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trnentg: zya55 DOTYBRO <br />ACORD-, CERTIFICATE OF LIABILITY INSURANCE 10/1 05°""""' <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />USI Irvine - C/L ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />'-ic## 0351162***949-790-9339(Suzan) HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />O Box 53310 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Irvine, CA 92619-3310 A _/!Z INSURERS AFFORDING COVERAGE NAIC # <br />INSURED INSURER A, American Int'l Speciality AIG <br />Doty Bros. Equipment Co. INSURER B: National Union Fire of PA AIG <br />11232 E. Firestone Blvd. <br />Norwalk, CA 90650 INSURER c: American Home Assurance AIG <br />INSURER D: <br />INSURER E: *10 day notice nonpay <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 />LTR <br />INSRN <br />TYPE OF INSURANCEPOLICY <br />NUMBER <br />POUCY EFFECTIVE <br />DATE M DD <br />POLICY EXPIRATION <br />DATE WDD <br />LIMITS <br />A <br />GENERAL LIABILITY <br />GL1558660 <br />10/11/05 <br />10/11/06 <br />EACH OCCURRENCE Si 000000 <br />X COMMERCIAL GENERAL LIABILITY <br />DAMAGE TO RENTEDPREMISES (Ea n $50 ,000 <br />MED EXP (Any one person) $5,000 <br />CLAIMS MADE Fx_1 OCCUR <br />X BFPD/XCU <br />PERSONAL & ADV INJURY $1,000,000 <br />x Contractual <br />GENERAL AGGREGATE s2,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMP/OP AGG $2,000,000 <br />POLICYX JECT LOC <br />BI/PD SIR $500,000 <br />B <br />AUTOMOBILE <br />UABIUTY <br />CAS262183 <br />10/11/05 <br />10/11/06 <br />X <br />ANY AUTO <br />COMBINED SINGLE LIMIT <br />(Ea accident) S1,000,000 <br />X <br />ALL OWNED AUTOS <br />BODILY INJURY <br />$ <br />SCHEDULED AUTOS <br />(Per person) <br />X <br />HIRED AUTOS <br />BODILY INJURY S <br />X <br />NON -OWNED AUTOS <br />(Per accident) <br />x <br />Comp $1,000 <br />Applies to 2003 <br />x <br />and newer cars <br />only <br />PROPERTY DAMAGE <br />(Per accident) S <br />Coll $1,000 <br />GARAGE LIABILITY <br />- <br />AUTO ONLY - EA ACCIDENT S <br />OTHER THAN EA ACC S <br />ANY AUTO <br />AUTO ONLY: AGG S <br />EXCESS/UMBRELLA LIABILITY <br />EACH OCCURRENCE $ <br />OCCUR ā‘ CLAIMS MADE <br />AGGREGATE S <br />S <br />DEDUCTIBLE <br />S <br />RETENTION S <br />S <br />C <br />WORKERS COMPENSATION AND <br />WC1347153 <br />10/11/05 <br />10/11/06 <br />X WCS IIMIT OTH- <br />EMPLOYERS' LIABILITY <br />E.L. EACH ACCIDENT S1,000,000 <br />ANY PROPRIETORIPARTNER/EXECUTIVE <br />OF EXCLUDED? <br />E.L. DISEASE - EA-ELIPLOYEE 51,000,000 <br />If yes, describe under <br />s, describe and <br />SPECIAL PROVISIONS below <br />E.L. DISEASE - POLICY LIMIT $1,000,000 <br />OTHER <br />DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br />RE: City of Santa Ana On Call Emergency Agreement <br />City of Santa Ana, its officers, employees, agents, volunteers and <br />representatives are included as additional insureds as evidenced by <br />attached endorsement. <br />f <br />City of Santa Ana <br />Public Works Agency <br />220 S. Daisy Ave., M85 <br />Santa Ana, CA 92702 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILLKDOCaUUM MAIL *3A DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />REPRESENTATIVE <br />-­._ Iā€” ­-, 1 oT z 1FMj;LUL"L1 SMZ 0 ACORD CORPORATION 1988 <br />