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Dec 10 2007 1:04PM • <br />71415-1464 P,1 <br />ACORD711 CERTIFICATE <br />OF LIABILITY INSURANCE <br />=.AT11WjDDffYYY) <br />PRODUCER 5 <br />1pollo General Ins. Agency, In <br />2165 N. GlasaalI Street <br />Orange, CA 92865 /j 00 /013 <br />714-685-1421 �^* <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 POLICES BELOW. <br />INSURERS AFFORDING COVERAGE NAIC# <br />INSURED R. V. Thomas Inc. dba <br />West Coast Land Clearing, <br />P. O. Box 90116 <br />Long Beach, CA 90809-0121 <br />r. �).1 <br />WEST02 <br />INSURERA: Interstate FGC Znaurance Co. <br />INSURERS: Ceat-KAt1oaal Insurance Co. <br />INSURER C: 1lirellans Fund Insurance Co. <br />INSURER D: State Coss ensation Ins. Fund <br />INSURER E: <br />TeFelYld-:7•Trl1-i <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <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 HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />UNA <br />POLE, NUMBER <br />POLICY EFFECTIVE <br />POLICY ►NATION <br />IILIITB <br />A <br />GENERAL LIASILRY <br />nAH1000075 <br />09/17/2007 <br />49/17/2008 <br />EACH OCCURRENCE 1 1000000 <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMSMADE ® OCCUR <br />DAMACIErCM <br />PREMISES a 0mance) 1 30.0000 <br />MEDEXP(Anvano ) / 5000 <br />PERSONAL& ADV INJURY 1 1000000 <br />X Demolition Program <br />GENERAL AGGREGATE 1 2000000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMP/OP AGG 1 2000000 <br />PCUCV F X PRO• LOC <br />B <br />ALITOMOSILELWBIUTY <br />Y <br />ANYAUTO <br />>?J1P164334 <br />09/17/2007 <br />09/17/2008 <br />COMBINED SINGLE UM IT <br />ME accident] ; 1000000 <br />BOOILYIN.lURY 1 <br />(Par perean) <br />ALL OW NED AUTOS <br />SCHEDULED AUTOS <br />A <br />X <br />HIRED AUTOS <br />NON-OWNEDAUTOS <br />BOOILYINJURY <br />(Peraccloeot) 0 <br />PROPERTY DAMAGE 0 <br />(Pafaccidettt) <br />GARAGE LIABILITY <br />AUTO ONLY -EA ACCIDENT 1 <br />OTHER THAN EA ACC { <br />ANY AUTO <br />, <br />AUTOONLY: AGO 0 <br />EXCESSIIMBRELLA LIABILITY <br />EACH OCCURRENCE f <br />AGGREGATE _ <br />OCCUR r7 CLAIMS MADE <br />4 <br />6 <br />DEDUCTIBLE <br />RETENTION <br />* <br />WORKERSCOMPENBATNONAND <br />1,077734 <br />10/27/2007 <br />02/01/2008 <br />X WCSTATU• OTH- <br />ORY UFA <br />EMPLOYERS'UANLITY <br />E L. EAC H ACCIDENT a 1000000 <br />ANY PROPRIETO"ARTNERIEXECUTIVE <br />E.L. DISEASE- EA EMPLOYEE 0 1000000 <br />OFFICERMIEMBER EXCLUOEDI <br />N Y"' dost' be uflder <br />E.L. DISEASE- POLICY LIMIT ♦ 1000000 <br />PECIAL PFOWSIONS below <br />C <br />OTHEn <br />Imcrv,01s3s6o <br />09/17/2007 <br />09/17/2008 <br />Eaah Item 500000 <br />Rented/Leased Squipme <br />Aggr 500000 <br />DESCRIPTION OFOPERATIONS / LOCATIONS / VGSCLES /EXCLUSIONS ADM BY ENDORBEMENT /SPECIAL PROVIBIONS <br />It is agreed The City o£ Santa Ana, Its Of£icars and Employees are named as Additional Insured as <br />respect& all operations of the named insured. Refer to Sudorsemant W/Primary attached. <br />CITY OF SANTA ANA <br />Public Works Dept. <br />20 CIVIC Center Plaza M-36 <br />P.O. Box 1988 <br />Santa Ana, CA 92702 <br />SHOULD ANY Of THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUNIEI INSUPUM WILL EMAIL 3 0 DAYS WWTTEN <br />NOTICE TO THE CERTRRCATE HOLDER NAMED TO THE LEFT, <br />ACORD26 (2001108) C ACORD CORPORATION 1988 <br />