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X'o: City of Santa Ana From: Blanca Roque 12-11-08 2:9tipm p. 2 of 3 <br />-ff-^/,,�oo 7 <br />/-^ OR!� <br />ACN <br />,�yq^ � I✓"s�' II <br />FSTI ff W`,'_ <br />?; Dae(mm/tlNYY) <br />7 <br />iaF beU <br />M <br />y y a _ 12111/2008 <br />Producer <br />THIS CERTIFICATE IS ISSUED AS AMATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. <br />Wood -Gutmann & Bogart/IIIB <br />THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE <br />940 Calle Negocio, Ste. 240 <br />COVERAGE AFFORDED BY THE POLICIES BELOW. <br />San Clemente, CA 92673 <br />INSURER Indian Harbor Ins. Company <br />(949) 542-7800 <br />www intogrityint.com <br />INSURER <br />Insured <br />INSURER <br />Fieldman, Rolapp & Associates, Inc. <br />Fieldman, Rolapp Financial Services, LLC <br />INSURER <br />19900 MacArthur Blvd, #1100 <br />Irvine CA 92612 <br />INSURER <br />E <br />_- <br />" <br />- <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED <br />NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE <br />TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />POLICY <br />POLICY <br />NSR <br />EFFECTIVE <br />EXPIRATION <br />LTR <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />DATE <br />DATEDD/Y <br />LIMITS <br />GENERALLIABILITY <br />EACH OCCURRENCE $ <br />COMMERCIAL GENERAL LIAB <br />DRE DAMAGE one fire $ <br />CLAIMS MADE MOCCOR <br />MED EXP (Any ore rwn $ <br />PERSONAL & ADV INJURY $ <br />GENERAL AGGREGATE $ <br />GEN 'L AGG LIMIT APPLES PER <br />PRODUCTS-COMP/OP AGG $ <br />POLICY MPROJECTn LOC <br />$ <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />COMBINED SINGLE LIMN <br />$ <br />ALL OWNED AUTOS <br />BODILY INJURY <br />SCHEDULED AUTOS <br />(Per Perron) $ <br />HIRED AUTOS <br />BODILY INJURY <br />NON -OWNED AUTOS <br />(Per ecCidela) S <br />PROPERTY DAMAGE <br />(Per e.Idmo $ <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT $ <br />ANY AUTO <br />OTHER THAN EA ACC $ <br />AUTO ONLY: AGG $ <br />EXCESS LIABILITY <br />EACH OCCURRENCE $ <br />OCCUR ❑ CLAIMS MADE <br />AGGREGATE $ <br />$ <br />DEIXICTIB LE <br />RETENTION $ <br />WORKERS' COMPENSATION & <br />e e n. <br />STATUTORY UMIT H s- <br />EMPLOYERS' LIABILITY <br />EL EACH ACCIDENT $ <br />EL DISEASE - EA EMPLOYEE $ <br />L DISEASE -POUCY EMIT $ <br />EIml <br />rrors missions <br />Ded. $100,000 <br />DE RIPTI N OF PF.RATI N !L ATI N VEHI LE EX LUN BY END R EQ/IEN,T. PF 1 L PRVI 1 4 <br />'AVD /DDEED <br />�. Iy; SIT 1 'I A>,, <br />I- <br />1N1WP1'1:1-MWer1i.'a M1 Tde-P: <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />City of Santa Ana <br />EXPIRA� ION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL <br />Attn: GIeNFefthc2ovrt <br />30_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE <br />Center <br />20 Civic Center Plaza (AA3�r M �/ 7 <br />LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION <br />Santa Ana 92702-1988 <br />OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRE- <br />SENTATI VES. ' 10 Days for Nonpayment of Premium <br />AUTHORIZED <br />REPRESENTATIVE <br />Dan Gorman <br />I , <br />CERT Nn.: 4176441 Blanca Fovue 19/11/Pe03 2:43:06 PM Paye 1 <br />