|
Sent By:'ALLIED BROKERS;
<br />949 4531244; Jul -26 -07 9:26; rage c
<br />AC ORD DATE(MNVDD/YYYY)
<br />TM CERTIFICATE OF LIASI:LITY INSURANCE or129rs0 1
<br />PRODUCER Pryq,v, 9) 1''tb Fmi; WBA58 -Y2d+4
<br />ALLIED 9;tz St YEARCT 4`g4URANCE AGENCY
<br />T'NIg' CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br />10375 EARRANCA, PARKWAY, OC-102
<br />ONLY AND CONFERS NO RfQKTS UPON THE CERTIFICATE
<br />HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br />IRVINE CA 82618
<br />ALTER THE COWRA00 AFFORDED BY THE POLICIES BELOW.
<br />06101/07 08/01108
<br />I
<br />1 INSURERS AFFORDING COVERAGE NAIC O
<br />AD PI ATIV
<br />X COMMt:RCIAL GENERA(: LIABILITY
<br />INSURED ,;
<br />INSURER A: 138TDOR1 Casualty kR:Urente Company 29424
<br />, ........
<br />3 300,000
<br />INSURER a National liable E Fire IusuTanu CO. 20052
<br />Culbertson Atkins d Assoctates, Ino,
<br />Os ArpDnaup Stilts 220
<br />WSURER C. Houston Casuany Nsuranca Company. a23T4
<br />.........
<br />ANao Vle)o CA 928564109
<br />INSURER D:
<br />INSURER E:
<br />.c,
<br />THE P CIE3 OF IWAINANtC U LOW HAVE BEEN ISSUED TO THE INIMED NAMED FOR THE POLICY PERIOD INDICATED, NOTMtH3TANDING
<br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT Olt OTHER DOCOMENT Von {'RESPECT TO INHICH THIS CERTIFICATE MAY BE ISSUED OR
<br />MAY PERTAIN, THE INSURANCE APPORDED BY THE #OLIC*,5 DUCRM50 HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
<br />POLICIES. AGGREGATE. LIMITS SHoAN MAY HAVE BEEN REDUCED BY PAID CLAMS,
<br />N6R ioov
<br />LTR INaRG TYPE DP INELIIt4NLE :POLICY NDM6Bt. VOLMYaPn[ " ; PaIMYWRANdN LIMITS
<br />rALURE TO DO BO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE
<br />GENERALUABIUTY 72813AN11293
<br />06101/07 08/01108
<br />I
<br />N r
<br />AD PI ATIV
<br />X COMMt:RCIAL GENERA(: LIABILITY
<br />Attvnbon: TONIA 7.ERBA SENIOR ACCT ASST
<br />PAMACETD RENTED
<br />, ........
<br />3 300,000
<br />I ClAIM9MA0E f
<br />1 X, OCCUR
<br />MED. DIP (Any ass peniar)
<br />5 10;000
<br />i
<br />PERSONAL L AbV INJURY
<br />5 21000 900
<br />,
<br />OkNERAL AOOREOATE
<br />5 4,000 000
<br />GENLAGGREGAIY LMMT APPLIES PEtEI
<br />PRODUCT &COMPIOPAGG
<br />S 4,000,000
<br />POLICY Lea iLOG;
<br />'-_...
<br />..,,.
<br />AUTOMOBILE UASIUTY 72SUANTt293 08!01107
<br />08101/09
<br />CbMeINED SINGLE LMfT
<br />ANY AUTO
<br />(Ea ar44-0)
<br />S 2,000,000
<br />ALL OVAlEOAUTOS
<br />BODILY INJURY
<br />SCHEM"O AUTOS I
<br />(Per pww)
<br />3
<br />A
<br />I
<br />HIREb AUTOS
<br />..
<br />NON ONNSD µ1T06 � 1
<br />ix
<br />BODILY INJURY
<br />(par rxitlam)
<br />i
<br />$
<br />+
<br />P• mil MDAMAGE
<br />OARAOEUA61LITY
<br />r••.e,�T�Ji�L�.
<br />Y'
<br />-
<br />3
<br />ANY AUTO
<br />x
<br />I
<br />EA ACC 1I:NF
<br />AU700NLY- R
<br />'
<br />THAN
<br />AUTO ONLY:
<br />!OTHER
<br />AGG
<br />3
<br />t="Sl UMBRELLA LIABILITY
<br />-- -
<br />EACH OCCURRENCE
<br />i
<br />�J
<br />OCCUR uCUM9 MADE
<br />AGGREGATE
<br />f
<br />4111
<br />SDDtw h ly AIL
<br />I "Cy'
<br />3
<br />DEOUCTMLE
<br />......___._.....
<br />i
<br />RtTENTIDN', i
<br />-
<br />3
<br />�OAIKIIRSCOMF ENE ATXRI AND
<br />MPLOYERS LIABILITY
<br />0100013394081
<br />D8/3T /08
<br />09!31/07
<br />X
<br />E.L. EACH ACCIDENTS 1,000,000
<br />rwcaM6xsER'EYeJA1p�T
<br />El. DISEASE -EA EMPLOYEE .....li 1,000,000
<br />S IN, hC,1b, 1mMr
<br />5P[CUt PLaV�eltlNa Mto•
<br />IS OIaWe- POLICY LIMIT 3 1,000,000
<br />OTHER: PROPEIISIONAL:LIABOJTY. H711919290 .10!08109 10/09109 $2,000,000 PER OCCURRENCE
<br />C CLAIMS MADE FORM,. $2,000,000 GENERAL AGGREGATE
<br />.. 510,000 DEDUCTIBLE EACH CLAIM
<br />..
<br />DESCRIPTION OF OPERA ;IONSTLOCAT7GNWWRICLESIEXL"L UBIDNS'ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS
<br />'EXCEPT 10 DAYS FOR NON PAYMENT OFPREMiUM, CERTIF"TE HOLDER IS ADDITIONAL INSURED PER ATTACHED FORM, PRIMARY
<br />WORDING APPLtEB
<br />AZ 0 ca LcvvTTvv / cartBlram ■ 9UD5 ® ACORD CORPORATION 1809
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
<br />CITY OF SANTA ANA, PLANNING AND BUILDING AGENCY
<br />EXPIRATION DATE THEREOF THE ISSUING INSURER WU ENDEAVOR TO MALL SDI
<br />DAYS MITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT
<br />rALURE TO DO BO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE
<br />20 CIVIC CLFNTbR PLAZA
<br />INSURER, WE AGENTS OR REPRE A S.
<br />..''
<br />PO BOX 19" 14 -2 0 :..
<br />jell . .
<br />AD PI ATIV
<br />SANTA ANA CA 92762
<br />Attvnbon: TONIA 7.ERBA SENIOR ACCT ASST
<br />Allied B MIYeargl BI De Agency
<br />AZ 0 ca LcvvTTvv / cartBlram ■ 9UD5 ® ACORD CORPORATION 1809
<br />
|