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i~'C'n- =~L~ -c - ACORD„ CERTIFICATE OF LIABILITY INSURANCE ioiziiz'ooe PRDDDCER (775)831-1422 FAX: (775)831-7873 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Cal-Nevada Insurance Agency HOLDER. THIS CERTIFICATE DOES NO7 AMEND, EXTEND OR Suite 100 926 Incline Way ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. , PO Box 5419 Incline Village NV 89450 INSURERS AFFORDING COVERAGE NAIC# INSURED wsuRERa St Paul Fire & Marine Ins Abbey Group Consultants INSURER e. 923 Tahoe Blvd, Ste. 212 INSURER C. INSURER O II1Cllne Village NV 89451 INSURER E. THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED A80VE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING AN REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAV BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BV THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. A REGATE LIMITS H WN MAV HAVE BE RED ED BV PAID L I INSR ADO'L POLICY EFFELTNE POLICY E%PIRATION LIMITS TYPE OFINSURANCE POLICY NUMBER GATE MMIDD DATE MMIDD GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 P 6 300 000 X COMMERCIAL GENERAL LIABILITY occurten REMISES Ea , $ A X CLAIMS MADEOCCUR TT09402129 03/20/2008 03/20/2009 MED EXP An one rsan 8 5,000 PERSONALS ADV INIURV $ 1,000,000 GENERAL AGGREGATE 8 2r 000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG s Include POLICY X JECT LOC AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1, 000, DDO ANY AUTO (Ea accitleny A Au owNED AUros TT09402129 03/20/2008 03/20/2009 BoDILV INJURv SCHEDULED AUTOS (Per parson) $ X HIRED AUTOS - BODILY INJURY X NON-0WNED AUTOS ('~Y ' F (Per accitlenq $ , J QRM PROPERTY DAMAGE (Per accitlent) $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANV AUTO "°LGSr OTHER THAN EAA C :iy AIL .. , AUTO ONLY U r ~ ~/ AGG $ EXLESSIUMBRELLALIABILITY H R $ 2,000,000 X OCCUR CLAIMS MADE AGGREGATE $ 2, 000. ODD 8 A X DeoucneLE TT09402129 03/20/2006 03/20/2009 $ RETENTION WORKERS COMPENSATION AND X WC STATIU X DR EMPLOYERS' LIABILITY TORIPARTNEPoEXECUTIVE P P E.L. EACH ACCIDENT $ 1, 000, 000 A RIE ANV RO OFFlCER'MEMBER EXCLUDED? HN-OB-1763L41-7 03/20/2008 03/20/2009 E.L. DISEASE-E4 EMPLOYE 1, OO D, 000 H yes, Oescnbe untler SPECIAL PROVISIONS belw EL DISEASE-POLICY LIMIT 8 1,000,000 OTHER profession8l Liab. Par Occurrence 1, 000, DDD A ESYOI6 & Omissions TT09402129 03/20/2008 03/20/2009 Geveral Aggregate 1,000,000 Occurrence Porm DESCRIPTION OF OPERATIONSILOCATIONSNEHILLESIEXCLUSIONS ADDED BY ENOORSEMENTISPECIAL PROVISIONS 10 days notice of cancellation due to nonpayment of premium. The City of Santa Ana, it's officers, employees, agents, volunteers and representatives are aamed as additional insured A also this policy will also be Primary S Non- Coatributory in regards to work performed by the named insured. CFGTIFICATF M(ll OFR CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE The City of Santa Ana E%PIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 20 G1V1C Center Plaza 3O DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT Santa Ana, CA 92701 FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, RS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE (/ d C ik/DD T J erry arc ACORD 25 (2001108) INCn9S m.nu, ne. ©ACORD CORPORATION 1968