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<br />From: Milis<:;a Gonzalez .At: Pacific Unified Insurance FaxID: 310-370.5454 To: Lynda Kelly
<br />
<br />Date: 7/1212007 D2:CO.oM Page: 20'5
<br />
<br />ACORD. CERTIFICATE OF LIABILITY INSURANCE C5R ~ r OJ~~;~;;;;;;;
<br />CONCO- 07112/0
<br />"'RODUCER THIS CERTIFICATE ISI55UED AS A MATTER OF IfIIFORMATIO/l
<br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />PACIFIC UNIFIED INSURANCE HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXiEND OR
<br />15901 Hawtborr.e Blvd. ste. 200 ALTER THE COVERAGE AFFORDED ~YTHE POLICIES BELOW.
<br />Lawndale CA 90260 --_._~-
<br />Phone:310-370.~000 Fax: 310-370-5454 INSURERS AFFORDING COVERAGE blJI.IC #
<br />l,..sURED n' .- ~- .- ~--_. ._-- ..
<br /> ~~RA:. :re~ral !!1sur~nce CODlp.~_. ~ --..
<br /> INSURER B Great ~l:"ican In~.~ COlllt>~~
<br /> .- ---. .-..
<br /> Conoorde Consulting, Ino. INSUReR c: Travelers Ins~ranc,!_. 10647
<br /> _.~--
<br /> 2221 Bosecrm~s A~e. Ste. 121 f-1~~~R 0
<br /> E1 Segundo CA 90 45 .--_.. ~---- .--.. ---.
<br /> INSURER E
<br /> ..,-'...-
<br />
<br />YI
<br />7
<br />
<br />COVERAGeS
<br />
<br />THE POLICIES OF INSURANCE LISTED e~lOW HAVE BEEN IssueD TO tHE INSURED NAME.D ABOVE FOR THE POL.IC"fPERIOD INDICATED. NOTWITHSTANDING
<br />At-fY REOUJREMENT, TERM OR CONDITION OF MY CONTRACT OR OTHER DOCUMENT WITH RE.SPECT TO WHICH THIS CE.RTlj:'ICATe MA~ Be ISSU~D OR
<br />~A,( PERTI4.IN T\-lE INSURANCE AFFOROED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL ruE Tt:RMS, EXCLUSIONS AND CONDITIONS OF SUCH
<br />POLICiES, AGGRIWATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />Ir~R ~~6-.--. ---,.. TYPE ;)F INSURANCE -----r-.---.. PO~Y NUMBER
<br />GSNERAL LIABll.ITY
<br />X . COMMERCIAlGENERAlllA8!L1TY ~ 35326109
<br />-l-l CLAIMS MAO(: J X I OCCUR
<br />X CQNPU'i"'ER SOFTWARE
<br />---------
<br />& SRVO E&O
<br />GrN'L AGGREG~TE LIMIT f,P~liF.S pe~.
<br />X I POLICY -- jr8i ~. Loe
<br />A'.ITOMOBILE LIABIUTI
<br />
<br />I W~.m,~'
<br />
<br />
<br />!.MitTS
<br />
<br />Alx
<br />
<br />03/01/07
<br />
<br />03/01/08
<br />
<br />EACli OCCURRENCE . $,JQ.9.9.!lQQ...
<br />IA\,:IE: IV Kl:1'II l:U
<br />PREMI$e$.(EaOCQUrencil} __tJOOOC!OQ.m_..
<br />MEO~PlAr1yone~rson) ~.lOOOO
<br />PERSQNAl & "'OV INJURY ; 1000 tl 00
<br />GEN-ERAl AGGREGATE -.-; .;;-2.0 00 () 00
<br />PRODUCTS --.CO-';ro-;;'AOOl$~ .00 Of; 00
<br />.. ----+-- .--.--..
<br />Emp Ben. 1000Q~___
<br />
<br />Ai
<br />
<br />35326109 03/01/07
<br />1,000,000 CLAIMS ~E03/01/07
<br />
<br />03/01/08
<br />03/01/08
<br />
<br />ANY Auro
<br />All OWNr,1 AUTOS
<br />SCHEDULED AUTOS
<br />X HIREOAUTOS
<br />X NON-{lWN~D AUTOS
<br />
<br />COMBINED SINGLE LIMIT
<br />(Eaiccidenl)
<br />
<br />i; J. ,OCC>,OOO
<br />
<br />BOUIL V INJURV
<br />jPer Pefson>
<br />
<br />A
<br />A
<br />
<br />73521011
<br />13521011
<br />
<br />03/01/07
<br />03/01/07
<br />
<br />03/01/08
<br />03/01/08
<br />
<br />80fJIlYINJlJRY
<br />(~raccid6ffl1
<br />
<br />PAOPERTV DAMAGE
<br />{Per8CC1dent!
<br />
<br />G l\RAGE LJASlllTY
<br />""-'----t-I ANY AUTO
<br />
<br />, !~EXCES5JUMBRl:LLA lIABILITY
<br />h r.]OCClJA .- Cl.ArMSMAOt:
<br />
<br />c -
<br />: DEOUCTIBI.E
<br />X RHENTION $ 0
<br />
<br />NOT APPLICABLE
<br />
<br />OTHER TH.I\N
<br />, AUTO ONLY.
<br />
<br />AUTOONl'l"-EAACCIOENr $
<br />EAACC $
<br />AGG ..
<br />
<br />; 79854681
<br />
<br />03/01/07
<br />
<br />03/01/08
<br />
<br />EACH OCCURRENCE
<br />AGClREGATE
<br />
<br />, ~ ,090, OOQ.
<br />'4. .000, OOQ.
<br />
<br />.
<br />
<br />,
<br />
<br />: WORKERS COMPENS.~TlON AND
<br />; EMI'LQ'l'EflS' UAB1UW
<br />B ,; AN\'P/~OPN/ETOR/PAFnNERlEX!:CUTIVE
<br />, QFFICI:i'llMEMOER EX::;lUDED?
<br />, ~~tl~1p~~V!S~ONS billow
<br />i OTHER
<br />Ai 3rd Party lridelity 35326109 03/01/07 03/01/08
<br />C : Excess Fid..lit 104104555 05/15/07 05/15/08
<br />aESCR/p .ION OF OPERATIONS I LOCAiJONSJ VEHJCLES 1 EXCLUSIONS ADDED BV ENDORSEMENT I SPI:CtAL PROvtSIONS
<br />ThQ City of Santa Ana, 20 Civio Center Plaza, Santa Ana, California 92701:
<br />Its officers, employees, agents and volunteers are named aa additional
<br />Insu]:eds (nadclitional insured.all) per attached Additiona1 Insured Endorsement
<br />form provided by 'I'he city of Santa Ana. Attached form also inoludes Primary
<br />and not contributing, and Separation of Insureds wording.
<br />
<br />CERTIFICATE HOLOER CANCELLATION
<br />
<br />WC5926018
<br />
<br />01/01/07
<br />
<br />01/01/08
<br />
<br />X'TORYlIMmi ft.
<br />E.L~~~HACCIDENT 1$ i J ooc}~.ooo
<br />-.- -------'----
<br />~,L. DISE.ASE - E:A~MP~?~tE. ~...:1. 10.00,000
<br />H DISEASE-POUCYLlMIT $l~,OOQ,oqL
<br />
<br />$10,000
<br />o
<br />
<br />$250,000
<br />3,750" 00l!__
<br />
<br />C-llll1<I:rA
<br />
<br />StiDUlO ANY OF TtiEABOVE DESCRIBED POUCIES BE CANCEll!;D DEFClRE TI~F. EXPlflA~110t
<br />DATElltEREOF, TH'e.LSSUINGINSURE.RWll..l.....-- 'JlJU.MAtI. 3..!!~._ DM't;WRIYUN
<br />NO'nCE TO THE CERTIFICATE HOLDER NAMED TO THE LE", ~~;ao:i1~O~Ml
<br />
<br />CITY ('F SlINT.1\. ANA
<br />INFOllMATION SERVICES M-12
<br />AT'l'N: LYNDA KELLY
<br />20 CrVIC CENTER APPR
<br />SANTA ANA CA 92701
<br />
<br />
<br />,1Jl.....\7~ .,,.. ....ft.tl"'.--n gRl -,. 'V''J'-.. 11111' "H_.' -'J: '.'lIUMir, FflS...&1if+f8oO!l:
<br />
<br />.
<br />
<br />ACORD 25(2001108)
<br />
<br />@ACORocoiToF;:ii,TION1981
<br />
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