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<br />ACORD". CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYY)
<br /> 08/02/2007
<br />PRODUCER Serial # 101196 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br /> LEGENDS ENVIRONMENTAL INS.SVCS,LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br /> 2165 N GLASSELL STREET ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br /> ORANGE, CA 92865 AI-- ~OO 7 -DB&"
<br /> LICENSE #OC79875 INSURERS AFFORDING COVERAGE NAIC#
<br />INSURED INSURER A: AMERICAN SAFETY CASUALTY INSURANCE
<br /> AMX ENVIRONMENTAL EVOLlJTION, L TO. INSURER B: ARCH INSURANCE CO. AMERICAN
<br /> 2351 W. NORTHWEST HWY, SUITE 2118 INSURER C: REINSURANCE COMPANY OF AMERICA, INC.
<br /> DALLAS, TX 75220 INSURER D:
<br /> I INSURER 10:
<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 CONDlTION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR
<br /> MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICES 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 />rn ~~~ TYPE OF INSURANCE POLICY NUMBER Pg~!fl/~~5JW Pg~fl/~~"t'~\gN LIMITS
<br /> GENERAL LIABILITY EACH OCCURRENCE S 1,000,000
<br /> - ENVO 12998-07-02 4/1/07 4/1/08 ~~~~~l~E~EJmgnce 50,000
<br />A X COMMERCIAL GENERAL LIABILITY S
<br /> ":";"1 CLAIMS MADE [K] OCCUR MED EXP (AnV one ~erson) S 5,000
<br /> X LEAD/ASB/MOLD PERSONAl & ADV INJURY S 1,000,000
<br /> .2l POLLUTION GENERAL AGGREGATE S 1,000,000
<br /> GEN'L AGG~n LIMIT APn, PER: PRODUCTS. COMPIOP AGG $ 1.000,000
<br /> h POLICY ~~p.;: LOC
<br /> ~OMOBlLE LIABILITY FBCAT0045204 -ARCH 8/13/07 8/13/08 COMBINED SINGLE LIMIT $ 1,000,000
<br />B ANY AUTO (Ea accidenl)
<br /> -
<br /> ALL OWNED AUTOS BODILY INJURY
<br /> X BAP4506909- AMERICAN 8/13/07 8/13/08 (Per po,,;on) S
<br /> SCHEDULED AUTOS
<br /> ~ TEXAS AUTOS
<br /> X HIRED AUTOS BODILY INJURY
<br /> X S
<br /> NON.OWNED AUTOS (Per acQdenl)
<br /> - PHYSICAL DAMAGE
<br /> X PROPERTY DAMAGE'
<br /> X COMP/COLl DEDS $1000 (Per aCl:idenl) S
<br /> RGE LIABILITY AUTO ONLY. EA ACCIDENT S
<br /> ANY AUTO OTHER THAN . EA ACC S
<br /> AUTO ONLY: AGG S
<br /> ffi~SSlUMBRELLA LIABILITY ENU012996-07-02 4/1/07 4/1/08 EACH OCCURRENCE S 9,000,000
<br />A X OCCUR 0 CLAIMS MADE AGGREGATE S 9,000,000
<br /> s
<br /> R DEDUCTIBLE $
<br /> RETENTION $ $
<br /> WORKER'S COMPENSATION AND WC 31504110101 11/1106 11/1/07 X h~~iUt!fs I RTH.
<br /> ER
<br />C EMPLOYERS' LIABILITY 1,000,000
<br /> ANY PROPRIETORlPARTNERlEXECUTIVE EL EACH ACCIDENT $
<br /> OFFICERlMEMBER EXCLUDED? EL DISEASE. EA EMPLOYEE S 1,000,000
<br /> ~~~Mr~~~v~~O~s below EL DISEASE. POLICY LIMIT S 1,000,000
<br />A ~SlROBIOLOGICAL ENV012998-07 -02 4/1/07 4/1/08 RETRO DATE 415/04
<br /> DECONTAMINATION $1,000,000 AGG. LIMIT
<br /> LIMITED COVERAGE $1,000,000 EACH CLAIM
<br />QESCRIPTION OF OPERATlDNSlLOCATlDNSlVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
<br />THE CITY OF SANTA ANA ,CALIFORNIA ,ITS OFFICERS, EMPLOYEES AND REPRESENTATIVES ARE NAMED AS ADDITIONAL
<br />INSURED ON THE GENERAL LIABILITY WITH RESPECTS TO WORK PERFORMED FOR THEM BY THE NAMED INSURED.
<br /> , '~ ,
<br /> i....... , f
<br /> 7lt~e~y /6
<br />CERTIFICATE HOLDER , - /
<br /> CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
<br /> CITY OF SANTA ANA, CALIFORNIA DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAll~DAYS WRITTEN
<br /> NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LE~E TO DO SO SHALL
<br /> 20 CIVIC CENTER PLAZA, M~29 IMPOSE NO OBLlGATIDN OR LIABILITY OF mvf1 UPON THE I URE ITS AGENTS OR
<br /> SANTA ANA, CA 92701 l'lEPRESENTATIVES. J . I
<br /> AUTHORIZED REPRESENTATIVE OF INOE7~:U~E IUltllll;'t,
<br /> I /J I}// 1"1' "
<br /> V "V
<br />
<br />ACORD 25 (2001/08)
<br />C:IFMPROICERTPROS.FP5
<br />
<br />@ACORDCORPORATION 1988
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