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<br />DATE (MMIDDIYVYY) <br />,a-co CERTIFICATE OF LIABILITY INSURANCE 1 <br />PRODUCER ,-. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />•Barrett/Mosier/Griffith/Sistrunk Ins. Services ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />12 Truman HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />Irvine, CA 92620 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />(949)559-6700 0684519 INSURERS AFFORDING COVERAGE NAIC # <br />www. g a rrett-m o s i e r. co m <br />INSURED Tait & Associates, inC. INSURER A: COIOn Insurance Com an Ar onaut <br />Tait Environmental Services, Inc. INSURER B: Continental Insurance Com an CNA <br />701 Parkcenter Dr. INSURER C: <br />Santa Ana CA 92705 <br />INSURER D: <br />CnVERAGES <br />TH E PO LICIES OF INSURANCE LISTED BELO W HAVE BEEN ISSUED TO THE IN <br />THER SURED NAMtU Ald <br />DOCUMENT WITH vvt rlrrc I n~ rvu <br />RESPECT TO WHI ~. ~ rr.r~ivv .,..~,...,, ~..• , • <br />CH THIS CERTIFICATE M ~- ~ • • • • • •- ~ ---- -- <br />AY BE ISSUED OR <br />AN Y RE QUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR O <br />BED H EREIN IS SUBJECT TO ALL THE TERM S, EXCLUSIONS AND CON DITIONS OF SUCH <br />MA Y PE THE INSURANCE AFFORDED <br />RTAIN BY THE POLICIES DESCRI <br />PO LICIE , <br />S. AGGREGATE LIMITS SHOWN MA Y HAVE BEEN REDUCED BY PAID CLAIMS. <br /> <br />INSR <br />DD' <br />POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS <br /> 000 <br />000 <br />1 <br />A GENERAL LIABILITY <br />EPK30003~ <br />9/1 /2009 <br />9/1 /2010 EACH OCCURRENCE <br />DAMAGE TO RENTED <br />PREMISES IEa occurrence _ , <br />, <br />$ <br />$ 50,000 <br /> COMMERCIAL GENERAL LIABILITY 000 <br />5 <br /> ^ MED EXP (Any one person) , <br />$ <br /> OCCUR <br />CLAIMS MADE 000 <br />000 <br />1 <br /> PERSONAL & ADV INJURY , <br />, <br />$ <br /> PrOfeS$IOnal I_lab. 000 <br />000 <br />2 <br /> GENERAL AGGREGATE , <br />, <br />$ <br /> / Contrs Pollution 000 <br />000 <br />2 <br /> PRODUCTS-COMP/OPAGG , <br />, <br />$ <br /> GEN'L AGGREGATE LIMIT APPLIES PER: <br /> PRO- <br />POLICY ~ LOC <br />B AUTOMOBILE LIABILITY <br />9/1/2010 COMBINED SINGLE LIMIT <br />(Eaacciden[) $ 1 <br />000 OOO <br /> 4016909543 9/1/2009 , <br /> ANY AUTO <br /> ALL OWNED AUTOS BODILY INJURY <br />(Per person) $ <br /> SCHEDULED AUTOS <br /> HIRED AUTOS BODILY INJURY <br />(Per accident) $ <br /> NON-OWNED AUTOS <br /> $1 OOO Comp. Ded. PROPERTY DAMAGE <br />(Per accident) $ <br /> 1 00 011. Ded. <br /> AUTO ONLY - EA ACCIDENT $ <br /> GA RAGE LIABILITY <br /> EA ACC $ <br /> ANY AUTO OTHER THAN <br />AUTO ONLY: <br /> AGG $ <br /> EACH OCCURRENCE $ <br /> EXCESS /UMBRELLA LIABILITY <br /> AGGREGATE $ <br /> OCCUR ^ CLAIMS MADE <br /> <br /> <br /> DEDUCTIBLE <br />AP~ S TO F RNI <br />$ <br /> RETENTION $ WC STATU- OTH- <br /> WORKERS COMPENSATION <br /> AND EMPLOYERS' LIABILITY Y / N ~,o,,,,_ <br />~ <br />E.L. EACH ACCIDENT <br />$ <br /> ANY PROPRIETOR/PARTNERlEXECUTIVE <br />OFFICERlMEMBER EXCLUDED? ^ ~ F ._ TC ER E.L. DISEASE - EA EMPLOYE E $ <br /> (Mandatory In NH) <br />If yes, describe under <br />('` I <br />Y ~~N E - <br />E.L. DISEASE -POLICY LIMIT <br />$ <br /> SPECIAL PROVISIONS below <br /> OTHER <br />DESCRIPTION OF OPERATIONS (LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br />RE: UST Removal next to City Hall <br />See Attached Addendum. <br />RE: UST Removal next to City Hall <br />City of Santa Ana <br />Office of the City Attorney <br />PO Box 1988 <br />Santa Ana CA 92702 <br />el Finn /~~ `~'~ .'~`•-- <br />SHOULD ANYOF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3O' DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />REPRESENTATIVES. `'10 Days for Non-Payment of Pramlum. <br />e1rTHnRIZED REPRESENTATIVE <br />ACORD 25 (2009/01) <br />CERT NO.: 5704459 Andrea Chastain 8/31/2009 1:51:43 PM Page 1 of 4 <br /> <br />