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0!19/200E 09:5Ft '14'I23790 SIMPLEXGRINNELL PAGE 02 <br />CERTIFICATE OF INSURANGE CERTIFICATE NUMBER <br /> ^518^3 <br />PRDUUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLT ANb CONFERS NO RIGHTg <br /> NPON THE CERTIFICATE HOLDEP OTHER THPN TH OBE PRpYIOED IN THE POLICY. THIa <br /> LERbFILATE ODES NOT AMEND, E%TENp OR 4LTER THE COVERAGE PFFORDEb BT THE <br />Marsh, In C. POLICIES DESCRIBED HEREIN. <br />1166 Avenue of the Americas <br />New VGrk, NV 10036 I COMPANIES AFFORDING COVERAGE <br />Telephone (212) 395-$000 COMPANY A: AI SGU[h Insurance Co. <br />~k - <br />~fJO 3 -/ k9 COMPANY B: American Home Assurance Co. <br />a <br />INRUaED COMPAN\' C: Illinois Naiianal InsurancE Co. <br /> <br />~ <br />~ COMPANY' p', InguranCe Company DF the S[all3 at PA <br />SImpIISkGrinnell, LP ~~ ~ <br />' o <br />~d <br />GOMPANV E: Nalionel Union Fire IngNranCC Co <br />1701 WEST SEQUOIA AVE /L <br />ORANGE, CA 92668 A - T~Gd Jam= r~.~.3 . <br />- COMPANY F. New HamDShire Ins. Go. <br />United 5(a[e5 : COMPANV G: New Vprk Marine & General InguranCe Ca (Lead) <br /> GOMPANI` H' Noetic 5 eciRll ~ Insurance GDm anV <br />COVERAGES <br />THI51$ i0 GERiIFY THAT THE POVCIE'c OF INg URANEr- IIF.SORIDED HERE Irv HnvF. BF. F N ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />AN1' REOUIRMENTg. TERM OR CONDITION OF ANY CONTItACT OR OTHER UOCLMENI WITH RESPECT TO WHICH THE CFRTIFI(:ATE MAV eE I$gUED OR MAY PERTAIN. THE INSURANGE <br />AFFORDED av THE POLIOIE$ LISTED HEREIN IS GVeJELT-O PI L THE TCRId$. CONDITIDrvS Arv0 EXCLUSIONS OF SUCH PpLILIES AGGREGATE UMITg $H01YN MAV HAVE BEEN HFDVCEO Mr <br />PAID CLAIMS. <br />CO TTPE OF IN9URANCE POLICY NUMBER IPOMC'EFFELTIVE POLICY E%PIgATION LIMITS <br />4Tq !DATE {MMIOO/YYI DATE IMMIOOr1Y{ <br />EI cENEkAL UPgILITY RMGL.S7d970P 10!1 /2005 10!1!2006 GENERAL AGGREGATE . $15,000,000.00 <br />X' COMMERCIAL GENERAL UABILIn' PRODUCTS-COMP/OP AGG $15.ODO.000.DO <br />CLAMS MADE X OCCUR PERSONALBADV MJURV ~ $7,500,000.00 <br />OwNER'S LCONTRALTOR'$ PROT EACH OCCURRENCE <br />$7,500,000.OD <br /> <br />I - <br />r-IRE DAMAGE IAny nn¢iirrtl $1,000,000.00 <br /> - MED EkF !Any Pne p8r6pn) $10,000.00 <br />B AUTOM081LE UABarrr RId CAOD17798 (TX) -1011/200$ 10/1!2006 COMHINEO SINGLE LIMIT $7500,000.00 <br />B ;x ~ AN1' AUTO : RM CA301%?99 (A05) 10/1/2005 10/1!2006 - <br />RMCA301779T (MAI <br />6 10/1!2005 10!112DD6 <br />n <br />Auowcp AU+DS <br />B RMCA301T796 (VA) RDC <br />(Y INJURY (Pe~uP•enel <br />10!1/2005 10/1/2006 <br />SGHEDPLEO AUTOS <br />X ~HIRFA AUTD$ BDDII I'.NJURY (Pe~PCdtle~O <br />J( ~NON.pWNEO AUTOS <br />' ~ PROPERTY DAMAGE <br />PgGPERTY <br />i <br />' EXCEEB LIABILITI' EACH OGCUHRErvCE i <br />UMBRELLA FORM AGGREGATE <br />' jOTHEH THAN UMakELLA FORM ~ ~ ~~ <br />9 WDRKER6GONPENEATION AND SEE PAGE TWO SEE PAGE TWO SEE PAGE TWO }( ~` '^" ~ °" <br />',~~~1 I,,~. <br />'~' <br />E EMPLOYERS'LIAEILRY - ~ <br />. <br /> <br />0 EL EACH AcoDENr $2,OOD,000.OD <br />THE PRDPRI ETDR~ <br />L ' PAFTNEHSIEXFCUTIVE INCL .._ <br />EL DISEASE-POLICY LIMIT $2,000.OOO.DO <br />F nFFlCERE ARC EkCI. EI. DISFASF,.EACH EMPLOVEI $2,000,000.00 <br />'OTHER <br />APPR~:~~/rw;3 ~S ~Q :1r <br />t <br />i <br /> , <br />: <br /> <br /> ~- _ <br />DEBLRIPTIDN DF OPERATIONSILOCATIONSrvEHICLESISPECIAL ITEMS ~ -+.-_~.,-..- <br /> <br />Please sae page 2 for atldl[ipnal insureds and any addi[i0nal IangUagP-. A581S1 <- ~ cuL9Ci@y <br />CERTIFICATE HOLDER CANCELLATION <br />CITY G F SANTA ANA ~ <br />y <br />D <br />; 'B <br />P <br />1 <br />J <br />I <br />~ <br />J <br />N <br />N <br />I <br />[N <br /> <br />ATTN; PURCHASING DEPAR7AdENT tlVRkN APE <br />Np~ND V, <br />w <br />(ripFA(]I' <br />V <br />N <br />L J <br />•uNU <br />[N <br />Np <br />I <br />- CG TO!HE <br />CERT'F Gn <br />VOIOEN NgwED HEgF'N, <br />20 CI'JIC CENTER PLAZA <br />SANTA ANA, CALIFORNIA 92701_np10 MAR5H US41NC. eY: <br />KPINEnnp O'LPPry. GP61iPIly PrAgmm ~]lv <br />. <br />~~~!/l.n/ <br /> , <br />~ <br />rr <br /> MM1(3fD2) VALID AS OF: 211 612 0 0 6 <br />(O . ~. <br />