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' ..ACORD CERTIFICATE OF LIABILITY INSURANCE CSR PC <br />HARPE-1 DATE (MILDD/YYYY) <br />07 13 07 <br />PRODUCER <br />U 6 A Insurance Agency <br />Unickel S Assoc. Lio#0827703 <br />Box 10727 <br />P <br />O 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 />San Bernardino CA 92423-0727 <br />Phone: 909-793-6810 Fax: 909-798-3959 ' <br />INSURERS AFFORDING COVERAGE <br />NAIC# <br />INSURED /I <br />~ ~~ /~ ~ ~~•L /~ A ~ goo/ ~ A~ O <br />7 INSURER A: CNA insurance COID Sn <br />^ <br />N ~ / flF ~ /1 O~ O W INSURER B: CT7A InBllranCB CO an <br />Harper S Assoc Engineering,Inc <br />Inc <br />er S Associates <br />Ha INSURER C: U. S. apacialty xnsuxance cc. <br />, <br />rp <br />1240 E. Ontario Ave, #102-312 INSURER D: <br />Corona CA 92861 <br />INSURER E: <br />PFS <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANV REQUIREMENT, TERM OR CONDITION OF ANV CONTRACT OR OTHER DOCUMENT W ITH RESPECT TO WHICH THIS CERTIFICATE MAV BE ISSUED OR <br />MAV PERTAIN, THE INSURANCE AFFORDED BV THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAV HAVE BEEN REDUCED BY PAID CLAIMS. <br />LTR NSR TYPE OF INSURANCE POLICY NUMBER GATE MMIDO GATE MhVDO LIMRS <br /> GENERAL LIABILITY EACH OCCURRENCE $1,000,000 <br />A }( }[ COMMERCIAL GENERAL LIABILITY 2072016797 06/24/07 06/24/08 PREMISES (Eaoxarenca $1,000,000_ <br /> CLAIMS MADE X^ OCCUR' MED EXP (Any one parson) $ lO,000 <br /> PERSONAL BADV INJURV $1,000,000 <br /> GENERAL AGGREGATE $2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 <br /> POLICY PRO LOC <br />JECT <br /> AUT OMOBILE LIABILRY COMBINED SINGLE LIMIT <br />$1,000,000 <br />$' X ANY AUTO 2072016100 06/24/07 06/24/08 IEaaccidenq <br />~ ALL OWNED AUTOS I <br />BODILY INJURV <br />$ <br /> SCHEDULED AUTOS (Par parson) <br /> <br /> $ MIRED AUTOS BODILY INJURY $ <br /> $ NON-OWNED AUTOS (Per acdtleny <br /> PROPERTY DAMAGE $ <br /> (Per ecdtlanl) <br /> GA RAGE LIABILRY AUTO ONLY-EA ACCIDENT $ <br /> <br /> ANV AUTO OTHER THAN EA ACC $ <br /> AUTO ONLY: AGG $ <br /> EXCESS/UMBRELLA LUBILRY EACH OCCURRENCE $ 2 , OOO , OOO <br />$ )( OCCUR CLAIMS MADE 2066377032 06/24/07 06/24/06 AGGREGATE $2,000,000 <br /> <br /> <br /> DEDUCTIBLE $ <br /> <br /> ][ RETENTION $ lO OOO $ <br /> WORKERS COMPENSATION AND TORY LIMITS ! ER <br /> EMPLOYERS' LIABILRY E.L. EACH ACCIDENT $ <br /> ANV PROPRIETORlPARTNEPoE%ECUTIVE <br /> OFFICERIMEMBER EXCLUDED? E.L. DISEASE-EA EMPLOYEE $ <br /> I if yes Describe untler <br />. SPECIAL PROVISIONS below E.L. DISEASE-POLICY LIMIT $ <br />OTHER <br />C Professional US 06 1133102 08/01/06 06/01/07 Oco/Agg $2,000,000 <br />Liabilit ~ Ded $10 000 <br />DESCRIPTION OF OPERATIDNS I LOCATN)NS/ VEKN:LES! EXCLUSN)NS ADDED BV ENDORSEMENT I SPECIAL PROVISIONS <br />*Except 10 day notice of cancellation for non payment of premium. Cex~Yala~ LJ FiS T i~OR <br />holder its officers, agents, employees are named additional insured <br />regarding General Liability per attached endorsement. Re: East and West <br />Reservoirs (A/I,XX) Fax: 714-647-3345 - <br />~ ,fa ..L(1 `. ..u~ <br />CERTIFICATE HOLDER CANCELLATION <br />SANTA-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES SE CANCELLED BEFORE THE EXPIRATION <br />City of Santa Ana DATE THEREOF, THE ISSUING INSURER WILL iNYNrVBR TO MAIL 3O• DAYS WRRTEN <br />Public Works AQenCy NOTK:E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, WfifAiltlR[T07030SR1RL <br />Attn: Steve Worrall I , <br />220 S. Daisey Ave., Bldg A <br />CA 92703 <br />t <br />A <br />San <br />a <br />na AUTHO ED REPRES N <br />ACORD 25 (2001108) v~ /u.urtu wrtrvranr rvn ~ aaa <br />