|
<br />ffo,-'-' Lilen \j~,c;;"
<br />
<br />,f,.,,,, ;,-,,",,,,,&,,'-..,,, '.3roup F'axl0 516-4664213 T,o: Michel Girgis
<br />
<br />Dale lfm20U{ Ul b.:. ;-',\ii ;-''''9'''
<br />
<br /> , CERTIFICATE OF LIABILITY INSURANCE OPID ,?&a/ DJ\lEjMMilJD'-'('fYVI
<br /> ACORD. CONSO-2 07/09/07
<br />. PRODUCER. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br /> Butwin Insurance Group ONLY AND CONFERS NO RIGHTS UPON THE CeRTIFICATE
<br /> Suite 414 HOLDER. THIS CERTIFICATE DOeS NOT AMEND. EXTEND OR
<br /> 60 -Cutter l1J,ll Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW,
<br /> Great t{ec:k NY 11021,-3104 I
<br />~~~e:51~=466=~2~ Fax:S16-466-4213 INSURERS AFFORDING COVERAGE I NAIC #
<br /> .-- -..--- --.--
<br />i o,JSLFEPA A7G ,
<br /> United Ins;pection , Testing i\S1..REC3 hUonalUn1oni'lulu. c..
<br /> Ine 1-- . ----
<br /> 22620 Goldencrest Drive i',SlRE;;C _ !louston Casualty Co. -
<br /> ,.-- --------- --
<br /> Suite 114 I 1~~.9.o~
<br /> Uoreno valley CA 92553 11\Si;~ti< ::: ----------- , -----------
<br />
<br />COVERAGES
<br />
<br />n-rf pc): ICIFsor NlI,:PANCE LlS"'ED 8ELOW ,"",Vf. BEEt; ISSL'tC TO HE I',ISU<,[DN"M(C "B,\'f. fOR ~I-f POliCY PER1CO l\iJ1CATE::) NC-'V~TI-GfNIOI"C;
<br />;..\ ;.~~~;....;dk::', ,t:'~:. '-';~ (.v[>l~ i,:YI:,1; Nj~ 'j)t-llllA::.i OHC H:.P m::rJl'/U,1 V,i::h kE'i"EC- -C WHICH lH,;; r~d~'iFiCAE M...V BE ISS..t.D<.:R
<br />'.'.','." ~C'~-,:';~' :: :.:c.!_::>:,'~~~ ..,~,,~;~~,~ '-'" H-'~ P0<.!CIESDESC~I8C:;; t-'fPFN I, ".1!R.:Fr:::T Tr !-'-l ,t-'F T,R''\3, EXCUS:O:-.lSN.o ~(;N~ITOll".rJF St.;r;-.
<br />KJI ~_!.' ",..;.,.,'tl>.l<,l LIMIi:;; So-jIJ\'I" MA'( :iA~:: tiel1\. fl'.oJLI;;UJ 8"'PAF..:, U-",1M';i
<br />
<br />LTIl. I'$RO
<br />
<br />TYPE OF INSURANCE
<br />
<br />POliCY tf..WBER
<br />
<br />LlMffS
<br />
<br />DATE (MIil/OD/VYJ DATE (MMIDDm'J
<br />I
<br />I
<br />07/01/07 !
<br />
<br />IAIX
<br />
<br />II
<br />I
<br />
<br />GENERAl liABILITY
<br />
<br /> E""CJ--<or:cLP~rNC[ 1$1,000,000
<br />07/01/08 PPEYIlso:~ IE~ ~CcLI~!1>1Cel IS500rOOO
<br /> MEC EXPIMy O,lQ,m50.11 l!-lO , 000
<br /> ~ER${;N.'>'_~p[;v,'\.Iu,<)' ! ~.~., 000,000
<br /> 1 :;:"NfAA..o\"GRFf,pJE .2,000,000
<br /> , '"'R-jC\jcrs CvM'l:.;PA.:>G !'2,OOO,O.0~
<br /> ..--..-.---
<br /> ';CM;JI"'E[)5j~j:)U:I.I:V:11 S 1/000/000
<br />07/01/08 -:bttt(cl~~1
<br />,- -~ .~ .~ --.
<br /> 30J!lY!l;,;l"n r
<br /> :hrOO!ll:ill)
<br /> ,-- ---- -- ---.--
<br /> 13(1::11' ;l,~LRY
<br /> :Pl><llcClIonIJ I:
<br />:'""j
<br /> "I'(()I'TI::1'Jl;,I,I,V\CT
<br /> :F'l4I:l<;C(\I;JllI
<br />
<br />,~\\ict?,~i.iIJ..('[:l~tl'i-<l.l"JjILI' I
<br />J ~,." i\Il,5- iVii~-,~ _ ^ . GCC~Fo' I
<br />
<br />402267.
<br />
<br />L--
<br />
<br />",-?...~: -",'
<br />
<br />_"S ;-E~
<br />
<br />"'--
<br />
<br />18
<br />I
<br />
<br />j\'.rt';L;l.iB!U;:LW~)'_n'i
<br />m...,
<br />X '.~I
<br />
<br />"-1 ~
<br />1"",1_"-::-
<br />
<br />3853974
<br />
<br />07/01/07
<br />
<br />! ',~-'" '~!,''1!':',) ~ . '~;.<
<br />
<br />.--,,-------------
<br />I GAllAGiLlABLlTY
<br />
<br />. ,.. I
<br />
<br />~#i-i
<br />f...t .
<br />,<-",. ,- , :
<br />
<br />I:;N.,;;-,X.l:U<ri['lJCf:
<br />
<br />..~ !. O_O~ r_O~~O._
<br />_4 !. ~Oll., ~~O...
<br />
<br />: /l:W "'"..fI'~)
<br />
<br />~~I~~~.?~~.~, -,~!\ ACCID12~T _ 'f~'-'
<br />:')1>1511 'lW, !:~.~(,~.(_:..j',_"d_
<br />,\IJI(j')Nty ,,_
<br />
<br />[-~-~-'----
<br />I ' IOl(CE:8S/l)lllijRa~A \.!ABILifY
<br />A ;, X i.~ I ~,.u,,. \,IAIMSW\~~,
<br />i
<br />,
<br />
<br />I
<br />I
<br />I BE4803422
<br />
<br />07/01/07
<br />
<br />07/01/08
<br />
<br />'..J'.f.,.........,,;,L
<br />
<br />.x
<br />
<br />~lO,OOO
<br />
<br />~ :,-
<br />
<br />I"
<br />
<br />,V,:;..".!{E;R$ ::;GMi>eJZHIOi'i /\"Jr:,
<br />I EMPlOYER!!' l",81U1Y
<br />1 ~y' ~?~i>2E~-~,:!~_AR_::r:-::..~'::~t_Ull';:;;
<br />- .,... "
<br />
<br />L~ J TQ.F!;~IJ~~I~_L _LE~
<br />~. !:t.C~ .o,:;:C();:N'"
<br />
<br />, 1000000
<br />, 1000000
<br />$ 1000000
<br />
<br />,
<br />i Wc7578176
<br />I
<br />
<br />07/01/07
<br />
<br />07/01/08
<br />
<br />iF l DISfASf [Af~/P _~'(:=E
<br />
<br />I :'l.~- <.iIl'?~,~aJ'J.e'.
<br />OTHEP:
<br />
<br />~, D'SEASF.; .F'Qll;.:\' L;~iT
<br />
<br />i c I profes$ional :r.iab I H70616143 I 10/01/06 I 10/01/07
<br />I i Retro Date 9/1/85 I ! I
<br />I oeSCRlPTION OF OPERATIONS :fLOCATIONS fVSHIClES I EXCUJSIONS AOOEO 81' ENOORSEMENT I SPECIAL PRO"VlSlOml
<br />THE CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS, VOLUNTEERS AND
<br />I REPRESEN'XATIVES ARE NAMED AS ADDITIONAL INSUREDS WI~ RESPEC'!rS TO THE
<br />OPERATIONS PERFClWED IlY Oil ON IlEHALF OF THE NAMED lNUSlWl, THIS INSURANCE IS
<br />l?Rn1A..ii.Y AND NON COl'lTlUBUTORY WITH ANY OTHER INSURANCE CARRIED BY OR FOR THE
<br />BENEFIT O!'THE. ADDITIONAL INSUREDS, 1.0 DAY NON PAYMENT CANCELLATION APPLIES
<br />
<br />1,000,00-0
<br />2rOOO,DOO
<br />
<br />Ea Claim
<br />Aggregate
<br />
<br />CERTIFICATE HOLDER
<br />
<br />CANCElLATION
<br />
<br />I
<br />I
<br />I
<br />
<br />SHOULD A~ OF THE ABCNE DESCRIBED POliCIES BE CANCELLED BEFORE THE EXPIRATION
<br />
<br />SANTAAN
<br />
<br />MAt.. 30 DAVS WRITTEN
<br />
<br />DATE lHfflEOf, THE ISSUING INSUflER WLL
<br />
<br />CITY OF SANTA ANA
<br />PUBLIC WO!lJ{S AGENCY
<br />ROSS S'l!RE!.T ANNEX-M-22
<br />20 CIVIC ~ER PLAZA
<br />SJI-..NTA ANA c..~ 92701
<br />
<br />NDTICE TO THE CERTifICATE HOLDER NA\1ED TO THELEFT
<br />
<br />AllT~~RE~SENTATI"'E
<br />
<br />OACORD CORPORATION 1988
<br />
<br />ACORD 25 (2001/08)
<br />
<br />A - .JOOM) C:rI
<br />-01
<br />-Ol
<br />-oJ
<br />- 0 'I
<br />
<br />ff
<br />
<br />ff
<br />
<br />f,
<br />
<br />"
<br />
|