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~ACORD CERTIFICATE OF LIABILITY INSURANCE csR Nx DATE (MM/DD/YYYY) <br />MGTOF-1 10 04 07 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Earl Bacon Agency, Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />3131 Lonnbladh Road HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />P . O . Box 12039 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Tallahassee FL 32317 <br />Phone: 850-878-2121 Fax: 850-878-2128 INSURERS AFFORDING COVERAGE NAIC # <br />INSURED INSURER A: Valle FOr @ IIIS Co. 20443 <br />Public Resource Management INSURER B: Continental Casualt 20443 <br />Group a subsidiary of <br /> <br />MGT off' Amercia, Inc. INSURER C: American Cas.Co.of Reading PA 20443 <br />2123 Centre Point B1Vd. <br />Tallahassee FL 32308 INSURER D: Travelers Cas6Surety Co of Ame 25623 <br /> <br /> INSURER E: <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED A80VE 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 NSR TYPE OF INSURANCE POLICY NUMBER DATEYMM/DD/Yl' E PDATEY MMIDD Y ~N LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ $1 , OOO , OOO <br />A X X COMMERCIAL GENERAL LIABILITY 2093390918 O8/19/O7 O7/O1/.O8 PREMISES (Eaoccurence $$ 300,000 <br /> CLAIMS MADE ~ OCCUR MED EXP (Any one person) $ $ 5 , OO O <br /> Blanket Add'1 Iris PERSONAL&ADVINJURY $$1,000,000 <br /> Blkt Waiver Of $u GENERAL AGGREGATE $$2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPlOP AGG $ $2 , O O O , OO O <br /> }{ POLICY PRO LOC <br />JECT <br /> AUT OMOBILE LIABILITY <br />COMBINED SINGLE LIMIT <br />' <br />E <br />id <br />t $ 1 OOO OOO <br />~ i <br />( ANY AUTO 2093563501 O8/19/O7 O7/O1/Qe ( <br />a acc <br />en <br />) <br /> ALL OWNED AUTOS <br />BODILY INJURY <br /> $ <br /> SCHEDULED AUTOS Fob - (Per person) <br /> }i; HIRED AUTOS v~ <br />S 1 <br />~ <br />BODILY INJURY <br /> ~~11 <br />~~ <br />~ <br />(Per accid <br />nt) $ <br /> }{ NON-OWNED AUTOS ~ 0~ e <br /> ~ <br />/ <br /> a PROPERTY DAMAGE <br /> QZ <br />~ $ <br /> ei ey (Per accident) <br /> GA RAGE LIABILITY ~ <br />~`1tJ AUTO ONLY - EA ACCIDENT $ <br /> ANY AUTO `n~ t <br />PSS,S~f OTHER THAN EA ACC $ <br /> AUTO ONLY: AGG $ <br /> EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 4 , OOO , OOO <br />B OCCUR ~ CLAIMSMADE 2093563496 O8/19/O7 O7/O1/O8 AGGREGATE $ Q ~ QQQ ~ QQQ <br /> <br /> DEDUCTIBLE $ <br /> X RETENTION $ $rj ~ Q Q Q $ <br /> WORKERS COMPENSATION AND <br />EMPLOYE <br />' }{ TORY LIMITS ER <br />A RS <br />LIABILITY <br />ANY PROPRIETORlPARTNERlEXECUTIVE 2093390921 O8 19 <br />/ /Q7 <br />O7/O1/O8 <br />E.L. EACH ACCIDENT <br />$ 500000 <br /> OFFICER/MENiBER EXCLUDED? <br />tf <br />d <br />ib <br />d E.L. DISEASE - EA EMPLOYEE $ SOOOOO <br /> yes, <br />escr <br />e un <br />er <br />SPECIAL PROVISIONS below <br />E.L. DISEASE-POLICY LIMIT <br />$ SQQQQQ <br /> OTHER <br />B Workers Comp - CA 2098117826 08/19/07 07/01/08 Empl Liab $1,000,000 <br />D Prof Liab-Clm Made 104968324 08/19/07 07/01/08 Liab/A r $3,000,000 <br />DESCRIPTION OF OPERATIONS /LOCATIONS 1 VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT !SPECIAL PROVISIONS <br />*45 Days Written Notice of Canc-Nonrenewal. *10 Days Written Notice of Canc- <br />Nonpayment. RE: Cost Allocation Analysis / The City of Santa Ana, its <br />officers, employees, agents and representative are included as an additional <br />insured under the general liability. <br />GERTIFIGATE HOLDER CANCELLATION <br />The City of Santa Ana <br />Attn.: Toni Zerba <br />20 Civic Center Plaza, <br />Santa Ana CA 92701 <br />BAANSA3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOP <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3O DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />PBA IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />M_2 O REPRESENTATIVES. <br />HI.VKU Zb (LUUI/US) ©ACORD CORPORATION 1988 <br />