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~ ACORD CERTIFICATE OF LIABILITY INSURANCE I DATE (MMfDDlYYYY) -._______TM 10/13/2006 PRODUCER (626)275-3000 FAX (626) 275-0130 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Golden Pacific Insurance Services ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR 181 W. Huntington Drive ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 200 Monrovia CA 91016-3494 INSURERS AFFORDING COVERAGE NAIC# !NSURED INSURER A: Golden Eaale Ins Corn 10836 Dekra-Lite Industries, Inc. INSURER B: 3102 W. Alton Avenue INSURER c. Santa Ana, CA 92704 INSURER 0: INSURER E" COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWiTHSTANDING ANY REQUiREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I~~:I~~~~ TYPE OF INSURANCE POLlCY NUMBER P8Al{~~~~68;W)E Pg~lf:I~,h~;;!gN LIMITS ~NERAL LIABILITY EACH OCCURRENCE , 1,000,000 X COMMERCIAL GENERAL LIABILITY ~~~~J7E~~~E~ncel , 100,000 A l CLAIMS MADE W OCCUR CBP8139450 4/9/2006 4/9/2007 MED EXP IAnll one ""'rson) , 5,000 J-.!- deductible -0- PERSONAL&ADV INJURY , 1,000,000 I-- GENERALAGGREGAiE , 2,000,000 rilLAGG:nE ~~~ nES PER: PRODUCTS-COM~OPAGG . 2,000,000 X POUCY JEeT LOC [JOMOBILE UABIUTY COMBINED SINGLE LIMIT X ANY AUTO (Eaaccidenl) , 1,000,000 A ~ I ALL OWNED AUTOS CBPS13 $1450 4/9/2006 4/9/2007 BODILY IMJURY (Per person) . I- SCHEOULED AUTOS I- HIRED AUTOS BOOIL Y INJURY , I- NQN-QWNED AUTOS (Peracciclent) I- PROPERTY DAMAGE , {Per3ccident) RRAGE L1ABIWTY AUTO ONLY - EA ACCIDENT . AN( AUTO OTHER THAN EA Ace $ AUTO ONLY: AGG $ t~rSSlUMBRELLA LlAB1UTY EACH~rURRENCE . 2,000,000 X OCCUR D CLAIMS MADE AGGREGATE . 2,000,000 . A ~ ~EDUCTiBlE CUS13$1650 4/9/2006 4/9/2007 . X RETENTION $10,000 . WORKERS COMPENSATION AND I T~~fIfJNs ! 10TH. EMPLOYERS' LIABILITY ER ANY PROPRIETORlPARTNERIEXECUTIVE E.l. EACH ACCIDENT , OFFICER/MEMBER EXCLUDED? E.l. DISEASE - EA EMPLOYEE $ If yes, de$cribe under SPECIAL PROVISIONS below E.l. DISEASE. POliCY LIMIT . A OTHER Equipment Floater CBP81B450 4/9/2006 4/9/2007 Leased/Rented Equip. 50,000 Hired Physical Damage Lind t 50,000 DESCRIPTION OF OPERATlONSlLOCATIONSNEHICL.ESIEXCL.USIONS ADDEO BY ENDORSEMENT/SPECIAL PROVISIONS City of Santa Ana, its officers, employees I agen ts, volunteers and representatives are included as additional insured as respects to the insureds operations and ONLY if required by written contract per the attached endorsement. 30 days Noe except 10 days for non-payment of premium. CERTIFICATE HOLDER CANCELLATION ACORD 25 (2001l0B) lN$025 (0108).06 AMS SHOULD ANY OF THE ABOVE DESCRlSED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL }G.)6~*:)( MAIL. 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, ~X X;l'~~~~~)(r)t.)(~l<.lli\(i\\~il!X ~~~~~ -~-::::!---- ----.. City of Santa Ana Attn, Dane11 Mercado 20 Civic Center Plaza, M-25 Santa Ana, CA 92702 AUTHORIZED REPRESENTATIVE Fritz Mutter/MER @ACORD CORPORATION 1988 Page 1 of2