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ACORD CERTIFICATE OF LIABILITY INSURANCE OP IZS DATE(MMtDDNYYY) <br />F 01/16/08 <br />PRODUCER <br />AIM, Inc. <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />Almanor Insurance Services <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />PO Box 70517 <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Reno NV 89570 -0517 <br />DATE MM,DD/YY <br />LIMITS <br />Phone: 702 - 827 -1400 A - o?00 %- /3 y <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />INSURED <br />INSURER A: Hartford Insurance Group <br />California Property <br />Specialists, Inc <br />INSURER B: Hartford Fire Insurance Co <br />A <br />INSURER C: <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE D OCCUR <br />6-00 W. Santa Ana Blvd, Ste 115 <br />Santa Ana CA 92701 <br />INSURER D: <br />12/20/08 <br />INSURER E: <br />$1 000,000 <br />MED EXP (Any one person) <br />COVERAGES <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 />LTR <br />NSR <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />DATEY MMlDDIYV <br />DATE MM,DD/YY <br />LIMITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE <br />$1,0001000 <br />A <br />X <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE D OCCUR <br />53SBATQ5714 <br />12/20/07 <br />12/20/08 <br />PREMISESEaoccurence <br />$1 000,000 <br />MED EXP (Any one person) <br />$ 10,000 <br />PERSONAL & ADV INJURY <br />$1,000,000 <br />GENERALAGGREGATE <br />s2,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMP /OPAGG <br />$2,000,000 <br />POLICY PRO- LOC <br />JECT <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />$1,000,000 <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />BODILY INJURY <br />(Per person) <br />$ <br />A <br />A <br />X <br />X <br />HIRED AUTOS <br />NON -OWNED AUTOS <br />53SBATQ5714 <br />53SBAT05714 <br />12/20/07 <br />12/20/07 <br />12/20/08 <br />12/20/08 <br />BODILY INJURY <br />(Per accident) <br />$ <br />PROPERTY DAMAGE <br />(Per accident) <br />$ <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT <br />$ <br />OTHER THAN EAACC <br />AUTO ONLY: AGG <br />$ <br />ANYAUTO <br />$ <br />EXCESSIUMBRELLA LIABILITY <br />OCCUR EI CLAIMS MADE <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />_ <br />$ <br />$ <br />DEDUCTIBLE <br />$ <br />RETENTION $ <br />$ <br />B <br />WORKERS COMPENSATION AND <br />EMPLOYERS'LIABlLITY ANY PROPRIETORIPARTNER /EXECUTIVE <br />OFFICER/MEMSER EXCLUDED? <br />If yes, describe under <br />SPECIAL PROVISIONS below <br />53WECYGO516 <br />03/01/07 <br />03/01/08 <br />TORY LIMITS X ER <br />E.L. EACH ACCIDENT <br />s-1-10-0-0-1-000 <br />E.L. DISEASE - EA EMPLOYEE <br />$1,000,000 <br />E.L. DISEASE - POLICY LIMIT <br />$1 000,000 <br />OTHER <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENTI SPECIAL PROVISIONS <br />Certificate serves as proof of insurance for general liabilty and workers <br />compensation only. Certificate holder is named as Additional Insured per the <br />terms and conditions of General Liability policy. <br />Job: Bristol Street Widening <br />Terms, Conditions, Exclusions, and Limitations apply as per policy. <br />%,crc r rrll.A I c MULUrK CANCFI I ATInN <br />_vv u La Icvv rrvo/ © ACORD CORPORATION 1988 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />City of Santa Aria <br />Public Works Agency <br />Attn : Souri Amirani <br />20 Civic Center Plaza <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO TH LEFT, BUT FAILURE TO DO SO SHALL <br />IMPOSE NO OBLIG TIO B TY UPON THE INSUR ITS AGENTS OR <br />Santa Ana 10 92701 <br />REPRESENTAT <br />AUTHORIZED E <br />Bill in pester <br />_vv u La Icvv rrvo/ © ACORD CORPORATION 1988 <br />