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<br />ACORD," CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDmYVI <br />01/08/08 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Hub Int" of CA -IE CL A - ~607-05& ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />Hub Int'l of CA Ins Serv, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />A. ;;;l.OO 7 -oc,~ ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />4371 Latham St, Ste #101 <br />Riverside, CA 92501 INSURERS AFFORDING COVERAGE NAIC# <br />INSURED INSURER A: Scottsdale Insurance Company 41297 <br /> HBA Incorporated INSURER B: Travelers Indemnity Company of CT 25682 <br /> 12891 Nelson SI. INSURER c: American States Insurance Company 19704 <br /> Garden Grove, CA 92840-5018 INSURER D: <br /> INSURER E: <br /> <br />Client#. 113941 <br /> <br />10HBAINCO <br /> <br />COVERAGES <br /> <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 />INSR ~~~~ TYPE OF INSURANCE POLICY NUMBER PJ'~{~~::r~&tW1E Pgi'.fJrif~~N LIMITS <br />LTR <br />A ~NERAL LIABILITY BCSOO15293 06/27/07 06/27/08 EACH OCCURRENCE .1 000 000 <br /> X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $1 00 000 <br /> I CLAIMS MADE [!] OCCUR MED EXP (Anyone person) . <br /> PERSONAL & ADV INJURY $1 000 000 <br /> GENERAL AGGREGATE $2 000 000 <br /> ~.~ AGG~EfilE LIMIT APAStPER PRODUCTS, COMP/OP AGG $2 000 000 <br /> POLICY X j:c?r LOC <br />C ~TOMOBILE LIABILITY 01CH1591592 06/03/07 06/03/08 COMBINED SINGLE LIMIT <br /> .!. ANY AUTO (Eaaccident) '1,000,000 <br /> - ALL OWNED AUTOS BODILY INJURY <br /> (Pef person} $ <br /> rx SCHEDULED AUTOS <br /> HIRED AUTOS BODILY INJURY <br /> f'-'- . <br /> r!- NON-OWNED AUTOS (Peracadent) <br /> I-- PROPERTY DAMAGE . <br /> (Peraccldenl) <br /> RRAGE LIABILITY AUTO ONLY - EA ACCIDENT . <br /> ANY AUTO OTHER THAN EA ACC $ <br /> AUTO ONLY AGG . <br /> pESS/UMBRELLA LIABILITY EACH OCCURRENCE $ <br /> OCCUR D CLAIMS MADE AGGREGATE . <br /> $ <br /> R ~EDUCTIBLE . <br /> RETENTION $ $ <br />B WORKERS COMPENSA TlON AND DTEUB7932L36908 01/01/08 01/01109 X I T~'S(~;U., I IOJ~' <br /> EMPLOYERS' LIABILITY E.L. EACH ACCIDENT .1,000,000 <br /> ANY PROPRIETORJPArnNERlEXECUTIVE <br /> OFFICERJMEMBER EXCLUDED? EL DISEASE - EA EMPLOYEE .1,000,000 <br /> If yes, describe under E.L. DISEASE - POLICY LIMIT $1000000 <br /> SPECIAL PROVISIONS below <br /> OTHER <br /> .\ '. ~ " <br />DESCRIPTION OF OPERA TlONS I LOCATIONS J VEHtcLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br />Re: Santa Ana Parking Struc1ure - Job #2515. GWGC, Inc. dba: Gordon and ./ Ily <br />Williams General Contractors and the City of Santa Ana, its officers, /')/'-<' L . <br />..,__--'-L;... _ y /. <br />directors, agents, volunterrs and representatives are an additional insured C' <br />per form: CG20330704, CG20370704, & UTS.3g-01 (3-92). Primary Wording v' <br />(See Allached Descriptions) <br /> <br />CERTIFICATE HOLDER <br /> <br />CANCELLATION <br /> <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />City of Santa Ana DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN <br />20 Civic Center Plaza, M36 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />Santa Ana, CA 92701-4058 IMPOSE NO OBLIGATION OR LIABILITY OF ANY IOND UPON THE INSURER, ITS AGENTS OR <br /> REPRESENTATIVES. <br /> ~li,l:EP~ <br /> <br />ACORD 25 (2001/08) 1 of 3 <br /> <br />#M35064 <br /> <br />RVE <br /> <br />" ACORD CORPORATION 1988 <br />