KOA CORPORATION (KATZ, OKITSU & ASSOCIATES)

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ate; 8/17/2007 Time: 11:59 AM To: Tonia Zerba @ 1714)9731461 1-51G-452--2193 Page: 002 DATE (III M CERTIFICATE OF LIABILITY INSURANCE 08/17/07 DIYY) Prsadena, THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION D &Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1es Ave Ste 540 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P11016 INSURERS AFFORDING COVERAGE INS RED INSURER A: Travelers Indemnity Co. of Connectic KOA Corporation INSURER B. Travelers Property Casualty Co of Am 1055 Corporate Center Dr #300 wsuRFR C. American Automobile Ins. Co. Monterey Park, CA 91754 INSURER D: ACE American Insurance Company INSURER E %, YCI[I1VC0 OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING T A AE POLICIES Y REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR AY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH PDLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LT TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE(MMIDDIYYI LIMITS A GENERAL LIABILITY 68020751_840 06115107 06/15/08 EACH OCCURRENCE $1 00O 000 FIRE DAMAGE (Any one fire) $1 00O 000 X COMMERCIAL GENERAL LIABILITY MED EXP (Any one person) $5 000 CLAIMS MADE FX_1 OCCUR PERSONAL & ADV INJURY $1 00O 000 GENERAL AGGREGATE s2,000,000 GENT AGGRFGATEI.IMITAPPLIFS PER. PRODUCTS-COMPIOPAGG s2,000,000 PRO- LOC POLICY 7 CT AUTOMOBILE LIABILITY BA20721_002 06/15/07 06/15/08 COMBINED SINGLE LIMIT $1,000,000 X ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ (Per person) SCHEDULED AU TOS BODILY INJURY $ X HIRED AUTOS X NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ — (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER IHAN EA ACC $ ANYAUTO $ AUTO ONLY: AGG EXCESS LIABILITY CUP6464YO33 106115/07 06/15/08 EACH OCCURRENCE $4 00O 000 AGGREGATE s4,000,000 X OCCUR C CLAIMS MADE $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND WZP80944693 09119106 09119/07 O X IWC ORY TIMTS ER F.L. EACH ACCIDENT $1 00O 000 EMPLOYERS. LIABILITY E.L. DISEASE -FA EMPLOYEE $1 00O 000 E.L. DISEASE -POLICY LIMIT $1 00O 000 OTHER Professional G23631684002 03/13/07 03/13108 $2,000,000 per claim Liability $2,000,000 annl aggr. D ESCRIPTION OF OPERATIONWLOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS APPROVED AS TO F e: Approved List for Environmental Services and Technical Studies MA73098 City of Santa Ana On -Call Planning Services City of Santa Ana, its officers, agents, volunteers and employees are named as additional insured as respects general liability for claims arising from the operations of the named BENJAM iN WOW i sured. hief Assistant Cit Actor SH OULD ANYOF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Santa Ana - Planning & Building Agency DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30_DAYS WRITTEN Ms. Tonia Zerba NOTICETOTHE CERTIFICATE H OLDER NAMED TOTHE LEFT, BUT FAILURE TO DOSOSHALL 20 Civic Center Plaza, M-20 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURERJTS AGENTS OR P.O. Box 1988 REPRESENTATIVES. Santa Ana, CA 92702 AUTHORIZED REPRESENT TIVE �iW cnan 2�s 17151711 _f i iic,2nfzodnuio7nao AAF (D ACORD CORPORATION 1988 )RM ley