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<br />CERTIFICATE OF LIABILITY INSURANCE ~l~/~~g'f"'l
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />
<br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INOICATED. NOlV'JlTHSTANDING ANY
<br />REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,
<br />THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.
<br />AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUrED BY PAID CLAIMS.
<br />INSR ADD'L
<br />
<br />,
<br />
<br />A - ,(dt7~ - 0<1- 7
<br />
<br />ACORD~
<br />
<br />PRODUCER (B18) 547-1975 FAX: (818) 242
<br />JOHN SARGEANT INSURANCE AGENCY
<br />750 FAIRMONT AVENUE, SUITE 100
<br />P. O. BOX 831
<br />GLENDALE
<br />
<br />5288
<br />
<br />INSURERS AFFORDING COVERAGE
<br />INSURERA,FIRST NAT'L. INS. CO/AMER
<br />INSURER B INDIAN HARBOR INS. CO.
<br />INSURERCAMERlCAN STATES INS. CO.
<br />
<br />CA
<br />
<br />91209-0831
<br />
<br />INSURED
<br />
<br />BARTEL-ASSOCIATES, LLC
<br />411 BOREL AVE STE 445
<br />
<br />INSURER 0:
<br />INSURER E
<br />
<br />SAN MATEO
<br />
<br />CA 94402
<br />
<br />TYPE. OF INSURANCE
<br />
<br />POLICY NUMBER
<br />
<br />P~14i~ri~~5g~~ ~~fJf~~~~N
<br />
<br />EAr.H Or.CURRENr.E
<br />~~~~~J9E~~t~h7r~ence
<br />MED EXP {An" ona oerson1
<br />PER~ONAl & ADV INJURY
<br />
<br />A
<br />
<br />~NERAL LIABILITY
<br />X COMMERCIAL GENERAL LIABILITY
<br />I CLAIMS MADE ~ OCCUR
<br />
<br />25CC12442930
<br />
<br />9/1/2008
<br />
<br />9/1/2009
<br />
<br />$
<br />$
<br />$
<br />$
<br />GENERAL AGGREGATE $
<br />PRODUCTC> - CaMP lOP Ar:..G $
<br />
<br />A
<br />
<br />-
<br />-
<br />~'lAGGRE~E LIMIT A~ES PER
<br />X I POLICY I I PfRi \ I LaC
<br />~TOMOBILE LIABILITY
<br />_ ANY AUTO
<br />_ ALL OVVNED AUTOS
<br />_ SCHEDULED AUTOS
<br />~ HIRED AUTOS
<br />~ NON-OVVNED AUTOS
<br />
<br />-
<br />
<br />PROPERTY DAMAGE
<br />(Peraccidentl
<br />
<br />COMBINED SINGLE LIMIT
<br />lEa accident)
<br />
<br />9/1/2009
<br />
<br />9/1/2008
<br />
<br />BODILY INJURY
<br />(Perpersonl
<br />
<br />25CC12442930
<br />
<br />BODlL Y INJURY
<br />(Per accident}
<br />
<br />~~GE LIABILITY
<br />---1 ANY AUTO
<br />
<br />~~ A.'; Tn f 01Zl\;1
<br />
<br />
<br />~-:, ~~3__
<br />
<br />AUTO ONLY EA ACCIDENT $
<br />OTHER THAN EAAr.C $
<br />AUTO ONLY AGG $
<br />
<br />....
<br />
<br />~ESSJUMBRELLA LIABILITY
<br />~ OCCUR 0 CLAIMS MADE
<br />
<br />I DEDUCTIBLE
<br />I RETENTION S
<br />C WORKERS COMPENSATlON AND
<br />EMPLOYERS' LIABILITY
<br />ANY PROPR1ETORlPARTNERlEXECUTlVE
<br />OFFICERJMEMBER EXCLUDED?
<br />tfyas, describe under
<br />SPECIAL PROVISIONS below
<br />B OTHER MISe. PROFESSIONAL
<br />LIABILITY
<br />
<br />AGGREGATE
<br />
<br />x I TVXi,$T~j,~, I
<br />
<br />E,L EACH ACCIDENT
<br />
<br />11/17/2007 11/17/2008
<br />
<br />E L DISEASE EA EMPLOYEE $
<br />E L. DISEASE - POLICY LIMIT $
<br />$l,OOO,OOO/PER CLAIM
<br />$2,OOO,OOO/ANN.AGGR.
<br />
<br />01WC14518320
<br />
<br />MPP001715204
<br />
<br />9/1/2008
<br />
<br />9/1/2009
<br />
<br />NAIC#
<br />
<br />LIMITS
<br />
<br />$
<br />$
<br />$
<br />$
<br />$
<br />IO,lb<-
<br />
<br />1,000,000
<br />1,000,000
<br />10,000
<br />1,000,000
<br />2,000,000
<br />2,000,000
<br />
<br />$
<br />
<br />1,000,000
<br />
<br />$
<br />
<br />$
<br />
<br />1,000,000
<br />1,000,000
<br />1,000,000
<br />
<br />DESCRIPTION OF OPERATlONSfLOCATlONSNEHICLESfEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
<br />CERTIFICATE HOLDER IS HEREBY NAMED AS ADDITIONAL INSURED ON POLICY #: 25CC12442930 AS RESPECTS OPERATIONS OF THE NAMED
<br />INSURED ONLY. SEE ATTACHED FORM #: CG202611BS.
<br />COVERAGE UNDER POLICY': 25CC12442930 IS PRIMARY & NON-CONTRIBUTORY ABOVE ANY OTHER INSURANCE THE CERTIFICATE
<br />HOLDER (S) MAY CARRY.
<br />10 DAY NOTICE FOR NONPAYMENT OF pREMIUM.
<br />
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELlED BEFORE THE
<br />City of Santa Ana EXPIRATION DATE THEREOF, THE ISSUING INSURER WlLL ENDEAVOR TO MAIL
<br />MTlT. :K.....:t......L~ \"e:.:o PMleWl- A,e6NPs-KIV& ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT
<br />P. O. Box 1988 )l.5y;z.! FAILURE TO DO SO SHALL IMPOSE NO OBLlGA TlON OR LIABILITY OF ANY KIND UPON THE
<br />Santa Ana, CA 92702
<br /> INSURER-ITS AGENTS OR REPRESENTATIVES.
<br /> AUTHORIZED REPRESENTATIVE V-=~--?" "'"
<br /> Joanne Sargean"t/0116 c;.;b-'=.-, _-L ,,~ ~_ r--
<br /> . .,
<br />
<br />CERTIFICATE HOLDER
<br />
<br />CANCELLA liON
<br />
<br />ACORD 25 (2001/08)
<br />INS025 (0108) DBa
<br />
<br />@ACORDCORPORATION1988
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