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ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID Nx DATE(MMlDDmYY) <br />MGTOF-1 06 30 08 <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 <br />MGT of America <br />Inc INSURER A: Valle FOr a Ins Co. 20443 <br />, <br />. <br />and Public Resourse Management <br />INSURER B: Continental Casualt <br />20443 <br />Group a wholly owned subsidiar <br />Of MGT .INSURER C: American Cas.CO.of Reading PA 20443 <br />2123 Centre P01nt B1Vd. <br />Tallahassee FL 32308 INSURER D: Travelers Cas6svrety Co of Ame 25623 <br /> INSURER E: <br />~~vtrw~ta <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 /> <br />LTR <br />NSR <br />TYPE OF INSURANCE <br />POLICY NUMBER POLICY EFFECTIVE <br />DATE MM/DDlYY POLICY EXPIRATION <br />DATE MM/DD/YY <br />LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ $1 , OOO , OOO <br />A X X COMMERCIAL GENERAL LIABILITY 2093390918 07/01/08 07/01/09 PREMISES Eaoccurence $ $ 300,000 <br /> CLAIMS MADE ~ OCCUR MED EXP (Any one person) $ $ 5 , 000 <br /> Blanket Add' 1 Ins PERSONAL & ADV INJURY $ $1 <br />000 <br />000 <br /> Blkt Waiver Of Su GENERAL AGGREGATE , <br />, <br />$$2 <br />000 <br />000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG , <br />, <br />$ $2 ~ OOO , OO O <br /> X POLICY PRO LOC <br />JECT <br /> AUT OMOBILE LIABILITY <br /> <br />C <br />X <br />ANY AUTO <br />2093563501 <br />07/01/08 <br />07/01/09 COMBINED SINGLE LIMIT <br />(Ea accident) $ 1 QQQ Q Q Q <br />i i <br /> ALL OWNED AUTOS <br /> BODILY INJURY <br />$ <br /> SCHEDULED AUTOS (Per person) <br /> X HIRED AUTOS <br /> BODILY INJURY $ <br /> X NON-OWNED AUTOS (Per accident) <br /> <br /> PROPERTY DAMAGE $ <br /> (Per accident) <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ <br /> ANY AUTO <br />OTHER THAN EA ACC <br />$ <br /> AUTO ONLY: qGG $ <br /> EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $4, QQQ,OOO <br />B OCCUR ~ CLAIMSMADE 2093563496 07/01/08 07/01/09 AGGREGATE $ 4,000~QQQ <br /> <br /> DEDUCTIBLE $ <br /> X RETENTION $ 1 O ,QQQ $ <br /> WORKERS COMPENSATION AND <br />EMPLOYERS'LIABILITY X TORY LIMITS ER <br />A <br />ANY PROPRIETOR/PARTNER/EXECUTIVE 2093390921 07 <br />/ O 1/ O 8 <br />O 7/ O 1/ O 9 <br />E.L. EACH ACCIDENT <br />$ 5 0 0 0 Q Q <br /> OFFICER/MEMBER EXCLUDED? <br />If yes, describe under <br /> <br />E.L. DISEASE-EA EMPLOYEE <br /> <br />$500000 <br /> SPECIAL PROVISIONS below E. L. DISEASE-POLICY~LIMIT $ 500000 <br />OTHER <br />B Workers Comp - CA 2098117826 07/01/08 07/01/09 Empl Liab $1,000,000 <br />D Prof Liab-Clm Made 104968324 07/01/08 07/01/09 Liab/A r $3,000,000 <br />DESCRIPTION OF OPERATIONS 1 LOCATIONS ! VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS ~~ 'iTED ~ fi0 FdJ'~~l! <br />*45 <br />~~ <br />Days Written Notice of Canc-Nonrenewal. *10 Days Written Notice o <br />anc- '~ <br />Nonpayment. Certificate holder included as an additional insured u~er the - <br />l li <br />bi <br />~ ~ <br />genera <br />a <br />lity. / <br />BI~NJAVfI~ ~lUi;r4~AN <br />ief Assistant City Atiarney <br />CERTIFICATE HOLDER cenlcFl t e-rinni <br />The City of Santa Ana PBA <br />Attn.: Toni Zerba <br />20 Civic Center Plaza, M-20 <br />Santa Ana CA 92701 <br />SAANSA3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1 O DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />REPRESENTATIVES. <br />AUTHORI REP ES TAT E <br />"""'"' `" ~`"" ""°~ ©ACORD CORPORATION 1988 <br />