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OPID p DATE(MWDOIYYYY) <br />�AGORd CERTIFICATE OF LIABILITY INSURANCE BEALTD6 02/13/07 <br />PRODUCER THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION <br />AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />Hays Affinity Solutions <br />1250 24th St NW Suite 725 <br />ONLY <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />FORDED BY THE <br />ALTER THE COVERAGE AFPOLICIES BELOW. <br />Washington DC 20037 Y.!' <br />Phone:202-263-4000 Fax:202-263-4001 <br />INSURERS AFFORDING COVERAGE NAICs <br />IN5URED <br />INSURER A: LID ds of London <br />LIMITS <br />EEACHOC10 HENCE E1,000,000 <br />I <br />PREMISESS J HEN <br />=J.1 SSD DDD <br />Ni <br />INSURER B: <br />wsORERc. <br />Aoalthy D N--oos-oGY�-ol <br />All a C. Drozd <br />Hunttiington BeachCCAAc92648 <br />INSURER O: <br />INSURER E: <br />COVERAUE5 <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. E)(CLLMNS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, <br />LTR <br />A <br />NSR <br />X <br />TYPE OF INSURANCE <br />GENERAL LIABILITY <br />X COMMERCIAL GENERAL LIABILITY <br />CVNMSMADE FX] OCCUR <br />POLICY NUMBER <br />D7D22g'ADD2D56 <br />Mmocr <br />DATE MMIC <br />02/07/07 <br />DATE MW Dm <br />02/07/06 <br />LIMITS <br />EEACHOC10 HENCE E1,000,000 <br />I <br />PREMISESS J HEN <br />=J.1 SSD DDD <br />MED IMP (MY aM person) B2 DDD <br />PERSONAL d ADV INJURY $1 ,000,000 <br />PO Box 1988 <br />Santa Ana CA 92702-1988 <br />REPRESENTATIVES. <br />A RIZED REPR <br />GENERALAGGREGATE S 1 DDD DDD <br />PRODUCTS-COMPIOPAGG S11000r000 <br />GENT AGGREGATE LIMIT APPLIES PER, <br />X POLICY jEOT LOC <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT S <br />(a awtl t) <br />ANYAUTO <br />ALL OWNED AUTOS <br />BODILY INJURY S <br />(Per person) <br />SCHEDULEDAUTOS <br />HIREDAUTOS <br />BODILY INJURY $ <br />(varawarY) <br />NON-0WNEO AUTOS <br />PROPETTYDAMAGE S <br />(PMawtlMa) <br />GARAGE LIABILITY <br />ANY AUTO <br />AUTO ONLY -EA ACCIDENT S <br />OTHERTHAN EAACC $ <br />AUTO ONLY: AGO $ <br />EXCESSNMBRELIA LIABILITY <br />OCCUR 71 CLAIMS MADE <br />EACH OCCURRENCE S <br />AGGREGATE f <br />S <br />S <br />DEDUCTIBLE <br />- --"— <br />S <br />RETENTION S <br />—�_ <br />WORNERBCOMPEN&1TIONAND <br />EMPLOYERS' LIABILITY <br />', <br />_ <br />TORY LIMITS ER <br />E.L EACH ACCIDENT S <br />EL DI6EA6E-FAEMPLOYEE S <br />ANY PROPRIETORIPARTNERI ECUTWE <br />OFFyFFImICERMGMRER E LUOEO'1 <br />) <br />E.L. DISEASE -POLICY UMU E <br />Ir <br />SP[CId PROV191ONS belox <br />- <br />A <br />OTHER <br />'E60 Liability <br />0702MFA002056 <br />02/07/07 <br />02/07/08 <br />Per Claim $1,000,000 <br />re ate $1 000 000 <br />DESCRIPTION OF OPEPATIONSI LOCAnONS IVIUN LMI EACLUSIONSAD BY ENDORSEMENT I SPECIAL PROVISIONS <br />,,City of Santa Ana, its officers, agents, employees, representatives, and <br />volunteers" is listed as Additional Insureds. <br />CERTIFICATE HOLDER <br />"^""'-"^""" <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANOE}EO BEFORE THE E%PNiATN)N <br />CITY -02 <br />City Of Santa Ana <br />DATE THEREOF, THE ISSUING INSURERMLL ENDEAVORTO MAIL 30 DAYS WRITTEN <br />20 Civic Plaza <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />Attn: Clexk for City Council <br />IMPOSE NO OBLIGATION OR LIABUI OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />PO Box 1988 <br />Santa Ana CA 92702-1988 <br />REPRESENTATIVES. <br />A RIZED REPR <br />®ACORD CORPORATION 1988 <br />ACORD 25 (2007/08) <br />