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<br />Nov 28 06 12:30p
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<br />p_ 1
<br />
<br />ACORD
<br />..
<br />
<br />CERTIFICATE OF LIABILITY INSURANCE
<br />
<br />DATE'MMIDOJYYYYl
<br />
<br />Oregon City OR 97045
<br />
<br />I 11/28106
<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 />I INSURERS AFFORCING COVERAGe: HAle #
<br />~...._w ._.,_"'_ __
<br />'~~JA:E.~ A .H!.rtford Ins.IJ-"~!lc.ew~5?mDan;(.__
<br />lINSY~______m~_~..._m
<br />j.!,SUR,!':'<C__ ______~__~_
<br />LJ:@d.~.~__
<br />INS0RERE
<br />
<br />--+--
<br />1-
<br />
<br />PRonut::1l:f11
<br />
<br />UnIted Insurance Agencies. LLC
<br />PO Box 2589
<br />Euyene OR 91402
<br />54H42:~164 ____
<br />JN$t.lJ\ISO Mappi"9 Solutions. Inc
<br />PO Box 2425
<br />
<br />COVERAGES
<br />fKE POLlC!ES OF INSURANCE iJ5TED 9ELOW HAVE: BEEoN ISSUED TO T'HE INSURED NAMED ASOVE >:01'\ Hi!:: POUCY PERIOD :~OICATED_ NOTVVHHSfANDiNG
<br />ANY RgQUlRE~"T, "'ERM OR CONDITiON OF ANY CONTRACT OR 01H:tR OO'';UMENT 'MTH RESPECT TO W1":ICI"i THIS CERTIFICATE MAY BE ISSUED OR
<br />/;lAY PERTAI",", THE lNSURANCE AFFORDEO BY THE POL.JCIES DESCRiBED HEREIN 1S SUfUECT 1'0 ALL THE TFRMS, E;;XCWSIQN$ AND CONDIT:ONS OF SUCH
<br />POLICIES AGGREGATE u.ms SHOWN MAY HAVE BEEN REOUCED BY ~AlO ClAIMS
<br />IMSR "-,--'.--, "_W__._._~ -~~y~~ "'o~iiVi--:-POi.K:Y:e~--- ---:w.ns _ww________
<br />
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<br />GENERAl.. UMUUn-
<br />, -l COr"~El=:CAl C'A::NE!lt:LuA&L!;Y
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<br />A ; CA Workers Compensation &
<br />I Em 10 8:~' Liabl1i
<br />DESCRJfY!'lON Of OPERATIONS I LOCA~S !VEHlCLE6IEXCLU$lONS ADOED BV ekOOR$EMIHT I SPECIAL 'I>f<<)\/lS1ONS
<br />
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<br />52WECKT2077
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<br />07125106
<br />
<br />, 07125107
<br />
<br />A;J10()N1Y'EI':,~<;C'DE~',:, j _~___
<br />0'i--'EI'< THAN Ji!<_ACC ._;~____
<br />A\J7{) (;l-;lv. "GO
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<br />,.Q.'!:t!~'3~, ~
<br />I AGGREGi!:':F, $
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<br />~~=-.l~ -~'
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<br />i X ~ ;'~~yS;;;.;-;Y;. i I
<br />I (L "C-'A"'"'" 'o,~_,_~ 500,000
<br />E L tIlSEA$(:;. lOA e.M~hP!..EE' 500 000 '
<br />f:'. -OlSEASf: - P~1L'C'( LIMIT $ 500,000
<br />E.L. Each Accident 1,000,000
<br />I E.L. Disea.. EA Em 1.000.000
<br />E::.L DI$f;t3se Limit 1,000 000
<br />
<br />i ilXC!SSlUIIHSI'!ELu. L.IMoIlLfTY
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<br />RETl",tHiON
<br />WORKIi.1l:S COM'Pl!~TIO'" AND
<br />EMf>t-OVE~S'l,..IAau.lTY
<br />Atoy PROPRIF;0HIP,l,RT'iE'</EXEC,nvE;
<br />C~fJC<'R}MCMeER EXCLI.'DEO"
<br />1y11ls,c,,~..ndo/ll'
<br />? i/I-' _l>~(}V:SI()"S l>Iocw
<br />: O'TH€R
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<br />52WECKT2077
<br />
<br />,
<br />107125106
<br />
<br />107/28107
<br />
<br />FaXI 714-647 ~5779
<br />
<br />CERTIFICATE HOLDER
<br />
<br />CANCELLATION
<br />
<br />Fire Administn'ttion
<br />City of Santa Ana
<br />1439 S. Broadway
<br />Santa A.na, CA 92707
<br />
<br />SHOOLe "~YOl"THli ABOVE [lE.SCRlUD fi>OUCISSIiECMCELtED DEFOR&; Tl-H. EXPlMTlON
<br />OA711l 'tk!'!'l1!'O!", "H~ mUl"G 1M~I.IRi:1'I, WIlL "'''DeAl/OR ro MAll ~ OA.YS WIUT'T"5N
<br />,..once TO 'THE CERTIfiCATE HO\.DElt NA!ltEO TO THE LEn, I!IJ1' 'A1lmCli ro OC 80 SHALL
<br />IlItPOtE NO OBUGATION OR UABlLtTY OF ANY KiNO UPON THe IHSUi'leR, In AGENi3 OR
<br />
<br />ACORD 25 t2001i08)
<br />
<br />
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<br />
<br />@AcaRDCORPOAATION1988
<br />
<br />~'7
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