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Dec 10 2007 1:04PM <br />71415-1464 P.1 <br />ACORD. CERTIFICATE OF LIABILITY INSURANCEDATE1 <br />MNI1DD/YYYY) <br />PRODUCER 5 <br />AN <br />General Ins. Agency, In <br />2165 N. GlasaelI Street <br />Orange, CA 92865A-67,006- <br />- � 00 6 .. 1 03 <br />714-685-1421 A <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />THE CERTIFICATE <br />ONLY Npollo <br />HOLDER.HISOCERTFICANFERS OTERDO SSONOTAMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />INSURERS AFFORDING COVERAGE NAICB' <br />INSURED R. V. Thomas Inc. dba <br />Went Coast Laced Clearing <br />P. O. Box 90126 <br />Long Beach, CA 30809-0121 <br />WSSTO2 <br />INSURER A: Interstate F&C Insurance Co. <br />INSURER 8: Cent -National Inauraaee CO. <br />INSURER C: FjreMans Fund Insurance Co. <br />INSURER D: State C*= en8ati0A Ina. Fund <br />INSURER E: <br />rnVCDAl2PS` <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 <br />DD'Lam <br />OF WSLJRAMCF <br />POLICY NUMBER <br />-- <br />POLICY EFFECTIVE <br />POLICY EXPIRATION <br />LIMITS <br />A <br />GENERAL LIABILITY <br />n,M1000075 <br />09/17/2007 <br />09117/2008 <br />EACH OCCURRENCE I 1000000 <br />X COMMERCIALGENERAL LIABILITY <br />P ER MSE T Me o RENTED B 300000 <br />CLAIMSMADE ® OCCUR <br />MED EXP(AnyOne Person) $ 5000 <br />PERSONAL& ADV INJURY 4 1000000 <br />X Demolition prograti <br />GENERAL AGGREGATE 4 2000000 <br />GEN'L AGGREGATE LIMIT APPLIES PER. <br />PRODUCTS - COMP/OP AGG E 2000000 <br />PCUCV R PRO- LDC <br />B <br />AUTOMOBILE <br />u <br />LIABILITY <br />ANYALI'f0 <br />2RP1"334 <br />09/17/2007 <br />09/17/2008 <br />COMBINED SINGLE LIMIT <br />(Eaeccidet) 6 1000000 <br />BODILY I NJURY <br />(Per Dares) i <br />ALL O W NW AUTOS <br />SCHEDULED AUTOS <br />BDDILYIPLIURY 0 <br />(Peraccla" <br />R <br />X <br />HIRED AUTOS <br />NON-OWNEDAUTOS <br />PROPERTY DAMAGE 0 <br />(Peracddeml <br />GARAGE LIABILITY <br />-711 <br />AUTO ONLY -EA ACCIDENT I <br />OTHERTHAN EA ACC 6 <br />ANYAUTO <br />f <br />AUTOONLY: AGO 6 <br />EXCESSIUMBRELLA LIABILITY <br />EACH OCCURRENCE 6 <br />OCCUR F7 CLAIMSMADE <br />AGGREGATE 6 <br />6 <br />0 <br />DEDUCTIBLE <br />0 <br />RETENTION <br />D <br />WORKERS COMPENSATION AND <br />1,877734 <br />10/27/2007 <br />01/01/2008 <br />WCSTATU- OTH- <br />X TORYLIMITA FIR <br />EMPLOYERS' LIABILITY <br />ANY PROPRIETORIPARTNERIEXECUTIVE <br />E.L EAC -i ACCIDENT 0 1000000 <br />E.L. DISEASE- EA EMPLOYEE 0 1000000 <br />OFFICEWMEMBER EXCLUDED? <br />If yea, decor be under <br />SPECIAL PROVISIONS below <br />E. L. DISEASE- POLICY LIMIT 4 1000000 <br />C <br />OTHER <br />""98123360 <br />09/17/2007 <br />09/17/2008 <br />Each Item 500000 <br />Rented/Leased Squipme <br />Aggr 500000 <br />DESCRIPTION OF OPERATIONS! LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY EN DORSE'M ENT / BPEMAL PROVISIONS <br />It is agreed The City of Santa Am&, Its Officers and Employees are named as Additional Insured as <br />respect& all operations of the named insured. Refer to Endorsement W/Primary attached. <br />CITY OF SANTA APPA <br />Public Works Dept. <br />20 Civic Canter Plaza M-36 <br />P.O. Box 1988 <br />Santa Ana, CA 92702 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL11;'Y�MAIL 3 0 DAYS WRITTEN <br />NOTICE TO THE CERTIIRCATE HOLDER NAMED TO THE LEFT.�����. <br />ACORD 25 (2001108) 1 c ACORD CORPORATIO <br />