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<br /> ---- I <br />M22BIl CERTIFICATE OF LIABILITY INSURANCE DATE (MMJDO/VYYY) <br />03/27/2006 <br />PROduCER (&00)524-7024 FAX (800)524-4013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Automatic Data Processing Insurance Agency, Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />1 ADP Boulevard ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Roseland, NJ 07068 <br /> INSURERS AFFORDING COVERAGE NAIC# <br />INSURED Hygiene Technologies International Incc INSURER A:. Employers Compensation Insurance Co <br /> 3625 Del Amo Blvd N - ;AfJo;!-/;J.;J.. INSURER B: <br /> Torrance, CA 90503 N - d-.t'o",).,-r::>..:2,O;J. INSURER C: <br /> 310 370 2474 Attn: Jenne ;1-~OD3 - 0/3 INSURER D: <br /> INSURER E: <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 REOUIREMENT, 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 BYTHE 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 />~~~ ~a~~ TYPE OF INSURANCF; POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS <br /> ~NERAL LIABILITY EACH OCCURRENCE $ <br /> COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ <br /> 1 CLAIMS MADE 0 OCCUR MED EXP (Anyone person) $ <br /> - PERSONAL & ADV INJURY $ <br /> GENERAL AGGREGATE $ <br /> ~'L AGG~nE LIMIT APPLIES PER: PRODUCTS. CQMPfOP AGG $ <br /> PRO- n <br /> POLICY JECT LOC <br /> ~OMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> ANY AUTO (Eaaccidenl) <br /> - <br /> - ALL OWNED AUTOS BODILY INJURY <br /> $ <br /> SCHEDULED AUTOS (Per person) <br /> - <br /> - HiRED AUTOS BOalL Y INJURY <br /> $ <br /> NON-OWNED AUTOS (Peraccidenl) <br /> - <br /> PROPERTY DAMAGE $ <br /> (Peraccidenl) <br /> ~:GE lIABIUTY AUTO ONLY - EA ACCIDENT $ <br /> ANY AUTO OTHER THAN EA ACC $ <br /> AUTO ONLY: AGG $ <br /> OESSlUMBREllA LIABilITY EACH OCCURRENCE $ <br /> OCCUR 0 CLA!MS MADE AGGREGATE $ <br /> $ <br /> R DEDUCTIBLE $ <br /> RETENTION $ $ <br /> WORKERS COMPENSATION AND ADP-33169901 01/01/2006 01/01/2007 X I T'X~"';tI,~~ I IOJ!,'- <br /> EMPLOYERS' LIABILITY 1,000,00C <br />A ANY PROPRIETOR/PARTNER/EXECUTIVE E.l. EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? E.L. DISEASE. EA EMPLOYEE $ 1,000,00C <br /> If yes, describe under I,OOO,Ooe <br /> SPECIAL PROVISIONS below E.l. DISEASE. POLICY LIMIT $ <br /> OTHER <br /> "\ ,-:-_T)D --~ " '" TO '-'). - <br /> .'_,,-i..'_ - .j. i ("U <br />DESCRIPTION OF OPERATIONS f lOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br /> ____~.-LL'L <br /> '--':~ l r" '.: : ~ _, _~ '- '.' j <br /> /\-,...;,i:."t: ....:,lv Ai l-~':' <br /> <br />CERTIFICATE HOLDER <br /> <br />CANCELLATION <br /> <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />City of Santa Ana EXPIRATION DATE THEREOF, THE ISSUING INSURER WilL ENDEAVOR TO MAIL <br />Risk Management ~ DAYS WRITTEN ~OTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />Emil yn Burnatae BUT FAilURE TO MAIL SUCH NOTICE SHAll IMPOSE NO OBLIGATION OR LIABILITY <br />POBox 1938 M- 28 OF ANY KINO UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. <br />Santa Ana, CA 92702 AlITHORIZED REPRESENTATIVE ~~~:.,'~ <br /> Richard GossettjVAL <br /> <br />ACORD 25 (2001108) FAX: (714)647-5311 <br /> <br />@ACORD CORPORATION 1988 <br /> <br />c 9., <br /> <br />