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<br />. CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDNY) <br />ACDBQ... 10/29/2007 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> JOHN SARGEANT INSURANCE AGENCY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> P. O. BOX 831 ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW. <br /> GLENDALE CA 91209 INSURERS AFFORDING COVERAGE <br />____ (811!} 547-:~_~!~_.______________________.________ <br />INSURED ~URER A: Fi-FisT NAT'L. INSURANCE CO. OF AMERICA <br />BARTEL-ASSOCIATES, L.L.C. ~NSURER;- INDfA-ifFfARBOR INSURANCE COMPANY ______.h_"__ <br /> I~URER-Z AMERICAtfSTATES INSURANCE 'COMPANY <br /> ------ .----"..- -~_..__.__...- <br />411 BOREL A VENUE, SUITE #445 [INSURER 0: --'-" --.. <br />SAN MAT~O CA 94402 f';;ru~ER E: <br /> <br />COVERAGES <br /> <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOlWlTHSTANDING <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 HA.VE BEEN REDUCED BY PA.ID CLAIMS. <br />~;l-~PE OF IN-;;URANCE POLICY NUMBER ----- ! P~Y EFFECTIVE ! ~i!fJt~=~~N !-----.------------- UMITS ------------ <br />GENERAL UABILITV ! i EACH OCCURRENCE $ 1,000,000 <br />-- I ~--------.------ <br />X COMMERCIAL GENERAL UABILlTY I i FIRE DAMAGE (Anyone lire) $ n .__~9.!M!Q.Q_ <br /> <br />A =--= =:J CLAIMS MADE 00 OCCUR I 25CC124429-2 9/1/2007 9/1/2008 ~:s~:~?~~:~~:~~:r~:~~----1 ,O~~:~: <br />~ ----.-------..------- I r-GEM=-;~-..;GG;s;::;:e--_r;_----- 2,000,000 <br />~L AGGRE~!,~E LIMIT AP~S PER: II PRODUCTS: CO~F.''.9.P..~<3.~__j-.!-----.- 2,Q_~,Q.~ <br />IXIPOLlCYI 1.':& I ILQC I <br />AUTOMOBILE UA8ILlTY I COMBINED SINGLE LIMIT I $ 1 000 000 <br /> <br /> <br />25CC124429-2 9/1/2007 91112008 <br /> <br />~ NON_~W_NE~~~:~_____ _____ II. I '.:~~.;;;;,---j~--- <br /> <br />I I (Per accident) i <br />I I <br />! ' <br />! <br /> <br />GARAGE LIABILITY <br />f---"I <br />! ANY AUTO <br />il <br /> <br />AUTO ONLY - EA ACCIDENT ! $ <br /> <br />OTHER <br />B MISC. PROFESSIONAL <br />LIABILITY <br /> <br />MPP001715203 <br /> <br />9/1112007 <br /> <br />9/1/2008 <br /> <br />;.....-.--------t---- <br />II OTHER THAN -~~ ACC '1'_ $ <br />AUTO ONLY: AGG , $ <br /> <br /> <br />~~~=-t::_==__=~ <br /> <br />$ <br />$ <br />._!_h~tIfJNsJ.__J~~: ___.___________ <br />E.L EACH ACCIDENT $ 1,000,000 <br />! -- <br />~L DISEASE - EA EMPLOYEE $ 1,000,000 <br />I E.~:-DI~SE-:-~O;:ICY UMlT $ 1,000,000 <br />$l,OOO,OOO/CLAlM <br />$2,OOO,OOIANN.AGG. <br /> <br />---- <br /> <br />EXCESS UABlUTV <br />~ OCCUR [] CLAIMS MADE <br /> <br />HI---, DEDUCTIBLE <br /> <br />RETENTION $ <br /> <br />I WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br />C! <br /> <br />01WC145183-20 <br /> <br />11/1712007 <br /> <br />11/17/2008 <br /> <br />DESCRIPTION OF OPERATIONSlLOCA11ONSlVEHICLESJEXCLUSlONS ADDED BY ENOORSEMENT/SPEClAL PROVISIONS <br /> <br />See Supplemental Information Page(s) <br /> <br />1~f.d~7 <br /> <br />CERllFICATE HOLDER <br /> <br />I I ADDITIONAL INSURED; INSURER LETTER: <br />4 <br /> <br />P. O. BOX 1988 <br />SANTA ANA <br />I <br />ACORD 25-S (7197) <br />lM: LPW vl.9.S on 1115107 - 7:59 by UserName <br /> <br />CA 92702 <br /> <br />CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />IMPOSE NO OBUGATlON OR U~ILlTY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />REPRESENTATIVES. I J b <br />( AUT.IT~ORIZED REPRESENT~ j' <br />/l~~ ~~CY~ .:I' <br />/''-____.--J . () €l ACORD CORPORATION 1988 <br />LP: LP\rVvl-:9.S on 11/5/07 - 8:06 by UserName PF \/1.0.1 <br /> <br />//- <br /> <br />CITY OF SANTA ANA <br />ATTN: ROBERT CORTEZ <br /> <br />