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<br />.. <br /> <br /> <br />~~ WW~_ p. L UL 1 <br /> <br />Date (mmfddfyy) <br /> <br />Producer <br /> <br />ChllriseMll'j <br /> <br />5/29/200 I <br /> <br />THIS CERTIFICATE IS ISSUED AS A MAl Tn~ OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THt. GI'RTlflCATE HOLDER. <br />THIS CERTIFICATE DOES NOT AMEND. tXTEND OR AlTER THE <br />COVERAGE AFFORDED BY THE POLICIES B~lO'N. <br /> <br />GarretVMosierfGriffithfSistrunk Ins. Services <br />12 Truman <br />Irvine CA 92620 <br />(949)559-6700 . <br />www.garrett-mosler.com <br />0B84519 <br /> <br />N'~007-()80 <br /> <br />INSUJ:ER Gemini Insurance Company <br />(CRC-Sterling West) <br />INSl"'. General Insurance Co (Salem) <br /> <br />Insur <br /> <br />INSU~Efl <br /> <br />Rick Hamm Construction Inc. <br /> <br />INSU~ ER <br /> <br />201 West Carleton Avenue <br />Orange <br /> <br />CA 92867 <br /> <br />rNSU~ER <br /> <br /> <br />THE OF INSURANC LISTED B lOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOV H 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 HEROIN IS SUBJECT TO ALL THE <br />TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDJCoD BY PAID CLAIMS. <br />POLICY POLICY <br />EffECTIVE EXPIRATION <br />D,\TE DATE: <br />) MMI 0 Y <br /> <br />NS. <br />LTR <br /> <br />TYPE Of INSURANCE <br /> <br />POLICY NUMBER <br /> <br />GENERAL LlABIUTY <br />A C~MERaAL GHERAl LIAR VCGP013929 <br />ClAIMS MADE 00CCUR <br /> <br />2/15(.'007 <br /> <br />2/15/2008 <br /> <br />B <br /> <br /> <br /> <br />lOC <br /> <br />24CC0329633 <br /> <br />2/15/:~007 <br /> <br />2/15/2008 <br /> <br />GARAGE LIABiliTY <br />ANY AUTO <br /> <br />EXCESS LIABILITY <br />OCCUR 0 ClAIMS MADE <br /> <br />Ai :~11..0 './B0 <br /> <br />DED.)CTlBLE <br />RETENTION S <br />WORKERS' COMPENSATION & <br />EMPlOYERS' liABILITY <br /> <br />.. ~' <br /> <br /><{fiLL -- . <br />c [",l <br /> <br />AS.:i15Wi1t Ci Y t\i;,T ';1. <br /> <br />DES RPTION OF OPERA110NS/LO ATI NSNEHICLE EXCLUSION ADDEO IlY ENDOFSEMEN IS CtAL PR VI IONS <br /> <br />LIMITS <br /> <br />EACH OCCURRENCE , <br />nRE DAMAGE (An . one fire S <br />MfOEXP' O~ ""'" s 5000 <br />PERSONAL,," ADV INJlIRY , 1 0000 <br />GENERAL AGGREGATE: , 00 <br />PROOUCTS-COMP/'JP AGG , 000 0 <br /> , <br />COMBINED SINGLE u....rr , 1 000 000 <br />BODilY INJURY <br />(Pe-rpersonJ , <br />BODILY INJURV <br />(Peraocldent) , <br />PROPERTY DAMAC [ <br />(Pffllcddenl) , <br />AUTO O~ V . fA ACClOfNT , <br />OTHER THAN EAAC , <br />AUTO CM.Y' AG , <br />fAD-! oCCURREN( E , <br />AGGREGATE: , <br /> , <br /> , <br /> , <br />STATUTORY UMll H <br />El EACH ACCIDENT , <br />El DISEASE. EA EMPlOYEE , <br />El DISEASE. PilleV LIMIT , <br /> <br />Cert holder is included as additional insured under general liability per attached endorsement lorm Vi001820304 but only <br />il required under written contract, subject to all policy terms and cc ndrtions. ' <br /> <br /> <br />City of Santa Ana <br />Community Development Agency <br />its officers, agents, employees & volunteers <br />Attn: Gaby Lomelli <br />PO Box 1988 M.25 <br />Santa Ana CA 92702 <br /> <br />SHOULD ANY OF THE AIlOYE DESCRIBED POLICIES BE CANCEUED BEFORE THE <br />EI(PIRATK)N DAlE THEREOF. THE ISSUING COMPANY Will ENDEAVOR 10 MAil <br />_ ~__~_DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE <br />lI:FT. BUT FAILURE TO MAtL SUCH NOllel S~iAl( tMPOSE NO OBUGATlON <br />OR lIABIlIlV OF ANY KIND UPON THE COMP."NY, ns AGENTS OR REPRE- <br />SENTATIVES. "10 Days for Non..paymerlt of Premium <br />AJTHORllID <br />RPRESENTATlVE <br /> <br /> <br />----0.,~----".. <br />. \- r'/_ <br />...... "< CLf-.J..- -- <br />'---- ~ <br /> <br />