Laserfiche WebLink
ACORD� CERTIFICATE OF LIABILITY INSURANCE <br />4/16/20 8 ' <br />PRODUCER (949) 852-0909 FAX: (949) 852-1131 <br />Milestone Risk Management & Insurance Agency <br />g y <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 />License No. OB72766 <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Santa Ana, CA 92701�� <br />8 Corporate Park, Ste 130 A-2008-085 <br />Irvine CA 92606 <br />INSURERS AFFORDING COVERAGE NAIC # <br />INSURED <br />INSURERA:AXIS Surplus Insurance <br />INSURER B: Hartford Casualty <br />Pacific Advanced Civil Engineering, Inc. <br />INSURER c: American Home Assurance <br />dba: PACE <br />INSURER D: Continental Casualty Co. 20443 <br />17520 Newhope Street, Suite 200 <br />INSURER E: <br />Fountain Valley CA 92708 <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING 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 REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />ADD'L <br />INSRD <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />DATE MM/DD <br />POLICY EXPIRATION <br />DATE(MMIDDIM <br />LIMITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE - $ 1,000,000 <br />PR PREM Ea occuence$ 50,000 <br />X COMMERCIAL GENERAL LIABILITY <br />MED EXP (Any oneperson) $ Excluded <br />ACLAIMS <br />MADE FX1 OCCUR <br />EAP70125507 <br />11/1/2007 <br />11/1/2008 <br />PERSONAL & ADV INJURY $ 1,000,000 <br />e�X�_;Ontractual Liab. <br />ap Up Excluded <br />GENERAL AGGREGATE $ 2,000,000 <br />GENT AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMP/OP AGG $ 1,000,000 <br />Total Aggregate $ 5,000,000 <br />POLICY X SCOT LOC <br />AUTOMOBILE <br />X <br />LIABILITY <br />ANY AUTO <br />COMBINED SINGLE LIMIT $ 1,000,000 <br />(Ea accident) <br />BODILY INJURY <br />(Per person) $ <br />B <br />ALL OWNED AUTOS <br />SCHEDULEDAUTOS <br />72UECTR2380 (CA) <br />72UECTR5063 (AZ) <br />11/16/2007 <br />11/16/2008 <br />BODILY INJURY $ <br />(Per accident) <br />X <br />X <br />HIRED AUTOS <br />NON -OWNED AUTOS <br />PROPERTYDAMAGE <br />(Peraccldent) $ <br />X <br />X <br />M <br />Comp. Ded. $ 500 <br />Coll. Ded. $1,000 <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT $ <br />OTHER THAN EAACC $ <br />ANY AUTO <br />AUTO ONLY: AGG $ <br />A <br />EXCESS/UMBRELLA LIABILITY <br />EACH OCCURR $ 10,000,000 <br />AGGREGATE $ 10,000,000 <br />X1 OCCUR F] CLAIMSMADE <br />EAU729588012007 <br />11/1/2007 <br />11/1/2008 <br />$ <br />HDEDUCTIBLE <br />$ <br />X RETENTION $10,000 <br />C <br />WORKERS COMPENSATION ANDX <br />EMPLOYERS' LIABILITY <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />3426866 (CA) <br />1/1/2008 <br />1/1/2009 <br />TH- <br />7WRY IMrU OER <br />E.L. EACH ACCIDENT $ 1,000,000 <br />E.L. DISEASE - EA EMPLOYEE$ 1,000,000 <br />OFFICER/MEMBEREXCLUDED? <br />3426867 (OTHER THAN CA) <br />1/1/2008 <br />1/1/2009 <br />If yes, describe under <br />SPECIAL PROVISIONS below <br />E.L. DISEASE -POLICY LIMIT $ 1,000,000 <br />D <br />OTHER Professional Liab. <br />AMA133328084 <br />11/1/2007 <br />11/1/2008 <br />Limit 5,000,000 <br />retro Date: 11/1/1995 <br />DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br />City of Santa Ana, its officers, employees, agents, volunteers and representatives are named as additional insureds <br />per CG 20 10 11 85, attached. Waiver of Subrogation applies where required by written contract. Waiver endorsement <br />forms SI 127, HA 99 16 12 99 & WC 04 03 06, attached. *10 days notice of cancellation for non-payment of premium. <br />CERTIFICATE HOLDER CANCELLATION <br />ACORD 25 (2001108)x' <br />INS025 (oios).oea j <br />l� <br />© ACORD CORPORATION 1988 <br />Page 1 of 2 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />City of Santa Ana <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL XeibX")0( MAIL <br />20 Civic Center Plaza <br />*30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, iIM <br />Santa Ana, CA 92701�� <br />AUTHORIZED REPRESENTATIVE <br />Catherine Sariana/CAS <br />ACORD 25 (2001108)x' <br />INS025 (oios).oea j <br />l� <br />© ACORD CORPORATION 1988 <br />Page 1 of 2 <br />