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p DATE(MM /DD /YYYY) <br />ACORD. CERTIFICATE OF LIABILITY INSURANCE 06/30/2009 <br />PRODUCER <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY <br />ADD Risk Services South, Inc. <br />AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />Atlanta GA office <br />CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE <br />3565 Piedmont Rd NE, Blgl, #700 <br />Atlanta GA 30305 USA <br />COVERAGE AFFORDED BY THE POLICIES BELOW. <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />FHoN- 866 283 -7122 FAX- 847 953 -5390 <br />INSURER suRERA: ACE American Insurance company <br />22667 <br />INSURED <br />Sapphire Technologies, LP <br />C <br />INSURER B: Travelers Property Cas Co of America <br />25674 <br />60 Harvard Mill Square <br />Wakefield MA 01880 USA <br />,e <br />INSURERC: Charter oak Fire Ins CO <br />25615 <br />INSURER D: The Travelers Indemnity Co. <br />25658 <br />d <br />9 <br />INSURER E: <br />° <br />5 <br />COVERAIGES <br />HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />THE POLICIES OF INSURANCE LISTED BELOW <br />OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY HE ISSUED OR MAY <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT <br />POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. <br />PERTAIN, THE INSURANCE AFFORDED BY THE <br />AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS- LIMITS SHOWN ARE AS REQUESTED <br />INSR <br />U <br />TYpE OF INSURANCE <br />POLICY NUMBER <br />POLICY <br />POLICY EXPIRATION <br />DATE(MNRDIXVY) <br />LIMIT'S <br />L'IR <br />S <br />DATE(MMWDWY) <br />HDOG24876470 <br />01/01/09 <br />01/01/10 <br />EACH OCCURRENCE <br />$2,000,000 <br />A <br />ENERAI, LIABILITY <br />DAMAGE TO RENTED <br />$100,000 <br />AL <br />X COMMERCIAL GENER. LIABILITY <br />PREMISES (Ea ..I <br />CLAIMSMADE ® OCCUR <br />Yore �n <br />, <br />PERSONAL &ADVINJURY <br />$2,000,000 <br />ri <br />rn <br />GENERAL AGGREGATE <br />54,000,000 <br />ry <br />GENT AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS- COMP/OP AM <br />$4,000,000 <br />m <br />O <br />POLICY PRO LOC <br />MCT <br />B <br />AUTOMOBILE <br />LIABILITY <br />TJBAP10OD6518TIL08 <br />05/01/08 <br />10/01/09 <br />COMBINED SINGLE LIMIT <br />° <br />accHmt) <br />$1,000,000 <br />d <br />UTOS <br />BODILY w1URY <br />AUTOS <br />BODILY INJURY <br />LNON <br />AUTOS <br />PROPERTY DAMAGE <br />fln —d O <br />AUTO ONLY - EA ACCIDENT <br />GARAGE LIABILITY <br />OTHER THAN EA ACC <br />ANY AUTO <br />AUTOONLY: <br />8 <br />AGO <br />EXCESS NMB"LLA LIABILITY <br />EACH OCCURRENCE <br />AGGREGATE <br />❑ OCCUR ❑ CLAIMS MADE <br />DEDUCTIBLE. <br />RETENTION <br />c <br />TC 3UB D <br />X <br />WC STAID- <br />OTH- <br />B <br />WORKERS COMPENSATION AND <br />TRIUB101DZ967 <br />05/01/09 <br />10/01/09 <br />$1,000,000 <br />EMPLOYERS LIABILITY <br />Tc2HU8101D2943 <br />05/01/09 <br />10/01/09 <br />HL EACH ACCIDENT <br />E.L. DISEASE -EA EMPLOYEE <br />511000,000 <br />p <br />ANY PROPRIETOR /PAR1'NEA /EXECUTIVE <br />TC2JU810102931 <br />05/01/09 <br />10/01/09 <br />B <br />OEFICF WMEMBER EXCLUDED? <br />E.L. DISEASE - POLICY LIMB <br />51,000,000 <br />ICyes, deer Hander SPECIAL PROVISIONS <br />Mbw <br />OTHER <br />DFSCRU`TION OF OPFRATIONSA ,OCATIONSNEHICLESIEXCLUS IONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br />CA 92701, ITS OFFICERS, EMPLOYEES, AGENTS, VOLUNTEERS AND <br />THE CITY OF SANTA ANA, 20 CIVIC CENTER PLAZA SANTA ANA, <br />INSUREDS WITH REGARDS 1-0 LIABILITY A DEFENSE OF SUITS ARISING FROM THE <br />- <br />REPRESENTATIVES ARE NAMED AS ADDITIONAL <br />BE <br />OR ON BEHALF OF THE NAMED INSURED PER ATTACHED CG2010 FORM. <br />OPERATIONS AND USES PERFORMED BV <br />CITY OF SANTA ANA <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />ATTN: LORI SMITH <br />DAIS THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL <br />30 DAYS WRITTEN NOTICE TO THE CEROPICA'TE HOLDER NAMED TO THE LEFT, <br />1439 5. BROADWAY <br />BUT FAILURE i0 DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY <br />SANTA ANA CA 92707 USA ROVED AS TO FORM <br />)' <br />OF ANY KIND UPON THE INSURER ITSAGENTSORREPRESENTATIVE& <br />—' <br />AUTHORIZED REPRESENTATIVE <br />A nnUn lVYDD(TO ATr/TN I OR <br />srnRnTC!'flWlroa) 'Teresa udd <br />'4 - ';Z p j)g r b U Deputy City Attorney <br />