B $ <br /> ~ ~EDUCTIBLE $ <br /> X RETENTION $ 10 , OOC $ <br /> WORKERS COMPENSATION AND I TO~-7 LrMlfs I IUER - <br /> EMPLOYERS' LIABILITY E.L EACH ACCIDENT $ <br /> E.L DISEASE - EA EMPLOYE $ <br /> E.L DISEASE - POLICY LIMIT $ <br /> 1k'll~'ERTY 660-818X4872 12/14/2001 12/14/2002 BUILDING $3,903,OI8/RC <br />A OED $2,500 BPP $150,000 <br /> SPECIAL FORM/COIN 100% BI W/EXTRA EXPENSE $300,000 <br />DESCRIPTlON OF OPERA TlONSlLOCA TlONSlVEHICLESJEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISION:~ <br />he City of 5anta Ana is named as Additional Insured as per CN0188 ~E~OJl~~C99t()Rld <br />nd Exhibit B attached with respects to the operation of the Named ~ <br /> - "- <br />Except 10 days for Non-payment of Premium. 'CftISTINE LEE SHAW <br /> Deputy City Attorney <br />CERTIFICATE HOLDER I I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> EXPIRATION DATE THEREOF, THE ISSUING COMPANYWILL~~ MAIL <br /> Jeff Stevens, Risk Manager *30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br /> City of Santa Ana 1lIXIlllOOI~KJ(atI0IlllllXlIIlIlOOWIIll>>llll~XX <br /> 20 Civic Center Plaza, M28 ~llJ( ~~XXXXXXXX <br /> Santa Ana, CA 92701 AUTH lY7b7E .( ~ <br /> (1;,.1 / . /,2 7/)1 <br />ACORD 25-5 (7/97) / f I ' @ACORD CORPORATION 1988 <br />