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1 1. <br />A <br />CORO CERTIFICATE OF LIA <br />BILITY INSURANCE <br />TE low YYYYI <br />DA <br />III /8/2009 <br />11 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> <br />Apollo General Insurance. Agency, 1. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />P. O. Box 1508 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Sonoma, CA 95476 <br /> INSURERS AFFORDING COVERAGE NAIC # <br />INSURED INSURER A: Interstate Fire & Casualty Company 22829 <br />J&G Industries, Inc. <br />18627 B <br />S INSURER B: The American Insurance Company 21857 <br />m t <br />treet <br />Fountain Valley <br />CA 92708 8 <br />alley INSURER C: Torus Speciality Insurance Company 44776 <br />, <br />, INSURUZ D: Westchester Surplus Lines Insurance Company 10172 <br /> NSURER E: <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 />INSR DO' <br />?F OF INSURANCE <br />POLICY NUMBER <br />OLICYEFFECTIVE <br />PDATE MMAnDIYYfYI <br />POLICYEXPIRATION <br />DAM IMMMD?t <br />LIMITS <br /> GENERAL LIABILITY DAN1000148 11/1/2009 11/1/2010 EACH OCCURRENCE $ 1,000,000 <br />A ? COMMERCIAL GENERAL LIABILITY DAMAGE T HEWED <br />P MI E E <br />$ 300,000 <br /> CLAIMS MADE ? OCCUR MED EXP (Anyone person) $ 5,000 <br /> PERSONAL&ADV INJURY E 1 <br />000 <br />000 <br /> , <br />, <br /> GENERAL AGGREGATE $ 2 <br />000 <br />000 <br /> , <br />, <br /> GEN•L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OPAGG $ 2,000,000 <br /> POLICY PRO LOC <br />IFCT <br /> AUT OMOBILE LIABILITY MXAS0276001 II/1/2009 11/l/2010 <br /> ? COMBINED LIMIT <br />IS 1 <br />000 <br />000 <br />B ANY AUTO . <br />, <br /> ALL OWNEO AUTOS <br /> <br />? <br />SCHEDULED AUTOS W'A. <br />NING: Additional Ins <br />ured BODILY INJURY <br />IPer person) IS <br /> ? HIRED ALTOS SiWll, only Valid if require by BODILY INJURY <br /> <br />? <br />NON-OWNEDAUTOS <br />wrt't <br /> <br />T <br />(Per ecddenq $ <br /> n c[ <br />ntrnct executed rior to <br /> <br />? <br /> <br />Autos S ecifiedOn e <br /> <br />SS. CoVeraDe IS Iimite <br /> <br />as per PROPERTY DAMAGE <br /> <br />lPer accident) <br />$ <br /> GAR AGE LIABILITY term an conditions in pol icy. AUTO ONLY-EA ACCIDENT $ <br /> H ANYAUTO EAACC <br />OTHER THAN IS <br /> <br />1 AUTO ONLY: AGG $ <br /> <br />C EXCESSI UMBRELLA LIABILITY <br />TUS-02-2009-5016 <br />11/1/2009 <br />11/1/2010 <br />EACH OCCURRENCE <br />$ 5.000,000 <br /> ? <br /> OCCUR CLAIMS MADE AGGREGATE S <br /> E <br /> DEDUCTIBLE $ <br /> RETENTION $ T? <br />APPROVED AS TO F oRim E <br /> WORKERS COMPENSATION <br />WC STATU- OTH- <br />1 <br /> <br />AND EMPLOYERS' LIABILITY 3Y LIMITS ER <br /> ANY PROPRIETORIPARTNENEXECUTIVE? <br />OFFICEMEMBER EXCLUDED? E. L. EACH ACCIDENT S <br /> (Mandator <br />in NH) <br /> y E.L. DISEASE - EA EMPLOYE $ <br /> B e;de.nt,eunder Laura [ -Sheed <br />y <br /> SPECIAL PROVISIONS neIOw E.L. DISEASE - POLICY LIMB $ <br />D OTHER an I y llorHeV G? lASgreSem: 1,000,000 <br /> Pollution Liability G22063959006 <br /> 11/1/2009 11/1Y2010 <br /> Cumrsaor: Penwroa: 1,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br />Re: Multi Site Demolition 2 Project. The City of Santa Ana, it's officers, agents, & employees. Additional Insured coverage is included if required by written contract per <br />endorsement hereto. <br />CERTIFICATE HOLDER CANCELLATION 10 Dav Notice For Non-Pavmcnt of P.iam <br />Holder's Nature of Interest: Certi licate Holder SHOULDANYOFTHEABOVEDESCRIBEDPOUCIESBECANCELLEDBEFORETHEEXMRAMON <br /> DATE THEREOF, THE ISSUING INSURER WILLX& dd{Ax)dWgb MAIL 3D DAYS WRITTEN <br />City of Santa Ana NOTICE TO THE CERTIFICATE HOLDER NAMEDTO THE LEFT]BUi1BMQURB(IIXBBNW911MILL <br />20 Civic Center Plaza M36 xEUptlYYGD1iYItlNtNXYBRxXAA7lwxiudKYANYVLa[i1tlkYVCIRCYRtt87Bi]RB'RF74?wBtR <br />Santa Ana, CA 92701 x# <br /> AUTOO R • S T (WD <br />ACORD 25 (2009101) 0 1988.2009 A66RD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD