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<br />
<br />.
<br />
<br />HARRAND-Ol
<br />
<br />AFDI
<br />
<br />PRODUCER
<br />Diversified Risk Insurance Brokers
<br />License #0529776
<br />5900 Christie Avenue
<br />Emeryville, CA 94608
<br />
<br />~URED Harris and Associates Inc.
<br />AUn: Susan Mandilag
<br />120 Mason Circle
<br />Concord, CA 94520-1238
<br />
<br />(510) 547-3203
<br />
<br />DATE (MMIDDNYYY)
<br />7/25t2006
<br />
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />
<br />!
<br />, NAIC#
<br />---T-------- ---
<br />
<br />I
<br />
<br />ACORD,.
<br />
<br />CERTIFICATE OF LIABILITY INSURANCE
<br />
<br />INSURERS AFFORDING COVERAGE
<br />
<br />_INSU~R~_~tIClntic: _~p~.c~alty In.surance Comp'~r~y.
<br />I INSURER 8: Hartford Fire Insurance Co. ;
<br />: INSU-~~~~: American Guarantee-s..-i..iabili!Y--T----
<br />INSURER 0: Alaska National Insurance Company i
<br />: INSURER E: Continental Casualty Co. I
<br />
<br />.~--
<br />
<br />COVERAGES
<br />
<br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLlCY 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 />rNSR ~~~'~ '-'PE . POLICY NUMBER POLICY EFFECTIVE r POLICY EXPIRATION i LIMITS
<br />LTR N R
<br /> I GENERAL LIABILITY i , 1,000,00
<br /> EACH OCCURRENCE $
<br />A X ;_"o"'""~"' ',,_~~OO' 8/1/2005 I 8/1/2006 I PREM~Ei1E~~~~fl~~L_ 50,000
<br /> $
<br /> -------- ---5;000
<br /> , CLAIMS MADE ~ OCCUR ~~D EXP (Anyone person) $
<br /> X ..X....C....U.. PERSONAL & ADV INJURY $ 1,000,00
<br /> i X Severability of Interest GENERAL AGGREGATE $ 2,000,000
<br /> ~ _. . m_. . n. . . . _ _ _._. _. _... __. __.__n____....._.._..._n_._...__..__ ; ~ 2,000,000
<br /> l~~~'L AGGR~G~T~ LIMIT ArPLlES PER PRODUCTS - COMP/OP AGG
<br /> , i I POLICY i X : ~~p,: lOC , _.__m__.___ ~-_._-----
<br /> ~OMOBILE LIABILITY I 1,000,000
<br /> COMBINED SINGLE LIMIT $
<br />B i X i ANY AUTO 57UENUL6878 8tl/2005 8tl/2006 (Eaaccident)
<br /> i -
<br /> I__m~ ALL OWNED AUTOS BODILY INJURY S
<br /> , ! SCHEDULED AUTOS (Per person}
<br /> , I
<br /> ~_)(~ HIRED AUTOS I
<br /> i BODILY INJURY S
<br /> iX NON-OWNED AUTOS (Per accident)
<br /> I
<br /> PROPERTY DAMAGE S
<br /> , (Per accident)
<br /> : GARAGE LIABILITY AUTO ONLY - EAACCIDENT S
<br /> ,--
<br /> f-- ANY AUTO OTHER THAN EAACC S
<br /> -------.--
<br /> , AUTO ONLY: AGG S
<br /> EXCESS/UMBRELLA LIABILITY , EACH OCCURRENCE S 5,000,000
<br />C ~ -J CLAIMS MADE AUC9305561-03 I 8/1/2005
<br /> ~ OCCUR 8/1/2006 I AGGREGATE $ 5,000,000
<br /> r-- ____m
<br /> I S
<br /> I ~ DEDUCTIBLE ----.-..- $
<br /> ,
<br /> I RETENTION $ $
<br /> I WORKERS COMPENSATION AND ~JJ:WC STATU- !OTH-
<br /> __ TQRY _I"IMITS L~
<br />0 EMPLOYERS' LIABILITY 05HWD40007 8/1/2005 8/112006 1,000,00
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT $
<br /> OFFICER/MEMBER EXCLUDED? EL DISEASE - EA EMPLOYE $ n..1,OOO,OOO
<br /> ~~~~I~ts~r~o~~16rNS below EL DISEASE - POLICY LIMIT $ 1,000,00
<br /> OTHER
<br />E Professional Liability AEAl13822501 8tlt2005 8/1/2006 Per Claim: 5,000,000
<br />E See Remarks on next page ,AEA 113822501 8tlt2005 8tl/2006 Aggregate: 5,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS {VEHICLES {EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
<br />In the event of cancellation for non-payment of premium, a 10 day notice will apply.
<br />Re: Bristol Corridor Widening, Phase I (H&A #062-0210.01)
<br />
<br />CERTIFICATE HOLDER
<br />
<br />CANCELLATION
<br />
<br />City of Santa Ana
<br />Public Works Agency, Office of the Exec. Director
<br />AUn: Souri Amirani
<br />20 Civic Center Plaza, 4lh FllXlr
<br />Santa Ana, CA 92701-' " H
<br />
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
<br />DATE THEREOF, THE ISSUING INSURER W1LL~**",AIL 3~ DAYS WRITTEN
<br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, B~~~
<br />~~~~
<br />,~~
<br />
<br />ACORD 25 (2001/08)
<br />
<br />
<br />AUTHORIZED REPRESENTATIVE
<br />
<br />~'-
<br />
<br />~.
<br />
<br />@ACORD CORPORATION 1988
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