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a —Gvt� /— v'1011 <br />ACDRD CERTIFICATE OF LIABILITY INSURANCE OP ID Ij <br />THEPO- SVJ <br />DATE(MM/DD/YYYY) <br />09/17/07 <br />PRODUCER <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />Arrow Insurance Service, Inc. <br />PO Box 940880 <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />Simi Valley CA 93065 <br />Phone:805-955-9555 Pax:805-955-9535 <br />INSURERS AFFORDING COVERAGE <br />NAIC# <br />INSURED <br />007 (36 3 <br />INSURER A: Essex Insurance Company <br />39020 <br />INSURER B: Mercury Casualty Com any <br />11908 <br />A- gyp+ - <br />INSURER C_ <br />A <br />Deckside Pool Service <br />INSURER D: <br />- <br />27758 Sta. Margarita Pkwy #194 <br />Mission Viejo CA 92691 <br />INSURER E. <br />MED EXP (Any one person) $ 5,000 <br />COVERAGES <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, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS _ <br />LTR <br />NSR <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />DATE MMIDDM! <br />DATE MM/DD/YY <br />LIMITS <br />GENERAL LIA81LITY <br />EACH OCCURRENCE $1,000,000 <br />PREMISES(Eaoccurence) $200,000 <br />A <br />X <br />X I COMMERCIAL GENERAL LIABILITY <br />PSAI 100154-3 <br />09/01/07 <br />09/01/08 <br />MED EXP (Any one person) $ 5,000 <br />CLAIMS MADE � OCCUR <br />PERSONAL & AOV INJURY I $ 1 , 000,000 <br />OOO <br />GENERAL AGGREGATE $2,—r$l, <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMP/OP AGG 000 , 000 <br />POLICY PRO LOC <br />JECT <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />COMBINED SINGLE LIMIT <br />(Ea accident) s$1,000,000 <br />BODILY INJURY <br />(Per person) $ <br />B <br />X <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />AC11057366 <br />02/15/07 <br />02/15/08 <br />BODILY INJURY $ <br />(Per accident) <br />X <br />X <br />HIRED AUTOS <br />NON -OWNED AUTOS <br />PROPERTY DAMAGE $ <br />(Per accident) <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT $ <br />OTHER THAN EA ACC $ <br />ANY AUTO <br />AUTO ONLY: AGG S <br />EXCESS/UMBRELLA LIABILITY <br />EACH OCCURRENCE $ <br />OCCUR CLAIMS MADE <br />AGGREGATE $ <br />$ <br />$ <br />DEDUCTIBLE <br />$ <br />RETENTION $ <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br />ANY PROPRIETOR/PARTNERJEXECUTIVE <br />J <br />ER <br />_ _ <br />E.L. EACH ACCIDENT $ <br />E.I. DISEASE - EA FMPLOYEFJ S <br />OFRCER/RIEMBER SYCLUDED7 <br />L// <br />If yes, describe under <br />SPECIAL PROVISIONS below <br />E.L. DISEASE - POLICY LIMIT S <br />OTHER <br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br />Swimming Pool Service & Repair <br />Certificate holder is listed as additional insured per form CG1010-1093 <br />*Ten Day notice of cancellation for non payment of premium applies <br />**Primary wording attached <br />CERTIFICATE HOLDER CANCELLATION <br />City of Santa Ana Parks, <br />Recreation & Comm. Srv. Agency <br />Attn: Carla Mack-Thompkins <br />220 South Daisy <br />Santa Ana CA 92703 <br />'f ZQri/GT:II <br />CITY042 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOI, <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30* 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. <br />1988 <br />