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05/31/2007 20:24 FAX 202 331 1598 TAE FERGUSOV GROUP <br />f~ 002/004 <br />f~- 2llr ,i...- r5! <br />ACORd CERTIFICATE OF LIABiLtTY INSURANCE DATE (MWDDIYYYY) <br /> 4/18/2007 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS MATTER OF INFORMATION <br />State-Farm Insurance, Pat ^ady -Agent ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />15215 Shatly Gxove Road, Suite 102 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />Rockville, MD 20850-3235 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />i <br /> INSURERS AFFORDING COVERAGE NAIC A <br />~~ INSURER A; State Farm Fize and Casuelt Com an 25193 <br />THE FERGUSON GROUP LLC <br /> <br />SUITE 30D INSURER B. <br /> <br />1130 INSURER C: <br />CONNECTICUT AVE NW <br />WASHINGTON DC 20036-3981 <br />wSURER D: <br /> <br /> MSURER E: <br />THE POLICIES OF N95URANCE 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 WRH RESPECT 70 WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, 7HE INSURANCE AFFORDED BV 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 />BSR ADDL POLIOY EFRECTN'E POLICY EANRATION <br />LTA NSRO TYPE OF N$URANCE POLICY NUMBER DATE NYA) OATS Y LINR$ <br />X X GEN 9tAL LU1BRfIT 99-HU-8962-7 4/8/07 9/B/OB EACH OCCURRENCE S 1, ODD, OCO <br /> Y COMMERCIAL GENERAL LIABILITY PREMISES Ea ocMarica 3 100,000 <br /> CLABAS MADE ~OCCU0. MEO E%P oM S 5,000 <br /> X Hired Auto PERSONAL $ADV INJURY S 0 <br /> X NOOOWI:ed Auto OENEMLAGGREGATE 000 <br />3 2 <br />000 <br /> GEMAfIOgEGATELnTrAJnESrfR <br />PR PROd/CTS-CONIPXIPRGG , <br />, <br />s 2, 000, 000 <br /> O- <br />POLICY JECT LOC <br /> AUT OMOBILE DABILM COMBINED SwGLE LIM17 <br /> <br />ANY AUTO <br />i <br />TEA ercEaN) f <br /> -t, <br /> ALL OMMED AUTOS ~. n.D ~ <br />.-~~ BODILY INJURY <br /> SCMEDULEO AUTOS ,~ <br />'^'- ~ - (PM Wrenn) f <br /> HIRED AUTOS / <br />/ ~ <br />- -' BODILY IWURV <br /> <br />NON-01VNED AUTOS <br />(Par °Of dW) 3 <br /> ~ PROPERTY DAMAGE <br /> _ 1 <br />I ' 1 ,. f <br /> „I <br />. (Par acdBenl) <br /> GARAGE LIA&LITY AUTO ONLY-EA ACCIDENT 3 <br /> ANY AUTO OTHER THAN ER ACC f <br /> AUTO ONLY: <br /> AGG <br />X E%GESSNMBRELLA LIABILT' 99-BU-8978-1 9/8/07 9/6/08 EACH DCC RRENCE s 4,000,000 <br /> ~X OCCUR ~ClAAlS MADE AGGREGATE S 4.000,000 <br /> S <br /> DEDUCTIBLE <br />3 <br /> X RETENTION 510000. <br /> f <br />X YNDRKERS COYPENSATIONAND <br />EMPLOYERS' LUIBILI7Y 99-M3-2190-3 9/8/07 4/8/OB X <br /> TGRY IBnrs <br />ER <br /> RNY PROPRIETORIPARTNERIE%ECIJfIVE <br />OFFICERAJEMBER EXCLUOE09 E.L EACH ACCIDENT S 1,ODOr 000 <br /> I/yyea, deaaEe under E.LDISEASE-EA EMPLOYEE f 1,000,000 <br /> SPECIAL PROVISIONS bMVa E.L. DISEASE-POLICY LNAR S 1,000,000 <br /> OTHER <br />DESCRIPTION OF OPERATONB J LDCATION$ J VEHICLES / EXCLU$K)NS ADDED BY EMDOR$EMEN71 $PECUIL PROVISIONS <br />ne nt, ~,w •~~ . <br />~~ VAMeVCLLIAI IVw <br />City of Santa Ana Its Officers JIOIAD AYY GF THE ABOVE OGYCAlBED PODIaP9 BE CANCq,en B60RE TI1E F1aNATKw <br />Employees, Agerit S, Vol Untee r3 & Repxe 50ntativeS DATE THEREOF, 7NE ISSUING INBURER MALL ENDEAVOR TO MAIL Tye DAYS WRITTEN <br />ZO C1V1C Center Pld Za NOTICE TOTNE CERTIFICATE HOLDER NAMED TO THE LEFT, BUi FAIWRE TO DO 30 SHALL <br />Santa ARa CA 927 O1 IMPOB! NO OBLHMTKNI OR UABILM OF ANY KIND UPON TXE INSURER, ITS AGENTS OR <br />Pat Dady, Agent 301-948-4914 <br />102849 <br />