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Date. 11/12/2007 01:27 PM Sender's Fax ID.
<br />From At: Heffernan Insurance F~eID: Hefkrnan Insurance To: Paafic HoEpdality Group, Inc
<br />Page 2 of H
<br />Date: 11/12Q007 11:10 AM Page:2 of 8
<br />ACORD, CERTIFICATE OF LIABILITY INSURANCE OP ID Z OATE (MM!°pIYYYY)
<br /> PACI009 11/12/07
<br />~OOUCEH THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORPAATION
<br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />(PA) Heffernan Insurance Brkrs HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br />1806A Embarcadero Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
<br />
<br />Palo Alto CA 94303 .
<br />Phone: 650-842-5200 Fax: 650-642-5201 - INSURERS AFFORDINU COYERAOE NAICN
<br />INSUgED
<br />Pacific Hospitality Group, LLC
<br />Im
<br />erial H
<br />t
<br />l G 'NS°NERA: CNA
<br />p
<br />o
<br />e
<br />roupp, LLC
<br />dba Docbletree Hotel Santa Ana INSUflER e; n~rL~n c„~,,,i„ L I,;,s,L,xr
<br />-- ~- -
<br />.- -
<br />Orange County Airport
<br />201 E
<br />t INSU RER C:
<br />- ~-
<br />as
<br />MacArthur Blvd.
<br />Santa Ana CA 92707 INSUREq D: _ -
<br /> INW REfl F.
<br />TIIE PJLILIES OF !NSURANCf LISTED BELOW RAVE BEEN ISSUED TO THE INSJRFJ NAMED gl'AVE FOR THE PCL~CV PE Ri001NJIGATE D. NOTWITHSTANDNG
<br />ANY REOUIREMCM, TERN Ofl CCNDIi ON CF ANV CONTRACT OR OTHER OOCUMEN$ W TH RESPECT TD VrIF11CH THIS CERTIFICATE MAYBE 155JEa OR
<br />MAY°ERTA N. TIL INSURANCE A-FOR0.J BY THE POLICIES^-SC ii BEO HERB IN SSUa ECT TO AJ_THE TERMS.E%CLOSIONS qNO CON JTIOIV$CF SUCH
<br />POLICI=S. AGGREGATE LIMT$ SHOWN $IAV Hg6E BEEN REDDCEJ BY PNJ CLAMS.
<br />L1R $q T•PE OF INSUNANCE POUCV NUNBEq PATE MAVDD'1'V) DATE IMM/DOrYY) LIMTS
<br />DENEPAL IIABLRY EACH OCCUR?ENCE $1, QQQ~QQQ
<br />A X I. (COMMERCIAL GtNo HrAL LABIUr 208339'5677 OS/Ol/D7 OS/Ol/OB aREMSes lEeommmce)
<br />~ ~ - E100, D00
<br />-
<br /> J CLRMS MgUE I ~ OuLUB
<br />I
<br />MEO F%P lNy mre perem') - - -
<br />$S, QQQ
<br /> PERSONPL BAD'/IV.WY $1, OOO, DQO
<br /> GENERN AGGREGATE $2, DOD, 000
<br /> GENL AGGREGATE LIMIT AF VLIES PER:
<br />PRC~ PROOUCTS~COMF/OP AGG s2, DOD, DDD
<br /> X POLICY
<br />~ECr Lac
<br /> Alf$OLIOMLE LIABLRY
<br />
<br />A
<br />X ANYa1TO
<br />BOA2083392761
<br />DS/Dl/07
<br />' OS/Ol/DB COWBIN-0 SINGLE LIM T
<br />IEee°rlcenq
<br />51,000,000
<br /> ALL OWNED AUTOS
<br /> BOCILV NJURY
<br />$
<br /> SCHE>ULEU quT05 (Per prior)
<br /> X wHtu AJrOS
<br /> X NON-OWNED gU105 BOCILV INJURY
<br />(Px eccrtlB,ll'r E
<br /> -
<br /> X 1D00 -Coll Oedt -~ -
<br /> ' X 1DD0 - Com Dedt IP~acotlenp w°aGE $
<br /> OARAOELy61LRY AUTOONLY~EA ACCIDENT $
<br /> -~Al1YAUI0 OTHER THPN EAACC, $
<br /> AUTOONLY. PGG E
<br /> ~E%CE55'UMmiELLA LIABl1rY EACH OCCURRENCE
<br />- $SO, QQQ, QQQ
<br />B ~ Dccw ~ ] c1AIMS MADE AUC3798620-OS 05/01/07 OS/Ol/DB AGGREGnr E 10, 000, 000
<br /> $
<br /> JFIXIC I IfY. E
<br /> $ RETBlTION g Q $
<br /> WOgKERS COMFENSIITION AND
<br />
<br />ERiR0V915'LIABILRV TORT UM TS ER
<br /> 4NY PgOPRIEIDR/PARTNEft'f%CCUTI'/'c
<br />~
<br />' EL BACH ALCI DENT $
<br /> OFY,LER
<br />MEM6ER 2%LLUOE p?
<br />l yes, tleseibu antler EL.OSEASE-EA fMPLOY[E $
<br /> SF-CIAL Pfl0U 510N5 pelow EL 05EA52-POLIf,V LIM,T $
<br />OTHEq
<br />~
<br />A Property Section RMP271013996 OS/D1/07 OS/O1/O8
<br />Blkt Bldg 32,227,993
<br />Blkt 8PP 4,092,215
<br />OESCgpIK1N OF OPEPATKIN6. LOCATIONS rVEHICLES / EXCW 6pN6 ADOEO fiY ENOOR6EMENi 16PEGAL PPOV6pN6
<br />Project: Event for the Santa Ana Police Department, 9/11/06. The City of
<br />Santa Ana its officers, employees, agents, volunteers and representatives
<br />are named as additional insured on General Liability policy per attached
<br />endorsement. Except 10 days notice for non-payment of premium.
<br />SANTAI9 SHOUIn ANY OF THE ABOVE OE5CgBED POLICE59E CANCELLm OEFOgETHE E%PIgATION
<br /> DATE T1miE0i, iHE156LNOINSUfEq WLLENOEAVCR TO MAL 3O* OAY6 WRRTEH
<br /> NOfK:EIOTNE CERTp'K;ATE HOLDER NAMEDTO THE LEFT, BUT FALUBE l0 DO 60 SHALL
<br />City of Santa Ana MPoSE NOOBUOATgN OR LIAal1TY OF ANY KND UPON THE N6I.RFA, RS AOEME OR
<br />20 Civ1C Center Plata gEPN[6ENTATNE .
<br />Santa Ana, CA 92701 AUTMOq NTATNE
<br />,% _ ,
<br />~.,
<br />V AUUHU UUHPURATION 1986
<br />
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