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<br />-~ DATE (MM/DDNYVY)
<br />ACORDM CERTIFICATE OF LIABILITY INSURANCE OP 10 J1!
<br />LAR.GE-2 10/05/07
<br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br />ISU Insurance Services- ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />The Roger stone Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br />5015 Birch street AL TER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />Newport Beach CA 92660
<br />Phone: 949-757-0270 Fax:949-757-0375 INSURERS AFFORDING COVERAGE NAIC#
<br />INSURED -
<br /> A-&. 00 ~ ~ O';() INSURER A Hartford Fire Ins CO
<br /> INSURER B
<br /> L~rge Screen Display Rentals INSURER C
<br /> K~rsten Hausman
<br /> 3401-3403 W. MacArthur Blvd INSURER D
<br /> Santa Ana CA 92704
<br /> INSURER E
<br />
<br />COVERAGES
<br />
<br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED ~WAED ABOVE FOR THE POLICY PERIOD INDICATE:> NOTWITHSTANDING
<br />MY REQUIREMENT, TERM OR CONDITION OF MY CONT~i\CT OR 01HER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
<br />MAY PERTAIN, TH= INSlJ1MCE !"=FORDED BY THE POc,CIES DESCRIBED HEREIN IS SUBJECT ,0 ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
<br />POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDLX:EO BY PAID CLAII'.'S,
<br />LTR NSRC TYPE OF INSURANCE POUCY NUMBER I PD'M'{MMfDOmt DATE (MMIODIYY) UMITS
<br /> GENERAL LIABILITY EACH OCCURRENCE $J ,.QQ.Q,09()
<br /> f-- .... .. ., " '."'" . .'. -~~'-- -. - - .'~ .. .
<br />A X X COMMERCIAL GENERAL LIABILITY 72CESOl!'0047 09/19/07 09/19!-08 PREMISES (E~':~~~';.';MCe) iMO,OOO ,)
<br /> f-- :=J CLAIMS MADE o OCCUR , . ,~
<br /> f-- MED EXP (Any'one person) n.O ~ 900' '..~ .
<br /> ,. PER"'O~ &ADV INJu~l' .;d..,:ooo,ooo
<br /> f--
<br /> GENERALAGGflEGA'TE; : $2, QO,O, 000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS. cbwlOP AGG $2t,MO,000
<br /> Xl n PRO- nLOC
<br /> X POLICY JECT
<br /> AUTOMOBILE LIABILITY ;,- ". ;;. ",' C6MBINED SINGLE LIMIT "-i, j'" )
<br /> I-- $
<br /> ANY AUTO -- :(Eaacci.d~t) .:\'
<br /> ~
<br /> - ALL OWNEDAUTOS BOOIL Y INJURY $
<br /> SCHEDULED AUTOS (Per person) ,
<br /> - .. .
<br /> HIRED AUTOS BOD 1 Y INJUR Y
<br /> f-- $
<br /> NON-OWt;EJ AUTOS (Per accident)
<br /> f-- .' ,.. ... .',.. _......._...r.~.~'_...._. """"'d ~ -- ...~. - ..",-,.., 0'_''" ...__.'
<br /> .'. . RROPERTY- DAMAGE. ,.. $ ,- ..... '-, .._..",~
<br /> Iper accident)
<br /> GARAGE LIABILITY AUTO ONLY. EA ACCIDENT $
<br /> ~ MY AUTO OTHER THAN EAACC $
<br /> AVTD ONLY: /lI3G $
<br /> EXCESSJUMBRELLA LIABILITY EACH OCCURRENCE $
<br /> ..J OCCUR LJ CLAIMS MADE ~ ------ --
<br /> AGGREGATE $
<br /> $ .
<br /> ==1 DEDUCTIBLE $
<br /> RETENTION $ $
<br /> WORKERS COMPENSATION AND APPRO' E:) (:" l,.J t'u IVI ITO~\ t:~I% I IV~~
<br /> EMPLOYERS' LIABILITY
<br /> !>N'I PROPRIETOR/PARTNER/EXECUTIVE ~h~~ EL EACH ACGJDENT $
<br /> OFFICERlMEMBER EXCLUJED? f~II~- ." $
<br /> .EL DISEASE - EA EMPLOYEE
<br /> If.yes, cescribe under .-
<br /> SPECAL PROVISIONS below ---,P . . E:L. DISEASE - POLICY LIMIT $
<br /> .. . "
<br /> OTHER , ~... .~.',. ,.
<br /> A ~si ~ t:', It .'-or -" .,
<br /> , j
<br /> '"
<br /> ,
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
<br />RE: Audio & visual conSUlting for the Santa Police .. .. -- .... .
<br />Ana Dept.
<br />Certificate Holder is named Addi tional Insured. .. ..
<br />*10 day notice of cancellation for non-payment of premiwn. .
<br />**Revised**
<br />
<br />CERTIFICATE HOLDER CANCELLATION
<br />CITYSA6 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES 6E CANCELLED 6EFORE THE EXPIRATION
<br />DATE THEREOF, THE ISSUING INSURER WILL E~AJL * 3 0 DAYS WRITTEN
<br />
<br />Ci ty of Santa Ana Police Dept. ----
<br />60 Civic Center Plaza
<br />P.O. Box 19B1
<br />Santa Ana CA 92702
<br />
<br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT F~JllX>1!XXmlliHALL
<br />
<br />HW~~'AIljI\lIQ""WIi~~vqNQ~~tl~WW~
<br />~~~V.V\ijiS,
<br />
<br />~REt::.Xr.E
<br />
<br />
<br />@ACORD CORPORATION 1988
<br />
<br />ACORD 25 (2001108)
<br />
<br />
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