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<br /> ACORD. CERTIFICATE OF LIABILITY INSURANCE OP ID}I~ DA'l1! (1IIODDIYYYY) <br />, KASItS-l 01126107 <br /> PRODUCER lHlS CER11FICATE IS ISSUED M A MAlTER OF "FORMATION <br /> Andreini " Compeny-Oxnard ONLY AND CONFERS NO RIGHTS UPON lHE CERTFICATE <br /> License 0208825 HOLDER. lHlS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> 300 Esplanade Drive, Suite 100 ALTER lHE COVERAGE AFFORDED BY lHE POLICIES BELOW. <br /> Oxnard CA ~3036 <br /> PhODe.805-~81-~5B5 Fax.805-~B1-0161 INSURERS AFFORDING COVERAGE HAlC. <br /> INSURED INSURER A: Pederal I:nsuraJ:loe C=env <br /> INSURER B: <br /> Kask ~8tems, :Inc. INSURER C: <br /> Rosa ~a <br /> 1l~5~ D Sc0V8~ Ct. INSURER " <br /> Koorpark CA ~3 21 INSURERE: <br /> <br />COVERAGES <br /> <br />TtE POUCIES OF t4SlJFW<<;E lISTED BElOW HAVE BEEN ISSUED TO THE INSURED NAUEON!C+IE FOR THE POl..ICY PERIOD INDlCAlED. NOTWITHSTANDING <br />>>N REQUIREMENT, TERM Cfl OONDtnON OF Nrf CONTRACTOR OTHER DOCUMENTWfTH RESPECTTO 'MtCH nilS CERTFlCAlEtMY BE ISSUED OR <br />MAY PERTAIN, THE HSURAt<<:EAFFORDEl BY THE POUCtES CESCRlBED HEREIN IS SUBJECT TO N..L lHE"l"EMCS. EXClUSIONS AND COHOmON8OF SUCH <br />POLICIES. AGGREGATE LMT5 SHOWN MAY HAVEaEeI REDUCED BY PAID ClAIMS. <br />~ TYPEOFNSURANCE POLICY NUMBER ~ DA..e~ LIIT8 <br /> ~N!RALLJABIL.I1'Y EACH OCCUMENC& 11,000,000 <br />A X .!.. ~1.6J. GENEfW.UABltIlY 3533~~03 12/18/06 12/18/07 PREMises -' 11,000,000 <br /> ClAIMS MADE [;J OCCUR MEn EXP (Any one pnon) 110,000 <br /> PERSONAL & NN INJURY 11,000,000 <br /> eeHEiW. AGGREGATE 12,000,000 <br /> . ~AGnILWfn,PER PRODUCTS - COMP1OP AQQ 12,000,000 <br /> POUCY ~~ LOC <br /> ~MJBILE UABIUTY COMBINED SINGLE LIMIT 11,000,000 <br />A ~ AHV AUTO 73225049 12/1B/06 12/18/07 (Eaacddenl:) <br /> >-- AU. OWNaJ AUTOS BOOL Y INJURY <br /> I <br /> '- SCHEOUlSJ AUTOS (Perf*Xll'l) <br />A ~ HIRED AUTOS BODLY IN.Il.RV <br /> I <br />A .!.. NON-OWNED AUTOS . (Pw_. <br /> PROPERTY DAMAGE I <br /> {Po<_ <br /> GARAGE LlABUTY AUTO ONLY - EAACCIDENT I <br /> ~-ANY AUTO OlliER THAN EAACo I <br /> AUTO ONLY: AGG I <br /> EXCES$IU_IIE.1AL..IABIlJ1'Y EACH OCCURF'lSICi. 15.000,000 <br />A !5~uR 0 CLAlMSMAllE 7972987~ 12/18/06 12/18/07 AGGREGATE 15,000,000 <br /> THIS CEF TlFICATI I <br /> ~ ~BLE . <br /> X REl'S<TlC>I 10 . <br /> WORKERScQllPENSAnON AND SUPERCED ~S THE (] NE l...&Iivl i I IUS!! <br /> ~lOYER.S' UABIUTY <br /> Nff PROPRIETORlPARTNER/EXECVTlV EJ.. EACH ACCIDENT . <br /> OFFJCERIMEMBER EXCLUDED? ISSU ~D ON E.L "SEASE. EA EMPlOYE! . <br /> ~~Sbelow E.L DISEASE. POLICY UNIT I <br /> OTHeR )~dJ. oJ f) /,0 <br />DESaIPTION OF OPERATIONS/LQCAnONS' VEHJCLES I EKCLUSIONS ADDED BY ENDORSEMENT I SPECIAl PROVISIONS <br />Certificate holder is additional insured under the general liability per <br />endOril_nt #80c02c2305 and 80-02-2373 attached. :Insurence :is primary per <br />attached endorsement 80~02-2000, pgs 22-23~ Waiver of subrogation applies, <br />per endorsement 80-02-2000, pg 24. The CANCELLAT:ION notice herein is amended <br />to read 10 Days as respects any caucellation due to non-payment of premium. <br /> <br />City of Senta Ana <br />60 Civic Center Plaza <br />Santa Ana CA 92703 <br /> <br />CANCELLATION <br />SHOULD AIf'( OF 11EABOYE D&SCRI8&D POUCIEIU CANC&U.ED BIFORB~ EXAM: <br />DATE THEREOF, THE ISSUING INSURERwtU ENJI!AVOR TO MAIL ~ DAYS WRITTEN <br />NOnCE TO THE CERTIFICATE HOLDER NAMED TO THe LIFT. BUT fAILURI!TO DO SO SHALL <br />IMPOSE NO OBUGA11ON OR UABI.JTY OF ANY KIND I.PON THI! ~ rTaAGeNTS OR <br />REPRESeNTATNS. <br /> <br />CERTIFICATE HOLDER <br /> <br />~~~ <br /> <br />ACORD 25 (2OD1/0B) <br /> <br />I ;,,) <br /> <br />C ACORD CORPORATION 19BB <br /> <br />. #~gJy. ;/t.... <br />