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ACORD CERTIFICATE OF LIABILITY INSURANCE OP IDE <br />czLLz 1 <br />°ATE (MM OgYYM <br />os/a9/o7 <br />PRODUCER <br />G. S. Levine Insurance A - zoo&-sf-/2 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />r <br />Sevices, Inc. //�� <br />10505 Sorrento valley Rd. #200 JA'1.'Z�s ' Z� <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />TYPE.IMMUMANCE <br />POLICY M umm <br />San Diego CA 92121 <br />Phone: 858-481-8692 Fax: 858-481-7953 <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />INSURED ----------- ------ <br />INSURERA tnvt.n IM�.RT C..! ct. <br />25682 <br />INEURERB 4r...L... o. t' T.. a .. <br />19046 <br />EAtl1000A/IRe10E f 1,000,000 <br />Gillis a Associates <br />X CANBBiCNLGENERALUAILITY <br />Architect Inc. <br />INSURE"o <br />- <br />-- <br />1Bfe,o- <br />2900 Bristol St. Suite G205 <br />Costa Mesa CA 92626 <br />- -- <br />DauREn � <br />COVERAGES <br />THE POLIGESOP NEL,P WCE LISTED BELOW HAVE BEEN ISSUED TOTE ROVED W*D ABOVE FOR TIE POLICY PERIOD INOIGTED. WTWITH11TANONG <br />ANY R6GUMOCENT. TOW ORCOANnONOPMA'CONTRACT OR OTHER OOCUMSDO YATM R6PECTTOW CHTG CERTIROLTE WY BE WWWOR <br />WAYPERTASI TE ININAVO4LAPFOMPD BY THE POLICIES DESOESFO HEREIN 6 SL61ELT TO ALLTHE TSNA E ADIARIGNSAFD CONDITIONS OF SUCH <br />POUCIEL AGGREGATE LAIRS SNDVM MY 1MVE BEEN REDUCED By PAD CLAIMS, <br />ISSR <br />LTR <br />D'L <br />D <br />TYPE.IMMUMANCE <br />POLICY M umm <br />POLICY EFFECTNE <br />DATE IMMDDM') <br />POLICY EIIRMTDN <br />DATE UM OWM <br />U1tlA <br />REPRESENTATAN. <br />""MO REPRESENT <br />GENERAL UABL'TY <br />EAtl1000A/IRe10E f 1,000,000 <br />A <br />X CANBBiCNLGENERALUAILITY <br />6802841L495 <br />07/24/07 <br />07/24/08 <br />GAVAWTOREWED <br />FREM=SUE.oPa. f 300,000 <br />—1 QMN6NNOE I—XI OCCLM <br />NEDOPIAMGriS+W f 5,000 <br />PEReowLaAOvwnm f 1,000,000 <br />Owner/Cont Prot. <br />�X <br />DEPBNLAGGREGATE f 2,000,000 <br />GENL AGGREGATE UMT APPUB PER <br />PRODUCR. OONPAP AGO f 2,000,000 <br />FOL16Y X le.T UDC <br />A <br />AUTBMOML[ <br />UASLRY <br />MY 400 <br />6802841L495 <br />07/24/07 <br />07/24/08 <br />DOWNED SSWI E UwT <br />IE.. -A!" f 1,000,000 <br />BoaLYIwLIRv f <br />IM1 P.." <br />ALL OVAIEDA TOB <br />SCHEDUEDMROIS <br />BOQLY IMI R Y f <br />(M1.DtlSPq <br />X <br />X <br />HRPawras <br />NONOWNEDALMOS <br />_— <br />PROPERTY DMVGE <br />IM1.:OONrC S <br />CANTOS LNBILITY <br />I <br />MAO ONLY• EA ACCDIW f <br />H ANYMro <br />I <br />OTHER THAN <br />I <br />AUTO OILY. IGC f <br />EXCESSNMRELLA UABR.m <br />EACH0CCl:*VNCE f <br />• <br />oenn ❑ CLAN6 NNOE <br />AGliiIEWTE f <br />f <br />f <br />OE000f1AE <br />f <br />. <br />RETa+r1ON f <br />WOIIRISA CowENEATNTNAND <br />XTORrWC SfuMITa ATLL mw <br />e+ <br />B <br />EMPLOYER. LIABILITY <br />UB711OY241 <br />09/01/07 <br />09/01/08 <br />ELEAHACODEM f 1000000 <br />ANY PROWNETOR9MOIEgF7¢CVRVE <br />EL DISEASE•EA ENPLOYEE 31000000 <br />oPRc6Ws,EEREXDunEDT <br />ST-Omw6sOUN <br />SpEp„L p,py6lp,0 , <br />EL.(; & _POLICYUNST I f 1000000 <br />OTNeI <br />0 <br />DESCRPTI°N CFO"MTIONS ULOCAMM$IVUMLUIEXCLUSKMS ADDED BY WDORSEMEMTISPECIAL PROWDONS <br />Re: All Operations. ,^ ✓ 'jA\I/^ ij1� <br />Proof of Insurance `' ""— <br />*10 days notice of cancellation applies for non-payment of premium. =L <br />CERTIFICATE HOLDER CANCELLATION Y <br />CITYS•A— <br />SHOULD ANY OF nWMOVEDESCROED POLICIES EE CAMCELLED BEFORE THIS EVNADOM <br />Clerk of the City Council <br />DATE TNEAEDF. THE ISSUING INSURER WILL ENDEAVOR TO MAL 30* DAYs WRITTEN <br />City of Santa Ana <br />NOTICE TO THE CERMICATE MOLDER NAMED TO THE LEFT BUT FAILURE TO 0050 SMALL <br />20 Civic Center Plaza (M-30) <br />P.O. BOX 1985 <br />LITr or ANY UPON THE INSURER. IT <br />IMPOSE MO OBUOATDN OR UAeK S AGENTS OR <br />Santa Ana CA 92702-1988 <br />REPRESENTATAN. <br />""MO REPRESENT <br />ACORD 25 (2001/08) 0 ACORD CORPORATION 1988 <br />