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CERTIFICATE OF LIABILITY INSURANCE III Dace (MM /DD/YYVV) <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />Leatzow Insurance HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />2301 W. 22nd Street Suite 208 ALTER THE COVERAGE AFFORDED BY THE POLICY BELOW <br />Oak Brook, IL 60523 COMPANIES AFFORDING COVERAGE <br />COMPANY <br />A New Hampshire Insurance Company <br />INSURED <br />COMPANY <br />Ann Christoph, L /A, ASLA <br />B <br />COMPANY <br />31713 South Coast Highway <br />South Laguna, CA 92651 <br />G <br />COMPANY <br />D <br />COVERAGES <br />THIS IS TO CERTIFY THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE NAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />CO <br />LTR <br />TYPE OF INSURANCE <br />I POLICY NUMBER <br />POLICY EFFECTIVE <br />DATE (MM /DD /YY) <br />POLICY EXPIRATION <br />DATE (MM /DD/YY) <br />LIMITS <br />GENERAL <br />LIABILITY <br />BODILY INJURY OCC <br />$ <br />BODILY INJURY AGG <br />$ <br />COMPREHENSIVE FORM <br />PROPERTY DAMAGE OCC <br />$ <br />PREMISES /OPERATIONS UNDERGROUND <br />PROPERTY DAMAGE AGG <br />$ <br />EXPLOSION COLLAPSE HAZARD <br />BI &PD COMBINED OCC <br />$ <br />PRODUCTS /COPMLETED OPER <br />DOES NOT APPLY <br />BI & PD COMBINED AGG <br />$ <br />CONTRACTUAL <br />INDEPENDENT CONTRACTORS <br />PERSONAL INJURY AGG <br />$ <br />BROAD FORM PROPERTY DAMAGE <br />PERSONAL INJURY <br />AUTOMOBILE <br />LIABILITY <br />BODILY INJURY <br />(Per Person) <br />$ <br />ANY AUTO <br />BODILY INJURY <br />(Per Accident) <br />$ <br />ALL OWNED AUTOS(Private Pass) <br />ALL OWNED AUTOS <br />(Other than Private Passenger) <br />DOES NOT APPLY <br />PROPERTY DAMAGE <br />$ <br />HIRED AUTOS <br />BODILY INJURY <br />NON-OWNED AUTOS <br />GARAGE LIABILITY <br />G <br />PROPERTY DAMAGE <br />COMBINED <br />$ <br />EXCESS LIABILITY <br />EACH OOCURENCE <br />$ <br />UMBRELLA FORM <br />DOES NOT APPLY <br />AGGREGATE <br />$ <br />OTHER THAN UMBRELLA FORM <br />WORKERS COMPENSATION <br />I a <br />OTH <br />AND EMPLOYERS LIABILi I Y <br />TORY LAI <br />t <br />EL EACH ACCIDENT <br />$ <br />THE PROPRIETOR/ B INCL <br />PARTNERS /EXECUTIVE <br />OFFICERS ARE EXCL <br />DOES NOT APPLY <br />EL DISEASE - POLICY LIMIT <br />S <br />EL DISEASE - EA EMPLOYEE <br />$ <br />OTHER <br />A <br />Professional <br />003710381 <br />1/14/2006 <br />1/14/2007 <br />1,000,000 each claim <br />Liability <br />1,000,000 aggregate <br />DESCRIPTION OF OPERATIONS /LOCATIONSNEHICLES /SPECIAL ITEMS <br />Re: <br />HOLDER CERTIFICATE <br />City of Santa Ana <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />Attn: Souri Amirani <br />EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL <br />20 Civic Center Plaza <br />Ross Annex <br />30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE OBLIGATION OR LIABILITY OF <br />ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. <br />Santa Ana, CA 92701 <br />AUTHORIZED REPRESENTATIVE <br />LEATZOW INSURANCE <br />.•D 25-N (1/95) <br />@ ACORD CORPORATION 1988 <br />